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Clinical Reference Systems: Pediatric Advisor 10.0

Hay Fever (Allergic Rhinitis) (for Teenagers)


  • You have a clear nasal discharge and an itchy nose and are sneezing and sniffing.
  • The symptoms occur during pollen season.
  • Similar symptoms occurred during the same month or months of the previous year.
  • You may also have itchy, watery eyes (eye allergies).
  • You may also have sinus or ear congestion.


Hay fever is an allergic reaction of the nose (and sinuses) to an inhaled substance. This allergic sensitivity is often inherited. During late April and May the most common offending pollen is from trees. From late May to mid-July, the offending pollen is usually grass. From late August to the first frost, the leading cause of hay fever is ragweed pollen. Although the inhaled substance is usually a pollen, it can also be animal dander or something else you are allergic to.

Hay fever is the most common allergy. More than 15% of people have it.

Expected Course

This is a chronic condition that will probably recur every year, perhaps for a lifetime. Therefore, it is important to learn how to control it.

Home Treatment

  1. Oral antihistamine medicine

    The best drug for hay fever is an antihistamine. It will relieve nose and eye symptoms. You need the antihistamine recommended by your physician. (Some effective nonprescription antihistamines are Chlor- Trimeton, Dimetane, and Teldrin.)

    Symptoms clear up faster if antihistamines are given at the first sign of sneezing or sniffing. For people with occasional symptoms, antihistamines can be taken on days when symptoms are present or expected. For people with daily symptoms the best control is attained if antihistamines are taken continuously (several times each day) throughout the pollen season.

    The main side effect of antihistamines is drowsiness. If you become drowsy, switch to a combination product that contains an antihistamine with a decongestant (such as pseudoephedrine or phenylpropanolamine). If you remain drowsy, continue the drug, but temporarily decrease the dosage. You should become tolerant of the regular dosage in 1 to 2 weeks.

  2. Prescription nasal sprays

    If antihistamines only give partial relief of symptoms, severe hay fever can usually be controlled by new cromolyn or steroid nasal sprays. Allergy shots are usually not necessary.

    These prescription nasal sprays must be used when the nose is not dripping. Take an antihistamine to stop the dripping before you use the spray. Nasal sprays do not help eye symptoms. Therefore they are usually used along with oral antihistamines. Use the nasal spray recommended by your doctor.

  3. Pollen removal to decrease symptoms of hay fever

    Pollen tends to collect on the exposed body surfaces and especially in the hair. Shower and wash your hair every night before going to bed. Avoid handling pets that have been outside and are probably covered with pollen.

  4. Prevention of hay fever symptoms

    Exposure to pollen can be reduced by not going on drives in the country and by not sitting by an open car window on necessary drives. You should stay away from someone cutting the grass during pollen season. When it is windy or the pollen count is especially high, you should stay indoors. Close the windows that face the prevailing winds.

    If your hay fever is especially bad, consider going to an air-conditioned store or theater for a few hours.

    Avoid feather pillows, pets, farms, stables, and tobacco smoke if any of them seem to bring on symptoms of nasal allergy.

  5. Eye allergies associated with hay fever

    If you also have itchy, watery eyes, wash your face and eyelids to remove pollen. Then apply a cold, wet cloth to the eyelids for 10 minutes. An oral antihistamine will usually bring the eye symptoms under control. If not, put two drops of long-acting vasoconstrictor eyedrops (a nonprescription item) in your eys every 8 to 12 hours for a few days. Ask your pharmacist to recommend a reliable product.

  6. Common mistakes

    Vasoconstrictor nosedrops or nasal sprays usually do not help hay fever because they are washed out by nasal secretions as soon as they have been put into the nose. Also, if they are used for more than 5 days, they can irritate the nose and make it more congested.

Call Your Physician During Office Hours If:

  • Your symptoms are not controlled in 2 days with antihistamines.
  • You develop sinus pain or pressure.
  • You have other concerns or questions.

Related Topic

Sinus Congestion

Written by B.D. Schmitt, M.D., author of "Your Child's Health," Bantam Books.
Copyright 1999 Clinical Reference Systems