Asthma and hay fever
For people with asthma, the symptoms of hay fever can create complications.
Asthma and hay fever are closely linked, so managing hay fever and asthma is an important part of asthma care.
What is hay fever?
Hay fever is the common name for allergic rhinitis. It is an allergic reaction to allergens, or triggers, breathed in through the nose – this causes an immune response in the lining of the nose where the nasal passages become red, swollen and sensitive. Some people may experience hay fever at certain times of the year (e.g. spring or summer) or all year round.
Symptoms of hay fever
Common symptoms of hay fever are:
- Itchy, runny or blocked nose
- Itchy or watery eyes
- Always feeling like you have a head cold
- Blocked nose
- Throat clearing or coughing to clear the throat
- Mouth breathing
Other symptoms can include
- Disturbed sleep
- Daytime tiredness
- Poor concentration
- Recurrent headaches
- Frequent sore throats
- Hoarse voice
- Facial pain or pressure
- Reduced sense of smell
- Recurrent sinus infections in adults
- Increased risk of ear infections in children
You may only experience some of these symptoms, as you do not need to have all of the symptoms to have hay fever.
How can hay fever impact your asthma?
Managing hay fever is an important part of overall asthma care.
Asthma affects 2.5 million Australians. About 80% of people with asthma also have hay fever and between 15% to 30% of people with hay fever also have asthma .1
Hay fever can make asthma worse and more difficult to control
The reason that the presence of hay fever can make asthma more difficult to control is not entirely clear but it has been suggested that breathing through your mouth when your nose is blocked can further aggravate your asthma by bypassing the nose’s filtering and humidifying function or that there is a reflex effect of nasal inflammation which triggers lower airway narrowing.
People with asthma who have hay fever experience:
- More asthma flare-ups
- More visits to their GP and asthma-related hospitalisations
- More time off work or school
- Higher annual medical costs 2,3,4
It is important to treat and manage both your asthma and hay fever well!
Treatment options for hay fever
Treatment of hay fever depends on the severity and frequency of your hay fever symptoms.
There are a range of different treatments available:
Corticosteroid nasal sprays
These nasal sprays are the most effective treatment for persistent or moderate to severe hay fever symptoms. They work to reduce the swelling in the lining of your nose (just like your asthma preventer medications). They can reduce all symptoms of hay fever, particularly nasal congestion (blocked nose) but need to be taken regularly to work properly – they may take a few days to work.
Some corticosteroid nasal sprays are available over the counter at your pharmacy and others are available with a prescription. You should speak to your doctor or pharmacist about which nasal spray is best for you.
Tips for using nasal sprays:
1. Shake the bottle before each use.
2. Blow nose before spraying if blocked by mucus.
3. Tilt head slightly forward and gently insert nozzle into nostril.
4. Aim the nozzle slightly away from the middle of the nose in line with the roof of the mouth.
5. Press down the spray, but avoid sniffing hard during or after spraying.
Antihistamine tablets or spray
Antihistamines are the most common choice for people with mild or occasional hay fever. They help to relieve a runny nose, sneezing, itching and eye symptoms. They are less effective in treating a blocked nose.
Antihistamines are available over the counter at your pharmacy. You should avoid the types of antihistamines that can make you drowsy. Newer antihistamines known as non-sedating antihistamines are less likely to make you drowsy and are a common choice for people with milder or occasional symptoms of hay fever. Avoid using sedating anti-histamines in children.5
Saline solutions can be used to help clear nasal congestion, wash away dust, pollen and other irritants and as a result, have the potential to relieve hay fever symptoms. They should be used about 10 - 15 minutes before other medicated nasal sprays. Ask your pharmacist or doctor about preservative-free nasal salines or washes especially if you're using other medicated nasal sprays.
Decongestant nasal sprays or tablets are used to unblock the nose. They should not be taken for more than a few days at a time. If you still continue to experience symptoms you should speak to your doctor. Ask your pharmacist or doctor about using a preservative-free nasal decongestant spray and when and how long to use it for.
Tips for people with hay fever
If you have hay fever and asthma, treating your hay fever will help keep your asthma under control.
Manage your asthma and hay fever by:
- Knowing the symptoms of hay fever and asthma
- Having the right plan and medications in place to best handle your symptoms
- Checking you are using your asthma and hay fever medications correctly
- Monitoring your symptoms regularly with your healthcare professional
Before starting hay fever treatment tell your doctor or pharmacist if you have any other medical conditions, are pregnant, taking other medications, or experience nose bleeds
If you have hay fever and/or asthma you may be at risk of thunderstorm asthma. For more information about thunderstorm asthma click here.
Remember, if you cough, wheeze or sneeze, talk to your doctor or pharmacist to help manage your asthma and hay fever
For information and support about asthma call 1800 ASTHMA Helpline (1800 278 462)
Download asthma and hay fever resources
Asthma and hay fever - flyer 1 (PDF 418.3KB) and flyer 2 (PDF 395.5KB)
Asthma and hay fever - poster 1 (PDF 1.3MB) and poster 2 (PDF 324.5KB)
Asthma and hay fever infographic (PDF 2.8MB)
Asthma and allergic rhinitis (hay fever) – An information sheet for Pharmacy (PDF 2.7MB)
Asthma and allergic rhinitis (hay fever) – An information sheet for General Practice (PDF 2.6MB)
References and further information
Australian Institute of Health and Welfare. Allergic rhinitis (‘hay fever’) in Australia. Cat. no. ACM 23. Canberra: AIHW; 2011. Available from: http:// www.aihw.gov.au/publication-detail/?id=10737420595
Bousquet, J., Gaugris, S., Kocevar, V. S., Zhang, Q., Yin, D. D., Polos, P. G. and Bjermer, L. (2005), Increased risk of asthma attacks and emergency visits among asthma patients with allergic rhinitis: a subgroup analysis of the improving asthma control trial. Clinical & Experimental Allergy, 35: 723–727.doi:10.1111/j.1365-2222.2005.02251.x. http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2222.2005.02251.x/full
Pawankar R, Bunnag C, Chen Y, et al. Allergic rhinitis and its impact on asthma update (ARIA2008)–western and Asian-Pacific perspective. Asian Pac J Allergy Immunol. 2009; 27: 237-243. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20232579
Price D, Zhang Q, Kocevar VS, et al. Effect of a concomitant diagnosis of allergic rhinitis on asthma-related health care use by adults. Clin Exp Allergy. 2005; 35: 282-7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/15784104