Dr Eduardo Di Cuffa – Thyme GP

As we step into March and enjoy the warmer, sunnier days, hay fever sufferers know that allergy season is just beginning! With tree pollen levels starting to rise, now is the time to get prepared.

1. Why Hay Fever Happens

Immune Overreaction: Your body mistakenly identifies pollen as harmful, triggering an immune response that releases histamine and other chemicals, causing familiar hay fever symptoms such as sneezing, congestion, and itchy eyes.

IgE Testing: IgE blood tests can identify specific allergens, helping you tailor your management plan. Skin prick tests are another option, though they may be less convenient for those with sensitive skin or multiple allergies.

2. Self-Care and Over-the-Counter Options

Everyday Habits to Reduce Pollen Exposure:

– Keep windows closed on high-pollen days.

– Shower and change clothes after spending time outside.

– Use air purifiers and avoid drying laundry outdoors.

Antihistamines: Medications like cetirizine, loratadine, and fexofenadine help block histamine and reduce symptoms.

Nasal Sprays: Steroid nasal sprays (e.g., Beconase, Pirinase) reduce inflammation and congestion when used daily.

3. Prescription Treatments and Specialist Care

If over-the-counter methods aren’t enough, your GP may recommend:

Stronger Medications: Higher-dose antihistamines, combination steroid-antihistamine nasal sprays, or additional treatments like montelukast.

Immunotherapy (Desensitisation): Gradual exposure to small amounts of allergens (via injection or under-the-tongue tablets) to build long-term tolerance.

4. The Role of Gut Health and Lifestyle

The Microbiome and Allergies: Research suggests a link between gut bacteria and immune regulation. A fibre-rich diet with fermented foods (e.g. yoghurt, kefir, sauerkraut) may help promote a healthier immune balance.

Managing Stress: Chronic stress can worsen allergy symptoms. Activities like mindfulness, exercise, and good sleep habits can support overall immune health.

5. Hay Fever Injections: Understanding the Risks and When It’s an Option

You may have heard of the “hay fever injection”, referring to triamcinolone acetonide (Kenalog)—a long-acting steroid injection that dampens the immune response to allergens. While some patients report relief lasting weeks or months, this is not a first-line treatment and should only be considered when other options have failed.

Why Kenalog Isn’t a Quick Fix

Kenalog affects the entire body, not just allergy symptoms, and carries cardio-metabolic risks that should be carefully considered. Potential side effects include:

– Increased risk of high blood pressure, fluid retention, insulin resistance, type 2 diabetes, and high cholesterol—factors that can increase the risk of heart disease.

– Greater susceptibility to infections (flu, shingles) due to immune suppression.

– Long-term risks with repeated use, including bone thinning (osteoporosis) and elevated blood sugar levels.

Unlike antihistamines or nasal sprays, Kenalog cannot be reversed once administered. The steroid is released slowly over weeks, so any side effects will persist until it naturally leaves the body.

When is Kenalog an Option?

Kenalog may be considered for severe hay fever only after other treatments have failed, including:

– Antihistamines (tablets or eye drops)

– Nasal steroid sprays (Beconase, Pirinase, etc.)

– Prescription options (stronger antihistamines, combination nasal sprays, montelukast)

– Immunotherapy (desensitisation treatment for long-term relief)

If these have not worked and hay fever is significantly impacting your quality of life, Kenalog may be an option only after a thorough consultation with a healthcare professional, with full awareness of the risks.

Key Takeaway

Kenalog is not a quick-fix hay fever cure. While it can help some patients, it should only be considered as a last resort after exploring all safer options. If you’re struggling with severe hay fever, book a consultation to discuss a personalised, long-term treatment plan.

Conclusion

Managing hay fever effectively means balancing preventive steps, medications, and lifestyle factors. While Kenalog remains an option for some, most patients achieve relief with safer treatments like antihistamines, nasal sprays, and immunotherapy. By taking a tailored approach—including gut health, stress management, and allergy testing—you can regain control and enjoy the outdoors again.

References (Selected)

1. Arrieta MC, et al. Sci Transl Med. 2015.

2. Abrahamsson TR, et al. Clin Exp Allergy. 2014.