Pollen problems

UK pollen seasons

If pharmacy customers keep track of their hayfever symptoms during the spring and summer, they may be able to work out roughly which types of pollens they are allergic to. This may help them to prepare for the pollen season in advance each year, with self-help measures and treatments. 

According to the Met Office, hayfever seasons may start at different times depending on where people are in the UK. In Northern England, for example, the seasons tend to start later and finish earlier, as there is generally less pollen. Urban areas have lower pollen counts than the countryside, and inland locations have more pollen than around the coast. In general, tree, grass and weed pollen seasons usually follow these specific patterns: 

• March to May: Tree pollens, such as birch, alder, hazel and horse chestnut 
• May to July: Grass pollen  
• June to September: Weed pollen (such as dock and mugwort). 

The Pollen Services and Research Unit website has a more detailed pollen calendar, showing when the main allergenic plants are in flower (and when their pollen counts are highest). Examples include:  

• Alder: January to mid-April 
• Hazel: mid-January to mid-April 
• Plane: mid-March to late May 
• Oak: April to mid-June 
• Grass: May to early September 
• Rapeseed: late March to mid-July 
• Nettle: early May to late September 
• Mugwort: late June to early September. 

Pharmacy customers can check the pollen count in their local ahttps://www.metoffice.gov.uk/rea using pollen forecasts on the news or smartphone apps or by visiting the Met Office website (metoffice.gov.uk).  

Self-help advice

With many allergies, the symptoms improve (or disappear) if the trigger is avoided. This is much more difficult with hayfever, as pollen remains in the air throughout the spring and summer months. However, there are several things that pharmacy teams can recommend to limit pollen exposure. Allergy UK has a useful factsheet to download through its website (allergyuk.org). Useful tips to pass on to pharmacy customers include:

• Remove outdoor clothing and shower or wash hair after being outside when pollen levels are high
• Close windows at night
• Vacuum regularly, preferably with a high-efficiency particle arresting (hepa) filter
• Avoid keeping flowers in the house
• Avoid drying washing outdoors when the pollen count is high or when cutting grass
• Avoid walking in grassy, open spaces, especially during the early morning and early evening
• Apply petroleum jelly around the nostrils to trap or block pollen from entering the nose
• Install pollen filters in the car if these are not already fitted
• Drive with the windows closed
• Consider wearing wrap-around sunglasses to stop pollen getting into the eyes when outdoors
• Keep an eye on the weather forecast for information about pollen count levels and avoid going outdoors when the pollen count is medium or high.

Treatment options

Hayfever management involves using allergy medicines to ease symptoms. Jacquie Lee, Numark medication safety officer and information pharmacist, says that pharmacy teams should ask which symptoms customers are struggling with the most, to advise on which are the best products for them to use. “Pharmacy teams should keep in mind that for first-time sufferers, it can take several attempts to find the remedy that suits their symptoms,” she says. “Pharmacy staff should be able to help with questions around drowsiness of products, which products are best for which symptoms, drug-free options, and whether products can be used together. They should also ask customers how long they’ve been using a product before moving on to something different, as using antihistamines consistently allows them to work best.”

Antihistamines (capsules, tablets, liquids or nasal sprays) are particularly effective at easing a runny nose and sneezing but are less effective for nasal congestion. Non-drowsy antihistamines, such as acrivastine, cetirizine, fexofenadine and loratadine, are the recommended first-line option, rather than using sedating antihistamines, such as chlorphenamine. “Antihistamines are the mainstay treatments,” says Holly. “Non-sedating products are the preferable choices for school, work and driving, but many people just grab whatever they find in a supermarket or corner shop. Pharmacy advice is important, as sedating antihistamines can make them feel groggy and tired.”

Corticosteroid nasal sprays reduce inflammation directly in the nose. They need to be used daily to work properly and can be used throughout the whole hayfever season to prevent symptoms. Ideally, the sprays should be used from one or two weeks before customers think their hayfever will start, as they can take a few days to work. Corticosteroid nasal sprays can cause side effects, such as stinging or burning inside the nose, a dry, irritated throat, an unpleasant taste, or nosebleeds.

“Demonstrating how to use nasal sprays is important, whether these are on prescription or bought over the counter,” explains Holly. “Nasal sprays are often misused, which means the hayfever is being under-treated or over-treated. People may say these medicines aren’t working when they haven’t been using them properly. The nasal sprays will only achieve maximum benefit if people are being shown how to use them.”

Eye drops containing antihistamines or sodium cromoglicate may ease sore, itchy hayfever eyes. Allergy eye sprays or soothing eye masks may also help.

Some customers may prefer to try a drug-free approach. “Allergen barrier balms will trap pollens before they get into the nose,” says Holly. “Saline nasal sprays, washes and rinses are effective at cleaning and removing allergens from the nasal passages.”

If symptoms are affecting the customer’s quality of life, they should be referred to their GP to discuss stronger prescribed treatments or immunotherapy. This involves having small amounts of pollen (as an injection or tablet) to build up the body’s immunity to pollen. Patients usually need to start this treatment around three months before the hayfever season begins. Immunotherapy isn’t suitable for everyone and is a specialist treatment that may not be available everywhere in the UK. “If they have tried a combination of treatments – antihistamines, nasal sprays and eye drops – and they are still suffering, they may be referred for grass pollen immunotherapy,” says Holly. “Another red flag symptom is if both hayfever and asthma occur together. This needs proactive management from the GP. If hayfever isn’t being well managed, this can impact on the lower airways.”

The Fusion Allergy range is proven to be as effective as antihistamines at relieving allergic symptoms in the eyes (conjunctivitis), eyelids, and nose (rhinitis), claims manufacturer SCOPE Healthcare. Containing the naturally occuring molecule Ectoin®, the drug-free and preservative- free formula creates a protective barrier against allergens whilst moisturising the lining of the nose and reducing inflammation, adds the company.