The hay fever season is fast approaching, indeed for some sensitive to the early spring tree pollens it is already here. Hay fever is caused by an allergic reaction to the tiny grains of pollen that float through the air at this time of the year. The highest pollen counts are usually during June and July typically reaching their peak during the "Wimbledon fortnight". When pollen settles in the nose/eyes/throat of someone who is sensitive it triggers the release of substances that make small blood vessels leaky, irritate the tissues and attract inflammatory cells. For this reason you might experience discomfort, itching, sneezing, a watery mucus from the nose and tears. This is bad luck really since these immune defences were designed to kill parasites and germs not to deal with pollen.

However, there are several things that may help. Firstly, the pollen count is highest during the evening and night. Therefore, if possible stay indoors during this time and keep doors and windows closed. Keep your bedroom window shut. If you must go out into the garden or grassy fields try to arrange this early in the morning or after a rain shower when the pollen count is reduced.

For those of you working in town, bear in mind that pollen is carried on the air to great heights so working in an office block with the windows open is not advisable. Do wear sunglasses to protect your eyes from sunlight when this irritates. The sunglasses will also help prevent pollen grain landing directly into your eyes triggering uncomfortable watering.

What can the doctor offer. Well, bear in mind that some effective remedies are available over the counter at the chemists. If you are caught unprepared you can buy some antihistamines although for long courses they may be more expensive compared to a prescription charge. Chlorpheniramine (Piriton) can be quite sedating so may be useful at night but beware of driving or using machinery if taking these. There is a range of newer, less-sedating antihistamines such as loratidine, cetirizine and astemizole that are more suitable for daytime use. Some of these interact with other drugs such as the antibiotic erythromycin in a dangerous way, so please check with your doctor or pharmacist whether they are safe for you to take.

You might also ask your doctor about using anti-inflammatory sprays for the nose. Beclomethasone aqueous is a steroid spray similar to some asthma inhalers. The dose of steroid that is used is tiny compared to taking steroids by mouth so don't be afraid of side effects. For them to be truly effective, however, it is important to start treatment early, preferably just before the hay fever really starts. In this way the immune cells that would react to pollen are suppressed before they have a chance to fill your nose with catarrh that stops effective treatment. If your hay fever starts in June consider starting beclomethasone in mid-late May. Do use the spray when your nose is not blocked up otherwise the spray does not have a chance to work. It may be best to use it first thing on waking before jumping out of bed, and before washing and irritating your nose.

You may have heard of injections for hay fever. There are two types. Firstly desensitising injections were popular some years ago. These involved a course of injections to reduce your sensitivity to pollen. The problem is taking the course of injections can be dangerous and patients have died from this so it is no longer recommended. The other type of injection is a long acting steroid that is given into a muscle and can last for a month or two. However, unlike the beclomethasone nasal spray this gives the body a large does of steroid and has the potential to cause problematical side-effects. We would not recommend its use.