Hay Fever

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Questions to Ask Your Doctor about Allergies
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Signs and Symptoms

Hay fever (allergic rhinitis) allergy symptoms are characterized by inflammation of the mucous membranes lining the nasal passages. Common allergy symptoms include sneezing, itchy eyes, ear congestion, rash, itching, and nasal symptoms that include postnasal drip; clear, thin nasal discharge; and nasal congestion.

When microscopic substances (called allergens) are inhaled into the nose and lungs, the immune system reacts to them as "invaders" and produces immunoglobulin E (IgE). IgE binds to cells in the body called mast cells, which release inflammatory chemical mediators (histamine and leukotrienes). These chemicals produce the well-known allergy signs and allergy symptoms—mucus secretion and itchiness—which are meant to protect the body by expelling the allergens and prevent them from entering the body by swelling the nasal lining.

People who have hay fever may experience not only an allergic reaction to specific allergens, but also may experience cross-reactivity (i.e., may experience irritant symptoms to substances that are not typically allergenic). This occurs when the proteins in the two substances are similar and the body's immunologic response is triggered. For example, a person allergic to birch pollen may experience allergy symptoms that include an itchy throat or watery eyes when peeling potatoes.

There are two main types of allergic rhinitis: seasonal (spring through fall) and perennial (all-year long). Seasonal allergic rhinitis often is caused by outdoor allergens (mold spores and pollen from trees, grasses, and weeds) and perennial allergic rhinitis is an allergic reaction to indoor allergens (dust mites, mold spores, and animal proteins like saliva and cat dander).

Pollen is produced by trees in the spring, grasses in summer, and weeds in the fall, marking the onset of seasonal allergies. For most allergy sufferers, hot, windy, and dry days result in the most severe allergic symptoms, as more allergens are carried through the air.

Cooler, damp days, when allergens are washed to the ground, provide a temporary allergy solution. For people who have mold-based allergies, symptoms often worsen after rainy days, when spores tend to multiply.

There are three main risk factors for allergic rhinitis:

• Family members with allergic rhinitis
• Repeated exposure to allergens
• A history of other allergic conditions (e.g., eczema, asthma, or allergies to cat dander or foods)

Without treatment, severe hay fever allergies can lead to sleeplessness and fatigue and can increase the risk for developing serious allergic conditions, such as non-allergic or allergic asthma. Asthma symptoms include difficulty breathing, tightness in the chest, wheezing, and coughing.

In most cases, allergy symptoms persist throughout life. Irritating substances in the air (e.g., smoke, air pollution, gas fumes, strong perfumes) may increase allergy symptoms. Women who are pregnant also may experience heightened allergic reactions. Over time, however, responses to some allergens may lessen in children and adults.

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