Hay fever and allergies — treatment options
Reviewed by the My London Pharmacy clinical team, Zaynab Ali, Pharmacist Independent Prescriber
·29 July 2026
·7 min read
Quick answer
Hay fever is an allergic reaction to pollen that causes sneezing, a runny or blocked nose and itchy, watery eyes. Most people manage well with antihistamines and steroid nasal sprays. When symptoms persist despite these, a clinician can review your treatment and discuss stronger prescription options after a consultation.
What causes hay fever and allergies
Hay fever, known medically as allergic rhinitis, happens when the immune system reacts to normally harmless substances such as pollen. When these allergens meet the lining of the nose and eyes, the body releases histamine and other chemicals, which produce the familiar symptoms of sneezing, itching and congestion. The reaction is the body over-responding to something that poses no real threat.
Triggers vary through the year. Tree pollen tends to peak in spring, grass pollen in early summer, and weed pollen later in the season. Some people react to allergens present all year round, such as house dust mites, pet dander or mould, which can cause similar symptoms outside the pollen season. This is sometimes called perennial allergic rhinitis, and it can be just as disruptive as seasonal hay fever, even though it is not tied to a particular time of year.
Recognising the symptoms
Allergic rhinitis often affects the nose and eyes together. Typical symptoms include:
- Frequent sneezing and an itchy, runny or blocked nose
- Itchy, red or watery eyes
- An itchy throat, mouth or ears
- Loss of smell, headache or a feeling of pressure around the face
- Tiredness, particularly when symptoms disturb sleep
Unlike a cold, hay fever symptoms do not come with a fever and can persist for weeks while the trigger is present. Because the symptoms are driven by an allergic response rather than an infection, they will keep returning as long as you remain exposed to the allergen, which is why ongoing management often works better than treating each flare in isolation. For some people the impact goes beyond irritation, affecting concentration at work or school and the quality of their sleep.
Everyday steps to reduce exposure
Reducing contact with the trigger helps any medicine work better. On high pollen days it can help to keep windows closed, shower and change clothes after being outdoors, and avoid drying washing outside where pollen can collect. Wraparound sunglasses reduce pollen reaching the eyes, and a small amount of balm around the nostrils can trap some pollen before it is breathed in.
For year-round allergies, measures such as regular cleaning, using allergen-proof bedding and managing pet contact can reduce exposure to dust mites and dander. Checking the daily pollen forecast allows you to plan ahead and start treatment before symptoms build, which is often more effective than waiting until they are severe. None of these steps removes the trigger entirely, but together they can meaningfully lighten the load on any medicine you use.
Antihistamines: the usual first step
Antihistamines work by blocking the effect of histamine, and they are a common and sensible starting point for allergy symptoms. Non-drowsy options such as Fexofenadine and a Cetirizine 10mg tablet are widely used and can ease sneezing, itching, a runny nose and eye symptoms in a single daily dose.
They can be taken as a daily preventer right through the season or as needed on bad days, though for many people steady daily use through their trigger period gives more reliable control than dipping in and out. Because different antihistamines suit different people, it is worth reviewing your choice with a pharmacist or clinician if one does not seem to help — switching to another can make a real difference. Some older antihistamines cause drowsiness, so the newer, non-sedating types are usually preferred for daytime use, particularly if you drive or need to concentrate.
Steroid and combination nasal sprays
When a blocked, congested or inflamed nose is the main problem, a steroid nasal spray such as Avamys Nasal Spray or Beconase can reduce inflammation in the lining of the nose, and is often more effective than antihistamines alone for congestion. These work best when used regularly rather than occasionally, and can take several days to reach their full effect, so it is worth persevering and using them every day rather than judging them after a single dose.
For more persistent symptoms, a combination spray such as Dymista Nasal Spray, which pairs an antihistamine with a steroid in one device, may be considered. A clinician can advise whether a combination approach is appropriate for you and check your technique — aiming the spray slightly away from the central wall of the nose gives the best results and reduces the chance of irritation or nosebleeds.
Making your treatment work its best
A surprising amount of allergy control comes down to how and when treatments are used, rather than which one is chosen. Steroid nasal sprays, for instance, are often dismissed as ineffective when the real issue is technique or inconsistency: they need to be used every day through the season to build up their effect, and directed correctly rather than sniffed hard. Antihistamines similarly work best when started early and taken regularly during your trigger season, rather than only reached for once symptoms are already severe.
It also helps to match the treatment to your main symptom. A blocked, inflamed nose usually responds best to a regular steroid spray; itchy sneezing and eye symptoms to an antihistamine; and stubborn combined symptoms sometimes to both together, or to a combination product. If you have worked through these steps carefully and are still struggling, that is a clear signal to have your treatment reviewed rather than simply enduring the season.
Managing eye symptoms
Itchy, watery, streaming eyes are one of the most bothersome parts of hay fever for many people, and oral antihistamines do not always settle them completely. In that case, anti-allergy eye drops that act directly on the eyes can help reduce itching and redness. Options include Opticrom Sodium Cromoglycate Eye Drops, which are used regularly to help prevent symptoms building, and Optilast, an antihistamine drop that can ease symptoms more quickly when they flare.
Simple measures help too: avoiding rubbing the eyes, which only worsens the irritation, using a cool compress, and wearing wraparound sunglasses outdoors to keep pollen away. If eye symptoms are severe or persistent, or if the eyes become genuinely painful, very red, or your vision is affected, it is worth seeking advice promptly to check the cause, as not every red or sore eye is due to allergy.
Longer-term options for persistent allergies
For most people, antihistamines and nasal sprays used correctly keep symptoms manageable. When they are not enough despite good technique and regular use, a clinician can look at stronger or combined prescription treatments, check for other contributing factors such as sinus problems, and make sure any related asthma is well controlled. Sometimes a short review of exactly how and when you are using your treatments reveals a simple adjustment that makes a real difference.
For a smaller number of people with severe, persistent allergies that do not respond to usual measures, specialist treatments such as immunotherapy — a course that gradually reduces the immune system's over-reaction to a specific allergen — may be considered under specialist care. This is not a first step and is not suitable for everyone, but it helps to know that options exist beyond day-to-day symptom relief. A clinician can explain whether referral for this kind of assessment might be worthwhile in your situation.
When to speak to a clinician
It is worth seeking advice if your symptoms are not controlled despite regular antihistamines and a nasal spray used correctly, if they are interfering with sleep, work or study, or if you are unsure what is triggering them. A clinician can review your treatment, check your technique and discuss stronger prescription options where appropriate.
Anyone with asthma should take allergy symptoms seriously, as poorly controlled hay fever can make asthma harder to manage. Seek urgent help for any sudden swelling of the lips, face or throat, or difficulty breathing, as this may indicate a more serious allergic reaction that needs immediate attention.
Frequently asked questions
What is the difference between hay fever and a cold?
Hay fever is an allergic reaction that lasts as long as you are exposed to the trigger and usually causes itchy eyes without a fever. A cold is caused by a virus, tends to last around a week and may bring a temperature.
Should I take antihistamines before symptoms start?
Starting an antihistamine a week or two before your usual trigger season, or before a high pollen day, can help keep symptoms under control, as it is often easier to prevent them than to settle severe symptoms.
Can I use a nasal spray and antihistamine together?
Many people use a steroid nasal spray alongside an antihistamine, and this combined approach can be more effective for some. A pharmacist or clinician can confirm this suits you.
Why isn't my hay fever treatment working?
Symptoms may persist if a spray is not used regularly or correctly, if the chosen medicine does not suit you, or if there is another trigger involved. A clinician can review your treatment and discuss further options.
What can I use for itchy, watery eyes?
Oral antihistamines help, and anti-allergy eye drops that act directly on the eyes can ease itching and redness. Seek advice if the eyes become painful, very red or your vision is affected.
Can hay fever affect my asthma?
Yes. Allergic rhinitis can worsen asthma symptoms, so it is important to manage both. Speak to a clinician if your breathing feels affected during allergy season.