Allergic rhinitis, often called hayfever, develops when your nasal passages and/or eyes encounter environmental allergens like pollen, airborne moulds, dust mites or animal dander. If your immune system overreacts to these substances, you may notice an itchy nose, frequent sneezing and watery, itchy eyes. To manage these symptoms, a tailored mix of treatments is usually advised. Try our online assessment or chat with your pharmacist to find out which products work best for you.
Types of Hayfever
Seasonal Hayfever Symptoms tend to peak in spring, summer and early autumn when grass, tree and weed pollens fill the air. Airborne mould spores can also provoke reactions, especially on breezy days. Perennial Hayfever When symptoms persist year-round, it’s called perennial allergic rhinitis. Common indoors triggers include pet dander, dust mites and mould. These may worsen at the start of pollen season, when outdoor allergen levels rise.
What are histamines?
Histamines are biogenic amines produced by the decarboxylation of the amino acid histidine, primarily stored in mast cells and basophils. When these cells encounter an allergen, they release histamine, which binds to four main receptor types (H₁, H₄). Activation of H₁ receptors in blood vessels and nerve endings causes vasodilation, increased vascular permeability (leading to swelling and redness), and itching. H₂ receptors regulate gastric acid secretion in the stomach, while H₃ and H₄ receptors modulate neurotransmitter release and immune cell chemotaxis, respectively. This complex receptor network underlies both the classic allergy symptoms and broader physiological roles of histamine.
Hayfever statistics
Allergic rhinitis affects an estimated 10–30% of adults worldwide, with incidence rising in urbanized regions due to increased pollution and changing environmental exposures. In Australia, roughly 20% of adults and 10% of teenagers report hayfever symptoms annually3, and prevalence in children can reach 30% 4. Besides its personal burden, impaired sleep, concentration difficulties and reduced quality of life, hayfever also imposes significant economic costs through lost productivity and healthcare expenses.
Curcumin hayfever relief
Curcumin, the active compound in turmeric, exhibits anti-inflammatory and mast cell, stabilizing properties. It inhibits the NF-κB pathway, reducing the production of pro-inflammatory cytokines, and can prevent histamine release from mast cells1. Clinical studies have shown that daily doses of 300–500 mg of curcumin extract may significantly decrease nasal congestion and sneezing frequency, offering a complementary approach alongside conventional allergy medications.
What is pollen count?
Pollen count quantifies the number of pollen grains per cubic meter of air, typically measured via volumetric spore traps (e.g. Hirst-type). Counts fluctuate hourly, peaking early morning and late afternoon, and seasonally, based on plant pollination cycles. Levels are often categorized as:
- Low: < 20 grains/m
- Moderate: 20–50 grains/m
- High: 50–100 grains/m
- Very High: > 100 grains/m
Knowing these thresholds helps you plan outdoor activities and medication timing6.
Common triggers
Below are some common triggers of hay fever:
- Grass pollens: Ryegrass, Bermuda and Timothy grass release copious grains in spring and early summer.
- Tree pollens: Birch, oak and plane tree pollinate in late winter to early spring.
- Weed pollens: Ragweed (Ambrosia), mugwort and plantain peak in late summer to autumn.
- Indoor allergens: Cat (Fel d 1) and dog dander, dust-mite fecal proteins (Der p 1, Der f 1), and mould spores (Alternaria, Cladosporium).
- Irritants: Diesel exhaust particulates, volatile organic compounds in cleaning agents, smoke and strong fragrances.
Hayfever triggers (mechanism)
When inhaled, allergenic proteins bind to IgE antibodies on mast cells in the nasal mucosa. This cross-linking prompts degranulation and massive histamine release, leading to:
- Vasodilation and plasma leakage → nasal congestion
- Nerve stimulation → itching and sneezing
- Glandular stimulation → excess mucus production
Common symptoms
- Nasal: Rhinorrhea (runny nose), nasal congestion, post-nasal drip
- Ocular: Conjunctival redness, tearing, eyelid swelling
- Throat/Lung: Scratchy throat, cough, occasional wheezing
- Systemic: Fatigue, headache, difficulty concentrating, sleep disturbance
Side effects of untreated hayfever
Persistent inflammation can evolve into:
- Allergic conjunctivitis and keratitis
- Sinusitis from blocked sinuses and mucus stasis
- Otitis media in children due to Eustachian tube dysfunction
- Asthma exacerbations in at-risk individuals
- Quality-of-life impacts: Poor work/school performance, mood disturbances, social withdrawal
Other manifestations
It can also evolve into:
- Urticaria (hives): Rapid onset of red, raised wheals that itch intensely1. May co-occur with angioedema, deep tissue swelling around eyes, lips or extremities.
- Atopic dermatitis: Chronic eczema flare-ups in sensitized individuals, often linked to indoor allergens.
Diagnosing Hayfever
Diagnosis combines:
- Clinical history: Symptom timing, environmental exposures, family history of atopy
- Physical exam: Nasal mucosa inspection (pale, boggy turbinates), eye assessment
- Allergy testing:
1. Skin prick test: Immediate wheal-and-flare response within 15–20 minutes 2. Specific IgE blood test: Quantifies antibody levels to particular allergens
- Differential diagnosis: Rule out non-allergic rhinitis, sinus infections, nasal polyps.
Hayfever treatment
A stepwise approach is recommended: 1. Allergen avoidance: Stay indoors during high pollen periods, use air purifiers, wash bedding weekly in hot water. 2. Pharmacotherapy:
- Second-generation oral antihistamines (e.g. cetirizine, loratadine) for rapid relief of sneezing and itching
- Intranasal corticosteroids (e.g. fluticasone, mometasone) as first-line for moderate to severe nasal congestion
- Leukotriene receptor antagonists (e.g. montelukast) for patients with concurrent asthma
3. Adjunctive therapies: Saline nasal irrigation, mast cell stabilisers (e.g. cromolyn sodium) 4. Allergen immunotherapy (AIT):
- Subcutaneous (SCIT) or sublingual (SLIT) protocols desensitise the immune response over 3–5 years
- Indicated for patients with poor control on medications or wishing to modify the disease course
5. Emerging biologics: Anti-IgE monoclonal antibodies (e.g. omalizumab) show promise in refractory cases.