Hay fever: Nine tips for coping with pollen and seasonal allergens

From the most effective medications to the most common triggers to avoid, we examine science-backed advice that should reduce your seasonal suffering.

The Sun is shining, the flowers are blooming – and, if you're like millions of other people around the world, you may be a sniffling, hacking, runny-eyed mess.

Globally, some 400 million people suffer from allergic rhinitis: a condition that occurs when the nasal passages are irritated by airborne allergens, including pollen. When this occurs seasonally, it's called hay fever. In North America, it's known as seasonal allergies (partly because the symptoms can be caused by an allergy to a wide range of different types of pollen or other allergens).

Making matters worse, it seems that both the number of hay fever sufferers and the severity of symptoms are on the rise, thanks in no small part to the consequences of climate change. (Read more about how climate change is supercharging pollen and allergies.)

Luckily, you don't have to suffer in silence (if one punctuated by coughs and sneezes). In just the last few years, a number of treatments have become available to everyday hay fever sufferers that are more effective than ever before, while a wealth of research has fed into guidance about exactly how and when these treatments work best.

Here are nine tips for how to suffer less this allergy season – and when to head to your doctor.

At the first sniffle, many of us tend to reach for an oral antihistamine like Claritin or Benadryl. But these pills tend to be less effective than intranasal options, because they work differently: like all oral medications, they have to be digested and distributed throughout the body. This means that the amount that actually reaches the nasal tissue, where it's needed, is limited.

Nasal sprays, on the other hand, are applied right where they need to go. And, unlike oral versions, they target inflammatory pathways themselves, helping them to address nasal obstruction, sneezing, and other symptoms more comprehensively.

All of this is why nasal sprays are now usually the recommended first-line treatment for both children and adults.

Within nasal sprays, the most effective tend to be corticosteroids, followed by antihistamines. But the best option, developed in the last decade or so, packs a one-two punch: a combined corticosteroid-antihistamine spray – which has proven most effective of all, with no worse side effects.

Nasal sprays will often clear eye symptoms on their own. However, if itchy eyes persist, eyedrops with olopatadine can be helpful, says Stephen Durham, emeritus professor of allergy and respiratory medicine at Imperial College London and Royal Brompton Hospital in the UK.

Not all nasal sprays are the same – and while many of us turn to decongestant sprays for relief from a blocked nose, this can backfire.

Decongestant sprays (which use ingredients like oxymetazoline, phenylephrine or xylometazoline) work by constricting the blood vessels, shrinking nasal tissue so you can breathe better. But with prolonged use – generally speaking, more than five days – blood vessels can become dependent on this effect and, when the drug isn't applied, swell too much. That leads to even more congestion ("rebound congestion") and, often, the unsuspecting patient starts using even more. There is even a danger of long-term damage and dependence.

If you decide to take a pill, opt for a "second-generation" option like certirizine (Zyrtec), loratadine (Claritin) or fexofenadine (Allegra). These newer medications work better and have less of a sedative effect than first-generation options like diphenhydramine (Benadryl), chlorpheniramine or doxylamine.

While it can be tempting to take both an oral antihistamine and a nasal spray, it's usually "a waste of money", says Glenis Scadding, vice president of the non-profit Euforea, which focuses on research and education around allergies, and honorary consultant allergist and rhinologist at University College Hospital London in the UK. "Oral antihistamines make very little difference to a nasal corticosteroid," she says.

Don't wait until you feel symptoms to start using your nasal spray: starting a few weeks before the season begins has the best outcomes. In one trial, hay fever sufferers who started using intranasal corticosteroids four weeks before pollen season did better than those who started using the spray only on seeing symptoms, for example.

"When people say [these medications] are ineffective, it's usually for one of two reasons," says Durham. "Either they're not taking them properly, or they're not taking them regularly."

Use your treatment at the same time each day, whether or not you are experiencing symptoms. It's also important to follow dosing instructions: the trial of combined corticosteroid-antihistamine spray found the greatest symptom reduction in those who used it twice – rather than once – a day.

Even when we choose an effective nasal spray, many of us are applying it wrong. A common error is to jam the bottle as high up in our nose as it will go, tilt our heads back, spray, and then sniff – all of which directs the medicine towards the back of the throat. But it needs to be in the nose to work.

More like this:

• The habits that prevent allergies

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• Six myths (and truths) about hay fever

Instead, lift the nostril and insert the spray so that it is aimed toward the ear on the same side (you may find it easier to get the right angle using the opposite hand). It should only be about a quarter inch (6mm) inside. Then tilt your head forward slightly and spray. Try not to blow your nose after. This allows the medicine to go where it's most effective and stay there – rather than being cleared out immediately.

Many people put their heads back and try to drop the medicine right on top of their eye. This often backfires, with the liquid spilling out immediately (or not spreading across the eyes surface).

Instead, tilt your head to the side, then drop the medicine into the inner corner and blink, Scadding and Durham advise. This distributes it more evenly across the eye.

Beyond medications, be mindful about your exposure to potential allergens. Keeping windows closed – even, unfortunately, at night – can help, as can wearing sunglasses or a mask when you go outside. It's also important to wash well (ideally, taking a shower) when you come in from spending any time outside; otherwise, allergens like pollen cling to your hair and face, where they can not only continue to irritate you, but can transfer to your furniture and bedding, allergists say.

Many of us shrug off hay fever as just part of the springtime package. But this is unnecessary and, worse, can be harmful. Both short- and long-term, it affects our quality of life, respiratory system, sleep, and, in children, academic performance. "It gets dismissed frequently as, 'Oh, it's just a runny nose,'" says Barrie Cohen, a paediatric allergist in New Jersey, US and author of a 2023 review on allergic rhinitis in children. "But if you're suffering, even for three months out of the year, that's significant."

If you are managing your symptoms properly and still find that you're struggling, see your GP (family doctor). In some cases, it may not be hay fever at all, but asthma or another respiratory illness.

Even when it is hay fever, people might benefit from other treatments – such as allergen immunotherapy – that can help reduce even severe symptoms longer-term, so that they can finally enjoy the summer free of their usual suffering.

* Disclaimer: All content within this article is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional. The BBC is not responsible or liable for any diagnosis made by a user based on the content of this site. The BBC is not liable for the contents of any external internet sites listed, nor does it endorse any commercial product or service mentioned or advised on any of the sites. Always consult your own GP if you're in any way concerned about your health.

** Amanda Ruggeri is a journalist who explores the science, psychology and history of the ideas we take for granted. Her upcoming book on sleep will be published by BenBella in summer 2027. She is @mandyruggeri on Instagram, Threads and TikTok.

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