For hayfever sufferers, summer means an exhausting combination of sneezing, streaming eyes and a runny nose. With the pollen season almost upon us, Hélène Hofmanlooks at what you can do to help relieve the symptoms
'On a sunny day I can feel it coming. It starts in the back of my throat and it goes into my chest and then I'm sneezing and crying. All I can do is go home, have a shower and go to bed - I just don't want to be awake when it's like that," says Sarah Doyle (22), a student and hayfever sufferer from Dublin.
She is just one of thousands of hayfever sufferers in Ireland. One in 15 people is affected every year.
"You don't want to moan because you're not ill but at the same time you have this thing that means you can't concentrate, and you're suffering. Sneezing takes a lot out of you. It's actually really debilitating," Doyle says.
Hayfever, or seasonal allergic rhinitis, is an allergic reaction to pollen or spores. When the pollen comes into contact with the lining of the nose, it produces the chemical histamine, which causes the lining to swell, produce excess mucus and itch. Histamine can also inflame the eyes and cause airways to constrict.
Most sufferers are allergic to grass pollen, which begins to fly between May and August and peaks in June and July. Others are allergic to tree pollen, which is released into the air as early as February.
A minority suffer from perennial rhinitis, where symptoms are triggered all year round by dust, mould spores, animal hair or feathers.
"People who suffer all year round come into summer already compromised compared to other sufferers," says Dr Paul Carson, who runs an allergy clinic in south Dublin and has written two books on allergies.
"Sufferers who live in cities are also likely to find it more difficult. Pollen grains 'leech', or join together, with diesel particles and produce a super pollen, so polluted areas like cities are particularly bad," he says.
"The symptoms of hayfever include itchy red eyes, runny nose, the sensation of being fatigued, wheezy chest, headaches and poor sleep pattern. But not everyone will suffer all of these symptoms," he says. "For many patients, they feel as if they've been hit by a train. It can also bring on an asthma attack and aggravate pre-existing eczema," he explains.
According to Frances Guiney, asthma nurse with the Asthma Society of Ireland, 80 per cent of asthma sufferers also have hayfever, while 40 per cent of hayfever sufferers have asthma.
"There is a strong link between asthma and hayfever. In fact, at least one in 10 patients I see here has hayfever," Guiney says.
"Getting the right diagnosis and starting treatment in time is essential. Someone with rhinitis and asthma might be only addressing the lungs but that's only half of the problem - it's something I see every day. If you don't treat the problem properly, it will only make the condition worse," she says.
For the first time this year, a new treatment known as specific immunotherapy has become available in Ireland. However, for most sufferers an over-the-counter remedy should be the first choice.
"For many people, taking an oral anti-histamine may be all they need. Eye drops may work also," says Dr Joe Fitzgibbon, who has a specialist interest in allergies and runs clinics in Dublin and Galway.
"The advantage of taking both of those is they work within about 20 minutes. There are nasal sprays also if one of your main symptoms is nasal congestion, but the difficulty is they take time, there's a time-lag of one-two weeks. You really need to start treatment before the pollen season begins," he says.
"If they don't give adequate release, specific immunotherapy has recently become available in Ireland. That should be taken up to four months ahead of the pollen season and you're in treatment for eight months," he says.
According to Fitzgibbon, he will see about 100 patients for pre-seasonal treatments this week.
Specific immunotherapy, also known as desensitisation, works by releasing small quantities of the allergen to moderate the body's immune response to it. Over time, the sufferer becomes less sensitive to the allergen. Specific immunotherapy comes in the form of a sublingual (under the tongue) tablet or in drop form, both of which are available through medical centres. Although it's too late for sufferers to begin specific immunotherapy this season, allergy experts here believe it will become increasingly popular in the future.
"My advice is, whatever you do, start therapy in time, especially exam students. Be sure to try out a few anti-histamines and know which ones work and which ones might make you drowsy," says Fitzgibbon.
"All allergies affect the way you live. The word hayfever itself - fever - suggests a malaise, or flu-like symptoms similar to those of viral infections. What we say is 'allergies are not to be sneezed at'. I know people whose allergies cause them to sneeze in bouts of 20 times and that's incapacitating. Allergies can cause misery," he says.
"It does bother me," says Doyle. "Near where I live there's a beautiful walk but I have to avoid it because I come out of it and my eyes are streaming. There is a certain amount of risk management to it. You can avoid certain areas for example - no-fly zones for hayfever sufferers you could call them - where there are a lot of bushes and trees. Unfortunately, it might seem like a beautiful day outside, but if you're a hayfever sufferer it will be anything but a beautiful day if you're not careful," she says.