symptoms and treatment of pollen allergy
Especially in spring and summer, the nose starts to run, the eyes itch and sufferers have to sneeze constantly. An allergy to pollen triggers the dreaded condition hay fever. The symptoms can be so severe that the sufferer’s quality of life is significantly affected. And that’s not all: an untreated pollen allergy often triggers asthma. Here’s what you can do.
In the case of an allergy, the immune system reacts disproportionately strongly to what are actually harmless, foreign substances. In a pollen allergy, the allergen is usually grass pollen. But the pollen from trees and herbs also makes life difficult for many people with allergies.
Pollen allergy – also known as pollinosis or allergic rhinitis – is the most common allergy in Western industrialised countries. In Switzerland, around 20% of the population suffers from it.
Pollinosis usually begins in childhood and occurs mainly during the pollen season in spring and summer. The resulting hay fever is therefore also called seasonal allergic rhinitis.
The main symptoms of a pollen allergy are:
- Runny nose
- Watery, itchy eyes
- Itching in the palate, nose and ears
Some people may experience other symptoms such as:
- Sore throat
- Jaw pain
- Strong feeling of illness
- Increased temperature
- Sleep disorders
Another key characteristic of hay fever is nasal hyperreactivity. Non-allergic stimuli such as tobacco smoke, temperature changes or intense odours can also lead to colds and sneezing.
Unlike food or insect poison, pollen rarely triggers life-threatening allergic reactions. However, pollen allergy sufferers should still take their condition seriously. If hay fever remains untreated, it may progress, with about one third of cases developing into allergic asthma. Another common comorbid condition is atopic eczema (neurodermatitis).
The incidence of allergies is particularly high in Western industrialised countries. Researchers have not yet been able to fully explain why this is the case.
In the event of an allergy, the immune system overreacts when exposed to harmless substances. The exact causes can only be surmised to date. Genetic predisposition seems to be an important factor. Accordingly, allergy susceptibility is inherited and is probably promoted by environmental pollution. Active and passive smoking, for example, increases the risk of allergies.
Contact with different microbes seems to strengthen the immune system’s tolerance to allergens. Children growing up on a farm are less prone to allergies.
Breastfeeding also plays an important role in the prevention of allergies. Mothers should exclusively breastfeed their babies for the first four to six months after birth if possible and continue to breastfeed after the introduction of supplementary food.
Triggers for hay fever
The most common trigger for a pollen allergy is the pollen of the following plants:
- Trees (e.g. birch, hazel) from January to April
- Grasses (e.g. timothy, orchard grass) from May to July
- Herbs (e.g. mugwort, ambrosia) from August to September
When the pollen enters the body of allergy sufferers via the mucous membranes or respiratory tract, certain messenger substances (e.g. histamine) are activated. They trigger inflammatory processes as a defensive reaction, and characteristic hay fever symptoms develop.
Many people who are allergic to pollen develop a cross-allergy – they are also allergic to other substances. This is most common in people with an allergy to birch pollen, 70% of whom also develop a food allergy (e.g. to strawberries, apples or celery).
Allergies are diagnosed by a doctor qualified in allergology. The patient is first asked during a patient consultation (medical history) when symptoms occur, for example, and whether there are allergies in the family.
The doctor also examines the patient’s inner and outer nose and eyes and the surrounding skin.
Skin tests are the most important diagnostic tool for detecting a pollen allergy. The standard test is the prick test. The doctor drips an allergenic solution onto the skin and scratches it slightly. If skin reactions occur, this indicates an allergy.
An in vitro blood test can also help to detect specific IgE antibodies that are produced in people with pollen allergies. This test is the preferred option when a prick test is not possible (e.g. in infants and young children who cannot tolerate the multiple scratches involved in the prick test).
A nasal provocation test can confirm an unclear diagnosis. The suspected allergen is applied directly to the nasal mucosa and triggers a corresponding reaction in allergy sufferers.
The most important measure in the case of allergies is to avoid the allergenic substances. In the case of a pollen allergy, however, this is often very difficult. This is why medications are used to minimise symptoms.
Antihistamines (e.g. in the form of tablets, nasal sprays or eye drops) and anti-inflammatory glucocorticoids (“cortisone”) – usually as a nasal spray – are the first choice for children and adults with allergic rhinitis. The two medications can also be combined and are suitable for long-term treatment.
In addition, there are other possible measures that are effective for allergies:
- Leukotriene antagonists, administered alone or in combination with an antihistamine, can relieve colds and nasal congestion.
- Decongestives cause the swelling of nasal mucosa to subside. They should not be used for prolonged periods of time.
- Mast cell stabilisers (chromones) inhibit the release of pro-inflammatory messenger substances. They are administered, for example, in the form of eye drops or nasal sprays.
Desensitisation can cure pollen allergy
Hyposensitisation (desensitisation, specific immunotherapy) can be used to treat the cause of the pollen allergy. The immune system becomes accustomed to the allergen over an extended period of time, thus reducing its hypersensitivity.
Allergy sufferers should start specific immunotherapy as early as possible and continue for at least three years. It is suitable for children aged five and older.
In order to avoid pollen, people with an allergy can find out about the pollen count in Switzerland. You should also keep your apartment or house as free of allergens as possible. Pollen screens for the windows enable you to ventilate in an allergic-friendly manner. Do not dry your laundry outdoors and vacuum your home frequently (with a special filter). To avoid bringing pollen into the bedroom, leave your clothes worn during the day outside the bedroom and wash your hair before going to bed.
For more information and support services, please visit:
- Leitlinie der Deutschen Gesellschaft für Allergologie und klinische Immunologie (DGAI): Allergische Rhinokonjunktivitis (Stand: April 2003)
- Leitlinie der Deutschen Gesellschaft für Allergologie und klinische Immunologie (DGAI) und der Deutschen Gesellschaft für Kinder- und Jugendmedizin (DGKJ): Allergieprävention (Stand: Dezember 2021)
- Ballmer-Weber and Helbling. 2017. Allergische Rhinitis. Swiss Medical Forum. Vol. 17. No. 08. EMH Media https://medicalforum.ch/de/detail/doi/smf.2017.02897
- Allergiezentrum Schweiz: Pollenallergie (Heuschnupfen), unter www.aha.ch (Abrufdatum 30.11.2022)
- Allergieinformationsdienst des Helmholtz Zentrum München: Heuschnupfen, unter: www.allergieinformationsdienst.de (Abrufdatum 30.11.2022)
- Chrubasik-Hausmann S. Schwarzkümmel (Nigella sativum). Uniklinik Freiburg. 2018