Treatment of Allergic Rhinitis (Hay Fever)
Allergic rhinitis is an allergic response to allergens such as pollen, dust mites, or pet dander, causing sneezing, runny nose, nasal congestion, and itchy eyes. Seasonal (hay fever) and perennial types are the main categories.
Managing Allergic Rhinitis (Hay Fever) effectively requires a combination of medical treatment, lifestyle modification, and regular monitoring. With a structured management plan, most people with Allergic Rhinitis (Hay Fever) can maintain a good quality of life and prevent serious complications.
First-Line Treatment Principles
- ✓Emollient therapy: cornerstone for atopic eczema (apply at least twice daily)
- ✓Topical corticosteroids: lowest effective potency; limit facial/flexural use to mild-potency
- ✓Biologic therapy (dupilumab, tralokinumab): for moderate-severe atopic eczema inadequately controlled on topicals
- ✓Step-up psoriasis: topicals → phototherapy → systemic (methotrexate, biologics)
- ✓Allergen immunotherapy (AIT): for allergic rhinitis, bee/wasp venom allergy, selected food allergies
What to Do Now
- Learn your personal risk factors for Allergic Rhinitis (Hay Fever) (family history, age, lifestyle)
- Attend regular health check-ups and screening tests appropriate for your age and risk
- Track new or changing symptoms, especially those associated with Allergic Rhinitis (Hay Fever)
- Use our AI symptom checker to assess whether your symptoms fit an early Allergic Rhinitis (Hay Fever) pattern
- Discuss preventive strategies and early monitoring with your GP
- Build a personalised management plan with your GP or specialist
- Adhere consistently to prescribed medications — do not stop without medical advice
- Adopt a Allergic Rhinitis (Hay Fever)-appropriate diet (anti-inflammatory, low-glycaemic, or disease-specific)
Medications Used in Allergic Rhinitis (Hay Fever)
Cetirizine is an antihistamine that blocks H1 receptors to relieve allergy symptoms including sneezing, runny nose, itching, and hives.
Loratadine is an antihistamine that blocks H1 receptors to relieve allergy symptoms including sneezing, runny nose, itching, and hives.
Fexofenadine is an antihistamine that blocks H1 receptors to relieve allergy symptoms including sneezing, runny nose, itching, and hives.
Diphenhydramine is an antihistamine that blocks H1 receptors to relieve allergy symptoms including sneezing, runny nose, itching, and hives.
Chlorphenamine is an antihistamine that blocks H1 receptors to relieve allergy symptoms including sneezing, runny nose, itching, and hives.
Desloratadine is an antihistamine that blocks H1 receptors to relieve allergy symptoms including sneezing, runny nose, itching, and hives.
Bilastine is an antihistamine that blocks H1 receptors to relieve allergy symptoms including sneezing, runny nose, itching, and hives.
Levocetirizine is an antihistamine that blocks H1 receptors to relieve allergy symptoms including sneezing, runny nose, itching, and hives.
Non-Pharmacological Management
- •Trigger identification and avoidance: house dust mite, pet dander, nickel, fragrance, food allergens
- •Regular emollient use: repair skin barrier; reduce infection and flare frequency in eczema
- •Phototherapy (NB-UVB): second-line for psoriasis, eczema, and vitiligo
- •Wet wrapping technique for severe eczema flares
- •Adrenaline auto-injector training for anaphylaxis-risk patients; medical alert identification
- •Dietary management: strict gluten-free diet for coeliac/dermatitis herpetiformis
- •Sun protection: SPF 30+ broad-spectrum for all inflammatory skin conditions
Treatment Goals
Monitoring Parameters
- ◆EASI/SCORAD: eczema severity scoring at each visit
- ◆PASI (Psoriasis Area Severity Index): baseline and at 12 weeks for biologic response assessment
- ◆Blood pressure and lipid monitoring for acitretin/ciclosporin in psoriasis
- ◆LFTs, FBC: methotrexate shared care monitoring
- ◆Skin cancer surveillance: regular full-body skin checks, especially in immunosuppressed
- ◆Patch testing for contact dermatitis: done at specialist patch test clinic
Red Flags — When to Escalate
- ⚠Any of the characteristic symptoms of Allergic Rhinitis (Hay Fever) — even mild — in a high-risk individual
- ⚠Progressive worsening of early warning signs over weeks
- ⚠Laboratory abnormalities (e.g., blood sugar, inflammatory markers) without full symptoms
- ⚠Unexplained weight loss, night sweats, or fatigue persisting >2 weeks
- ⚠Strong family history of Allergic Rhinitis (Hay Fever) combined with new relevant symptoms
- ⚠Sudden worsening of Allergic Rhinitis (Hay Fever) symptoms despite established treatment
Escalation Criteria
- →Anaphylaxis: IM adrenaline immediately; call emergency services; antihistamine/hydrocortisone adjuncts
- →Erythrodermic psoriasis or pustular psoriasis: urgent hospitalisation; systemic immunosuppression
- →Eczema herpeticum: antiviral (acyclovir) urgently; consider hospitalisation
- →Inadequate response to topicals in psoriasis after 8–12 weeks → phototherapy or systemic referral
Special Populations
Clinical Insights
Compare With Similar Conditions
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