Wellness & Injectables
Hayfever
Comprehensive hayfever management — from prevention tips and over-the-counter treatments to the Kenalog injection for severe symptoms. Nurse Clare provides informed consent-led care for clients whose quality of life is affected by allergic rhinitis.
What is hayfever?
Hay fever, also known as allergic rhinitis, has nothing to do with having a fever. It is actually an allergic reaction to airborne pollen. It can also be an allergy to dust or pet dander (fur etc.). It causes inflammation of the nasal passages and sinus areas.
What symptoms does hayfever cause?
Hayfever symptoms vary from person to person and can be mild in some people, right through to very severe in others.
Nasal symptoms
Sneezing, runny or stuffy nose, and itching.
Ocular (eye) symptoms
Itchy, red or watery eyes — or all three.
Throat symptoms
Itchiness or soreness of the throat.
Other symptoms
Coughing, headache, fatigue, and difficulty sleeping. Some people can also get skin reactions such as hives.
What can I do to prevent hayfever symptoms?
Avoidance
Limit your exposure to whatever it is you are allergic to. If it is pollen, try avoiding cutting the grass, stay indoors if possible when the pollen count is high, avoid gardening and flowers, and places like garden centres which are inevitably full of pollen.
Nasal rinsing
It is always a good idea to rinse out your nasal passages and sinuses. Not only will this help prevent pollen build up, but it will also reduce your chances of getting infections such as common colds. Saline nasal rinses such as Sterimar can be bought over the counter. Use twice per day in each nostril — tilt your head down and point the tip into your nose at a 45-degree angle, facing the septum.
Home environment
Use air purifiers to remove pollen from the air at home. Keep windows closed during high pollen peaks. Place Vaseline at the base of the nose — this catches pollen and traps it so it does not enter your nose and cause symptoms.
After being outdoors
When you return home, remove your clothes and put them in the washer, then have a shower — making sure you also wash your hair. This removes all the excess pollen which is on your skin. A shower before bed can also help you sleep much better and prevents pollen attaching to your pillow case. Do not dry your washing outside — pollen attaches to the clothes and then you and your loved ones wear them.
If prevention does not work — what medication can I use to treat my hayfever symptoms?
Antihistamines
Best started 2–3 weeks before your hayfever normally starts — that way you are already reducing your histamine levels which will prevent symptoms coming as severely when your hayfever actually starts. They help reduce itching, sneezing and runny nose. Available over the counter in tablet and liquid forms, including Loratadine, Cetirizine, Chlorphenamine and Fexofenadine.
Nasal corticosteroids
These target the nose specifically and work by reducing inflammation. This includes Fluticasone and Beconase (mometasone).
Leukotriene receptor antagonists
These are prescription drugs in the UK and work by blocking certain chemicals in the immune system which can make allergies worse. In the UK this is typically Montelukast.
Mast cell stabilisers
Prevent the release of histamine and other chemicals which can contribute to symptoms getting worse. Typically in eye drop form in the UK — Sodium Cromoglicate (Opticrom eye drops).
Immunotherapy
In the UK, your GP can refer you to a hospital immunologist who can start a course of allergy injections to gradually desensitise the immune system to allergens. This is usually for people with severe hayfever affecting their daily living and for whom other treatments are not effective. Risks include severe allergic reaction such as anaphylaxis, but these are reduced by treatment in a hospital setting with reversal drugs to hand.
Treatment
Kenalog injection
This is where we can help. Nurse Clare administers these injections in clinic.
Each Kenalog injection contains Triamcinolone acetonide 40mg/1ml. Triamcinolone acetonide belongs to a group of medicines called corticosteroids (steroids). The main effect of corticosteroids is to reduce the body's inflammatory and allergic response, and they are used very commonly for many serious medical conditions in the NHS and elsewhere. Their use has saved countless lives since they were discovered in the 1940s, but they do have significant risks.
Kenalog injections were given routinely to severe hayfever sufferers via the NHS until about 5–10 years ago but have now fallen out of favour. The NHS no longer prescribes or administers Kenalog for hayfever, as their guidelines have determined that the potential risks do not justify the benefits that people may gain from the treatment.
Kenalog continues to be routinely administered to patients in other countries around the world. A Kenalog injection does not cure hayfever — it temporarily suppresses the immune system enough to take away the symptoms in most people who need it.
The potential problems from Kenalog last for about 3 weeks after the injection but can be long term. Many people find the relief from symptoms commonly lasts the entire season. Some people need just 1 injection per season; the odd person may need 2 injections per season.
Nurse Clare provides full informed consent counselling before administering Kenalog, ensuring you understand all risks and benefits before making your decision.
Why do we give the Kenalog injection if it comes with higher risk?
Everything comes with risks. We believe that the decision to proceed with the Kenalog injection is not our decision — it is yours. An informed decision-making process gives the client all the information to make their own decision as to whether or not they are willing to accept the risks.
If hayfever is significantly impacting a client's quality of life with severe symptoms after trying the treatments above, sometimes quality of life is what is more important to the individual client — which is where this injection can help.
How to book
Struggling with severe hayfever that affects your quality of life? Book a consultation with Nurse Clare to discuss whether the Kenalog injection is right for you.