Which type of hay fever nasal spray is right for you?

How do hay fever nasal sprays work?

If you're battling with hay fever symptoms in order to enjoy Great British Summer-time barbecues, picnics, and other outdoor activities, you're not alone. Over a quarter of adults and 10-15% of children¹ experience this seasonal allergy to pollen (a form of allergic rhinitis) every year.

Most people reach for the hay fever tablets first; a fast-acting and budget-friendly treatment for itchiness, runny noses, and irritated or watery eyes. However, if you often have a blocked and bunged-up nose (nasal congestion) you may want to consider a hay fever nasal spray. These can help to ease congestion as well as the other irritating and uncomfortable symptoms you may have.

How to use hay fever nasal spray

1. Blow your nose.

2. Give the bottle a shake.

3. Tilt your head forwards.

4. Insert the tip of the upright bottle just inside one nostril (don't angle the bottle, just your head).

5. Use your free hand to close your other nostril.

6. Apply one or two sprays as prescribed while breathing in (don't sniff too hard as the spray could travel past the nose and into the throat).

Main types of hay fever nasal spray

• Steroid nasal sprays - contain a medicine called a steroid (also known as a corticosteroid) which reduces swelling (inflammation) and mucus in your nose. These are available over the counter and on prescription in higher doses.

• Antihistamine nasal sprays - contain a medicine called an antihistamine which works by blocking the action of the chemical called histamine in your nose. It's the chemical reaction of histamine - when triggered as an immune system response to pollen - which causes symptoms. These sprays are only available on prescription.

• Combination nasal sprays - contain both a steroid and an antihistamine and are a great option if the above single-treatment sprays don't provide you with enough relief. These are only available on prescription.

When hay fever nasal sprays aren't right for you

These sprays are generally safe to use. It's always best to read the label or ask your pharmacist about the maximum daily dosage and length of time you can use them for. If you follow these instructions, it's unlikely you will experience any adverse side effects.

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Drug allergy

Medicines can cause allergic reactions. In this leaflet these reactions are called 'drug allergies'. In this instance the drugs referred to are medicines people take for their health. For example, antibiotics or anti-inflammatory painkillers rather than drugs of addiction. Allergic reactions can happen with prescribed medicines as well as those you have bought from a pharmacy. Drug allergies may be mild, moderate or severe. Some can come on in a matter of minutes. Others may take days or even weeks to develop. Some reactions are so severe they can be life-threatening. Mild reactions can sometimes be treated simply by stopping the medicine. Severe reactions usually require hospital admission.

by Dr Hayley Willacy, FRCGP

If any of the below risk factors are relevant to you, check with your pharmacist or doctor before using a hay fever nasal spray:

• You have reacted badly to steroids in the past.

• You have recently had surgery on your nose.

• You have tuberculosis (TB).

• You have an infection in your nose.

• You want a spray for your child (some nasal sprays aren't suitable for children).

• You are currently having - or have recently had - steroid injections or steroid tablets.

• You are pregnant, breastfeeding, or are trying for a baby (nasal sprays are normally safe, but it's a good idea to get expert advice first).

FAQs

Can you use hay fever tablets and nasal spray together?

The short answer to this question is yes, it's perfectly safe to combine the two. Hay fever tablets are antihistamines, tackling all symptoms aside from nasal congestion. On the other hand, steroid nasal sprays are typically better at treating a stuffy, blocked nose. If a mix of different symptoms is causing you to feel under the weather, you may benefit from using both treatments.

What's the best children's hay fever nasal spray?

In the UK, if you're looking for a hay fever nasal spray for your child, you'll need a prescription from their doctor. This is because some children may be more vulnerable to side effects such as poor sleep (insomnia) and irritability. However, the common steroid sprays used today are considered to be low-risk⁴.

Different nasal sprays can be prescribed to children of different ages - for example:

• Mometasone - may be prescribed to those aged over three years.

• Fluticasone - may only be prescribed to those aged over four years.

• Budesonide - is usually prescribed to those aged over six years (occasionally a younger child may have it prescribed for them).

• Beclometasone - may be prescribed to those aged over six years.

What's the best non-drowsy hay fever nasal spray?

Taking medication that makes you drowsy in the day can be dangerous, particularly during activities such as driving or if you work with dangerous machinery and tools. If you're using a steroid nasal spray, you don't need to worry about this. However, antihistamine nasal sprays can be either drowsy or non-drowsy - you should check with your doctor which kind they are prescribing.

Further reading

1. Allergy UK statistics and figures.

2. The National Institutes of Health "Hay fever: Which medications can relieve allergic rhinitis?".

3. J M Berlin, S J Golden, S Teets, E B Lehman, T Lucas, T J Craig "Efficacy of a steroid nasal spray compared with an antihistamine nasal spray in the treatment of perennial allergic rhinitis".

4. G K Scadding "Corticosteroids in the treatment of pediatric allergic rhinitis".