Seasonal Allergies Treatment: Step-by-Step Hay Fever Relief in the UK

Seasonal allergies — known medically as allergic rhinitis — affect millions of people across the UK each year. They are most commonly triggered by tree, grass, and weed pollen, although other airborne allergens can play a role. If you are looking for practical guidance on how to treat seasonal allergies, this article walks through the key steps: reducing pollen exposure, choosing the right over-the-counter medicines, using nasal sprays correctly, and knowing when to seek further help.

Symptoms often include sneezing, a blocked or runny nose, itchy and watery eyes, throat irritation, tiredness, and disrupted sleep. These can range from mildly annoying to genuinely debilitating during peak pollen season.

This article is for general information only and is not a substitute for personalised medical advice. If symptoms are severe or not improving, speak to a pharmacist or a qualified clinician. We offer nurse-led blood sampling for laboratory allergy testing; it can support trigger identification when appropriate.

What Seasonal Allergies (Hay Fever) Usually Feel Like

Hay fever symptoms can vary in severity from person to person and from season to season. The following are the most commonly reported symptom groups, based on NHS and Allergy UK guidance. Experiencing one or more of these during pollen season does not confirm an allergy diagnosis on its own, but a consistent pattern may warrant further assessment.

• Nasal: Frequent sneezing, a runny or blocked nose, and itching inside the nose. Nasal symptoms are often the most dominant complaint and can affect breathing and sleep quality.
• Eyes: Itchy, watery, or red eyes — sometimes referred to as allergic conjunctivitis. Eye symptoms can be particularly troublesome outdoors on high pollen days.
• Throat and ears: An itchy throat, a sensation of post-nasal drip (mucus running down the back of the throat), and occasionally itchy or blocked ears.
• Tiredness and poor sleep: Many people with seasonal allergies report fatigue and difficulty sleeping, which can affect concentration, mood, and daily functioning. These symptoms may be linked to nasal congestion and disrupted breathing at night, although other causes should also be considered.

Seasonal Allergies vs a Cold (Quick Check)

One of the most common questions during spring and early summer is whether symptoms are caused by hay fever or a common cold. While the two can feel similar — both involve a runny nose, sneezing, and congestion — there are some practical differences that may help you tell them apart. This is a general guide, not a diagnostic tool.

If you notice that your symptoms follow pollen forecasts, improve on rainy days, or return at the same time every year, seasonal allergies are a likely explanation. A cold, by contrast, tends to run a set course and often includes general aches and a mild fever. If you are unsure, a pharmacist can help you work through the differences.

The Simplest Way to Treat Hay Fever: Start with the Symptom That Bothers You Most

UK guidance from NICE and the NHS generally recommends a practical, symptom-led approach to seasonal allergies treatment. Rather than prescribing one fixed plan for everyone, the idea is to match the treatment to the symptom that is most troublesome for you.

For most people, the commonly recommended starting options include antihistamines (tablets, liquids, or eye drops) and steroid nasal sprays, used alone or in combination depending on which symptoms are dominant. Antihistamines tend to help most with itching, sneezing, and watery eyes, while steroid nasal sprays are often more effective for nasal congestion and blockage.

The key principle is to start with what targets your main symptom and then step up if needed. There is no single "best treatment for everyone" — what works well can depend on your symptom profile, the severity of your hay fever, and how consistently you use treatment.

Step 1 — Reduce Exposure (So Medicines Don't Have to Work as Hard)

Before reaching for medicines, practical pollen avoidance measures can make a meaningful difference. These strategies are recommended by the NHS and Allergy UK as part of a sensible hay fever management plan. Reducing your overall pollen exposure may lessen symptom severity and improve how well your medicines work.

• Check the pollen forecast and plan outdoor time accordingly. Pollen counts tend to be highest in the early morning and late afternoon. If possible, schedule outdoor activities for lower-count periods.
• Keep windows closed at peak times; ventilate strategically. On high pollen days, try to keep windows shut during the worst hours. If you need fresh air, early evening may be a better option in many areas.
• Shower and wash your hair after being outside. Pollen can settle on your skin and hair throughout the day. A quick shower when you get home can help remove it before it continues to trigger symptoms indoors.
• Change your clothes after outdoor time. Pollen clings to fabrics. Changing into fresh clothes when you come inside — and keeping outdoor clothing out of the bedroom — can reduce overnight exposure.
• Wear sunglasses or wraparound glasses for eye symptoms. This creates a physical barrier that can help reduce the amount of pollen reaching your eyes, which is particularly useful on windy days.
• Dry laundry indoors on high pollen days. Hanging washing outside when pollen counts are elevated allows allergens to settle on your clothes and bed linen, potentially worsening symptoms when you wear or use them.

Antihistamines (Tablets, Liquids, Nasal Sprays, Eye Drops)

Antihistamines are one of the most commonly used hay fever treatments in the UK. They work by blocking histamine receptors, which helps reduce the itching, sneezing, runny nose, and watery eyes that characterise allergic rhinitis. They are available over the counter in several forms, including tablets, liquid formulations, nasal sprays, and eye drops.

Modern non-drowsy antihistamines are generally preferred for daytime use because they are less likely to affect alertness — an important consideration if you drive or operate machinery. Older-generation antihistamines can cause drowsiness and may be less suitable during working hours, although some people find them helpful at bedtime if symptoms are disrupting sleep. Always read the patient leaflet for guidance on drowsiness and driving.

If your main complaint is itchy, watery eyes, antihistamine eye drops can be a targeted option that works directly where symptoms occur. These can be used alongside oral antihistamines if needed. Some people find that a combination provides better overall relief than either approach alone.

For children, pregnant or breastfeeding individuals, and those taking other medications, it is important to check suitability before use. A pharmacist can advise on age-appropriate formulations and any potential interactions. Do not assume that all over-the-counter antihistamines are suitable for everyone.

Steroid Nasal Sprays (Often the Difference-Maker for Blockage)

If nasal congestion and blockage are your dominant symptoms, a steroid nasal spray (also called an intranasal corticosteroid) is often the most effective option. These sprays work by reducing inflammation inside the nose, which helps relieve stuffiness, improve airflow, and reduce the overall burden of nasal symptoms. They can also help with sneezing and, to some extent, eye symptoms.

Unlike antihistamines, which tend to work relatively quickly, steroid nasal sprays need consistent daily use to build their full effect. It can take several days of regular use before you notice a significant improvement. This is a common reason people give up on nasal sprays too early — they expect immediate relief and stop before the spray has had a chance to work properly.

For people with moderate or persistent nasal symptoms, steroid nasal sprays are one of the commonly recommended options in UK guidelines. They are available over the counter from pharmacies, and a pharmacist can help you choose an appropriate product.

Starting a steroid nasal spray before the pollen season peaks — sometimes called a "pre-season approach" — may help prevent symptoms from becoming established. This can be particularly useful if you know from experience that your hay fever starts at a predictable time each year.

If symptoms are not improving after a fair trial of consistent use with correct technique, the troubleshooting section below covers common reasons and sensible next steps.

Saline Sprays and Rinses (Supportive, Low-Risk)

Saline (salt water) nasal sprays and rinses are a simple, low-risk option that can support your hay fever management. They work by physically rinsing pollen and other irritants from the nasal passages, helping to soothe dryness and reduce the allergen load inside your nose. Allergy UK includes saline rinses as part of a general approach to managing allergic rhinitis symptoms.

Saline products can be used alongside antihistamines and steroid nasal sprays without interaction concerns. Some people find that rinsing the nose with saline before applying a steroid spray helps the medication work more effectively, because the spray can reach the nasal lining more easily when excess mucus has been cleared.

Use saline products as directed on the packaging. If you are unsure about which type to use or how to use a nasal rinse safely, a pharmacist can guide you.

Decongestant Sprays (Use Carefully)

Decongestant nasal sprays can provide rapid short-term relief from a severely blocked nose by reducing swelling in the nasal passages. They can be tempting to reach for when congestion is at its worst, and they often produce noticeable results within minutes.

However, decongestant sprays are not suitable for regular or prolonged use. The NHS advises against using them for more than a few days at a time, as extended use can lead to rebound congestion — a cycle where the nose becomes more blocked when the spray wears off, prompting further use and worsening the problem.

If you feel you need a decongestant spray, use it only for short-term relief while other treatments (such as a steroid nasal spray) build their effect. Always follow the patient information leaflet and check with a pharmacist if you are unsure about duration of use or suitability.

How to Use a Nasal Spray Properly (Quick Technique Guide)

Even the right nasal spray will underperform if used incorrectly. Research — and guidance from Allergy UK and the BSACI — suggests that poor technique is one of the most common reasons people feel their nasal spray "isn't working." Taking a moment to check your technique can make a real difference to how well treatment works.

1. Clear your nose gently first. Before spraying, blow your nose softly to remove excess mucus. This helps the medication reach the nasal lining rather than sitting on top of blockage. Avoid blowing forcefully, as this can irritate the tissues.
2. Aim slightly outwards, away from the septum. Point the nozzle gently towards the outer wall of your nostril — not towards the central partition (septum). Spraying directly onto the septum can cause irritation, nosebleeds, and discomfort, and reduces how effectively the medication is distributed.
3. Don't sniff hard after spraying. It is natural to want to sniff the spray upwards, but doing so pulls the medication past the nose and down the throat, reducing its local effect. Instead, breathe in gently through the nose while spraying, or simply hold your breath for a moment afterwards.
4. Use daily as directed. For steroid nasal sprays in particular, consistency is important. Use the spray at the same time each day as directed on the packaging or by your pharmacist. Skipping days or using it only when symptoms flare reduces its overall effectiveness.

Correct technique is one of the simplest changes you can make to improve your hay fever management. If you are unsure whether you are using your spray correctly, ask your pharmacist for a quick demonstration.

Common Reasons Symptoms Persist

If you have been using hay fever medicines but still feel like your symptoms are not under control, it is worth checking whether one of the following common issues could be a factor. Often, the problem is not that the treatment itself does not work, but that something about how or when it is being used is limiting its effectiveness.

• Started too late. Steroid nasal sprays in particular need several days of consistent use to build their full anti-inflammatory effect. Starting them after symptoms are already severe means you are playing catch-up rather than preventing inflammation.
• Inconsistent use. Using a nasal spray only on "bad days" and skipping it when you feel better undermines the steady state it needs to maintain. Regular daily use through the season is usually recommended.
• Using antihistamine alone when congestion is dominant. Antihistamines are effective for itching, sneezing, and eye symptoms, but they are often less effective at relieving significant nasal blockage. If congestion is your main issue, a steroid nasal spray may be more appropriate.
• Poor spray technique. Aiming incorrectly, sniffing hard after spraying, or using an expired product can all reduce how well a nasal spray works. See the technique section above for guidance.
• The trigger may not be pollen. If symptoms do not clearly follow pollen patterns — for example, they persist year-round or worsen indoors — other allergens such as house dust mites, pet dander, or mould may be involved. This does not mean you should self-diagnose, but it may be worth discussing with a pharmacist or clinician, or considering an allergy blood test to explore further.

A Sensible Step-Up Plan (UK-Aligned)

If single treatments are not providing adequate relief, combining approaches can be appropriate and is supported by UK clinical guidelines. The general principle is to step up treatment in a measured way rather than jumping straight to stronger options.

A common combination for moderate symptoms is using a steroid nasal spray alongside a non-drowsy antihistamine tablet. The spray addresses nasal inflammation and congestion, while the antihistamine helps with itching, sneezing, and eye symptoms. Adding antihistamine eye drops can provide further relief if eye symptoms are particularly troublesome.

For moderate-to-severe allergic rhinitis that is not well controlled with the above, combined intranasal corticosteroid and antihistamine sprays are available. These deliver both an anti-inflammatory and an antihistamine directly to the nose in a single product. They are licensed for use in moderate–severe allergic rhinitis and are typically available on prescription, although some may be obtainable through a pharmacy consultation. Speak to a pharmacist or clinician about whether this type of product may be appropriate for you.

The step-up approach is designed to find the minimum effective treatment for your symptoms. If you have worked through these steps and are still struggling, this is a reasonable point to seek a clinician review, as outlined in the section below.

Red Flags (Don't Ignore These)

Most hay fever symptoms are uncomfortable but manageable. However, certain signs require prompt medical attention. If you experience any of the following, do not delay seeking help:

• Wheeze, chest tightness, or breathlessness. These may indicate that your airways are being affected and could suggest an asthma component. This requires timely assessment.
• Swollen lips, tongue, or face, feeling faint, or signs of a severe reaction. These symptoms may indicate anaphylaxis, which is a medical emergency. Call 999 immediately and use an adrenaline auto-injector if available.
• Symptoms significantly affecting sleep or daily functioning despite a consistent treatment trial. If you have been using the right medicines correctly for a reasonable period and your quality of life is still markedly affected, a clinical review can help explore whether your treatment plan needs adjusting.
• Recurrent sinus or ear symptoms with fever or severe pain. Persistent facial pain, fever, or pressure symptoms that worsen over time may suggest a secondary infection or complication that needs assessment beyond standard hay fever management.

For OTC treatment optimisation, a pharmacist is an excellent first port of call and can review what you are taking and how you are using it. For urgent symptoms such as severe breathing difficulty or signs of anaphylaxis, call 999. For non-urgent concerns that need clinical input, contact your GP or NHS 111.

Can an Allergy Blood Test Help with Seasonal Allergies?

For many people, the link between pollen season and symptoms is clear enough that a clinical diagnosis of hay fever can be made based on history alone. However, there are situations where an allergy blood test may be helpful — for example, when symptoms persist outside typical pollen seasons, when multiple triggers are suspected, or when someone wants a clearer picture of what they may be sensitised to before exploring treatment options.

Allergy blood tests typically measure allergen-specific IgE antibodies. A raised level for a particular allergen — such as grass pollen or birch pollen — indicates that the immune system has produced a response to that substance. This is known as sensitisation and may support the clinical picture when taken alongside symptom history and exposure patterns.

It is important to understand the limitations: a positive IgE result does not always mean you will experience clinical symptoms upon exposure. Sensitisation and clinical allergy are not the same thing. Equally, a negative result does not rule out all forms of sensitivity. Results are most useful when interpreted in the context of your symptoms, timing, and environmental exposures — ideally with input from a qualified healthcare professional.

If you experience symptoms consistent with hay fever and would like to understand your specific triggers better, testing may be a useful step.

What Your Nurse-Led Test Appointment Usually Involves (Process Overview)

If you choose to have an allergy blood test through our service, the process is straightforward. You may be asked a few brief questions about your symptoms and what you are hoping to test for, to help ensure the right panel is selected.

A trained clinical professional then collects a venous blood sample using standard phlebotomy procedures. The appointment is typically short — around 15 to 20 minutes in total. The sample is sent to a UK-based accredited laboratory for specific IgE analysis against the allergens included in your chosen panel.

Results are delivered to you securely, usually within several working days. The service does not include medical consultation or diagnosis. We recommend discussing your results with a registered healthcare professional who can interpret them in the context of your clinical history.

What to Test for in the UK (Keep Practical)

The UK pollen season broadly runs from early spring through to autumn, with different pollen types peaking at different times. Tree pollens (such as birch and oak) tend to peak in spring, grass pollens dominate during late spring and summer, and weed pollens (such as mugwort and nettle) may appear in late summer and early autumn. If your symptoms follow one of these patterns, testing for the relevant pollen group may be informative.

However, if your "seasonal" symptoms do not follow a clear pollen calendar — for example, if they persist year-round or worsen when indoors — perennial allergens such as house dust mites, pet dander, or mould spores may be worth investigating. These allergens are present throughout the year and can mimic seasonal patterns in some situations.

You can explore the range of allergy blood tests available through our service to see which panels may be relevant to your symptoms.

Seasonal Allergies in Children

Hay fever is common in children and can affect their concentration at school, their sleep quality, and their enjoyment of outdoor activities. Symptoms in children are similar to those in adults — sneezing, itchy eyes, congestion — but younger children may not always be able to describe what they are feeling clearly.

Many over-the-counter antihistamines and nasal sprays are available in formulations designed for children, but it is essential to check age suitability before use. Product labels will state the minimum age, and a pharmacist can advise on appropriate options and dosing.

If a child's hay fever is affecting their schoolwork, sleep, or daily activities despite using age-appropriate treatments correctly, it may be worth seeking a pharmacist review or discussing further options with a clinician.

Pregnancy and Breastfeeding

Managing hay fever during pregnancy or while breastfeeding requires extra caution. Not all over-the-counter medicines are considered suitable during these periods, and the guidance can vary depending on the specific product and stage of pregnancy.

The safest approach is to check before taking any hay fever medicine. Speak to a pharmacist, midwife, or GP for guidance on which options may be appropriate for your situation. Non-medicine measures — such as pollen avoidance, saline rinses, and wraparound sunglasses — remain helpful and carry no medication-related concerns.

Asthma and Hay Fever (Important Overlap)

Hay fever and asthma frequently coexist, and poorly managed hay fever can worsen breathing symptoms in people with asthma. Pollen exposure can trigger airway inflammation, leading to increased coughing, wheezing, and breathlessness during pollen season — sometimes referred to as "thunderstorm asthma" in extreme weather events.

If you have asthma and notice that your breathing symptoms worsen during pollen season, it is important to continue using your preventer inhaler as prescribed and ensure your asthma action plan is up to date. UK respiratory charity guidance emphasises that managing hay fever effectively — with antihistamines and nasal sprays — can help reduce the risk of asthma flare-ups triggered by pollen.

If you experience new or worsening wheeze, chest tightness, or breathlessness, seek a timely clinical review. Do not wait for symptoms to become severe before seeking help.

Frequently Asked Questions

Conclusion

Effective seasonal allergies treatment in the UK comes down to a practical, step-by-step approach: reduce pollen exposure where possible, choose the right medicines for your dominant symptoms, use nasal sprays with correct technique, and step up or seek review if things are not improving. Most people can achieve meaningful relief with over-the-counter options used consistently and correctly.

If symptoms recur each year or triggers are unclear, allergy testing may help clarify what you react to. Our nurse-led service offers blood sampling for lab testing.

References

1. NHS — "Hay fever" (NHS patient information page)
2. NHS — "Allergic rhinitis" (NHS Health A to Z)
3. NICE Clinical Knowledge Summaries — "Allergic rhinitis: management"
4. Allergy UK — "Hay fever & allergic rhinitis" (patient guide)
5. Allergy UK — "Nasal sprays and saline rinses" (general approach guidance)
6. BSACI — "Nasal spray technique" (patient guidance PDF)
7. Met Office — "Pollen forecast" (UK pollen count information)
8. Asthma + Lung UK — "Hay fever and asthma" (patient information)