Events

Summer allergies web chat 11 May at 13.00

As spring moves into summer, plenty of us suffer from hay fever or worry about allergic reactions caused by bites or stings.

Join us Wednesday 11 May at 13.00 to discuss hay fever and summer allergies with respiratory consultant Sophie Farooque and Adnan Custovic, clinical professor of paediatric allergy. They will spend one hour answering your questions – don’t miss out! 

We’ll open the web chat for questions at 12.30, then Dr Farooque and Professor Custovic will join us at 13.00 to get started. You can join the chat right here on this page, or follow along via Twitter @ImperialNHS. You are also welcome to email your questions to web@imperial.nhs.uk. If you can’t make it to the live chat, check our website later to see the chat in full.

If you want to learn more about hay fever, watch Dr Farooque's interview on ITV's 'This Morning'. 

Dr Farooque & Dr Custovic: 
Here’s Dr Custovic’s favourite description of hay fever to get us started: 
As first described in 1819 by Salter: ‘"About the beginning or middle of June in every year ..... .... A sensation of heat and fullness is experienced in the eyes .... To this succeeds irritation of the nose producing sneezing .... .... To the sneezings are added a further sensation of tightness of the chest, and a difficulty of breathing."
Comment From Anon 
I have been told that hayfever runs in a seven year cycle, e.g. year one you may have really bad hayfever symptoms, year three - slightly less symptoms, year five - mild symptoms and year seven -no symptoms. Is this true or a myth?
 
Dr Farooque & Dr Custovic: 
That is a myth! However, the level of pollens may vary considerably from year to year, so the severity of your symptoms may differ from year to year.
 
Comment From Anon 
Can hayfever effect your skin?
 
Dr Farooque & Dr Custovic: 
Hay fever typically affects airways (nose, lungs) and eyes. Some patients with eczema may find their skin is slightly worse during pollen season, but hay fever doesn't cause skin symptoms in general.
 
Comment From Anon 
I want to ensure I protect my young baby from bites and stings this summer. If they do get bitten, is there any symptoms I should look out for which may require further treatment?

Dr Farooque & Dr Custovic: 
Don't worry too much about insect bites and stings. Life-threatening allergies to bee and wasp stings tend very much to be a problem in adults rather than young children.
 
Comment From Guest
Why the sudden onset of hay fever for a single summer when I have never suffered with it before? 

Dr Farooque & Dr Custovic: 
More and more people notice an allergy as they progress through life. You need to be exposed to something in order to be allergic to it - allergies do not present with the first exposure to an allergen.
 
Comment From Guest 
I swim competitively. I also suffer with hayfever. My swimming club told me that I shouldn't take hayfever tablets because it will increase my heart rate, which isn't good when doing a lot of fitness anyway. Is this really the case?
 
Dr Farooque & Dr Custovic: 
Most of the newer anti-histamines do not affect the heart. But don't ever use an old-style anti-histamine like Piriton - these can cause side effects such as drowsiness and fatigue and are also far less effective than their modern counterparts. For you, it is very important to get appropriate treatment for your hay fever (usually nasal spray and modern anti-histamines) as it can affect your performance.
 
Comment From Guest 
I have to take Cetirizine regularly - are there any side effects of this medicine if used for long term?
 
Dr Farooque & Dr Custovic: 
Of anti-histamines, Cetirizine is a very good one. It acts very fast and will give you protection for over 24 hours. A small number of people may experience some sedation (if you fall into that category, try taking it at night). There are no known long-term side effects. Using an anti-histamine regularly does not make it less effective.
 
Comment From Guest
What is the best over the counter remedy for a streaming nose?
Do hayfever allergies tend to run in families?

Dr Farooque & Dr Custovic: 
Yes, but most hay fever sufferers have no family history of allergy.
 
Comment From Janice Foster 
I HAVE A SESITIVITY TO SUNCREAM I HAVE TRIED VARIOUS PRODUCTS OVER THE YEARS BUT NONE SEEM TO HELP. I CAN PUT ON SUNCREAM BUT WHEN I GO OUT INTO THE SUN MY FACE EXPLODES ANY IDEAS PLEASE.
 
Dr Farooque & Dr Custovic: 
We suggest that you talk to your GP and that you are referred to a dermatologist for patch testing. This is a clever way of working out exactly which ingredient you may be allergic to, and they may even be able to make an individualised sunblock for you.
 
Comment From Basil 
What are the chances of suffering from a summer allergy and is there anything I can do to avoid summer allergies?
 
Dr Farooque & Dr Custovic: 
One in four people suffer from hay fever and this number is likely to increase. But the good thing is that it can be very successfully treated. Avoiding pollen is impossible if you are living in the UK, so be sure to get appropriate treatment.
 
Comment From Guest
What is the best over the counter remedy for a streaming nose? 
Is it possible to cure hayfever?
 
Dr Farooque & Dr Custovic: 
Allergy vaccination (desensitisation/immunotherapy) to tree or grass pollen is an excellent option (this treatment was first discovered at St Mary's in 1906) if you have terrible persistent symptoms despite trying usual treatments (antihistamines, nasal sprays, eye drops). This treatment can "cure" hay fever and patients often enjoy long-term remission for a number of years after completing the 3 year course.
 
Comment From Guest
Why the sudden onset of hay fever for a single summer when I have never suffered with it before? 
Could hay fever make my asthma worse?
 
Dr Farooque & Dr Custovic: 
Yes - it very important to get appropriate treatment for hay fever, as it may improve asthma control.
 
Comment From Guest
What is the best over the counter remedy for a streaming nose? 
 
Dr Farooque & Dr Custovic: 
We need a bit more detail to understand why your nose is streaming. 

However, if it is streaming because of hay fever, then we would strongly advise that if antihistamines are not sufficient, that you start using a nasal spray regularly, as these drugs are usually brilliant at treating allergic noses and allergic eyes.
 
Dr Farooque & Dr Custovic: 
This is provided they are used correctly - many people do not use nasal sprays as they should be used! Nose sprays don’t work immediately, so it takes time to see results. So don’t give up if things don’t improve in a day or two – you will get there! It is also important to clear your nose before you use a nasal spray. Use salt water to clear your nose – you can buy products over the counter. This is really important or the spray cannot penetrate (after all you would not put a moisturiser on through your clothing!). Then don’t sniff after you have used the spray (if it dribbles out then dry with a tissue) or you will swallow the spray and it won’t be effective! And inhaling your snot won’t do you any favours!!!!
 
Comment From Guest 
Is Loratidine good also?
 
Dr Farooque & Dr Custovic: 
Yes it is, but different people may favour different antihistamines. NEVER use old-style antihistamines as they will make you very drowsy, affect your ability to drive safely and are associated with a drop in GCSE grades (as is untreated hay fever).
 
Comment From John 
What do you think of the idea of regularly having locally produced honey to reduce you hay fever
 
Dr Farooque & Dr Custovic: 
There's no evidence that this works so we don't routinely recommend it. We can think about why it could help, but it is a long shot!
 
Comment From Guest 
Is Fexofenadine tablets good?
 
Dr Farooque & Dr Custovic: 
Yes - see above answer regarding Loratadine.
 
Comment From Guest 
What do you mean by "old-style antihistamines"
 
Dr Farooque & Dr Custovic: 
Chlorpheniramine is the most commonly prescribed and used old-style antihistamine. It is commonly sold under the name Piriton. If buying over-the-counter, always request Cetirizine or loratadine (acrivastine lasts for 4 hours, so we do not routinely suggest it).
 
Comment From James 
How do I convince my GP to put me on immunotherapy? I've tried every pill & spray under the sun and none have worked, but the doctor seems reticent to put me forward for the jabs.
 
Dr Farooque & Dr Custovic: 
Please ask your GP to refer you to our allergy clinic at St Mary's Hospital. We will be very happy to see you, assess which pollens you may be allergic to, see if anything can be done to improve your medical treatment, and commence immunotherapy if necessary. We run the oldest immunotherapy clinic in the world, open for more than 100 years, so we have plenty of experience!
 
Comment From Sheree 
I've heard there is an injection that can protect you throughtout the hayfever season. Would you recommend this?
 
Dr Farooque & Dr Custovic: 
We are not sure if you mean allergy vaccines (which are great but which require a course of injections over 3 years) or long-lasting steroid injections. Depot corticosteroid injections e.g. Kenalog can stay in your body for a very long time. Whilst effective, they have ABSOLUTELY no place in the management of hay-fever their side-effects can be devastating– particularly osteoporosis. They weaken the bones and we have seen patients with broken bones as a consequence of receiving Depot steroids. If it is getting to the point where you need these injections, your GP should be referring you to a specialist for help.
 
Comment From Guest 
Is hay fever contagious? I’ve always had hay fever, but my husband only seemed to develop it once we moved in together!
 
Dr Farooque & Dr Custovic: 
No! But given how common it is, this is not surprising.
 
Comment From Guest 
When I get hay fever I have breathing problems at night I don't suffer from asthma...is this normal?
 
Dr Farooque & Dr Custovic: 
It is likely that you have seasonal asthma and instead of suffering alone you should see your GP. You require treatment for both your nose and your lungs.
 
Comment From Guest 
I am 50 plus. Is there any possibility that I can get hayfever at this time? Are diabetic people also affected by hay fever ? Thanks
 
Dr Farooque & Dr Custovic: 
It is unusual to develop hay fever after the age of 50, but it is certainly possible. Diabetic people are also affected by hay fever.
 
Comment From anon 
Could nutrition, non organic food (i.e foods exposed to pesticides or GMO) and immune system play a part in allergies especially sudden onsets?
 
Dr Farooque & Dr Custovic: 
Allergy is an immune-mediated disease. A number of aspects of modern life are likely to affect allergies, including diet, exposure to microbes, etc. One interesting fact is countries that have far higher levels of air pollution than we do often have less allergies than us. It probably relates to a western lifestyle and affluence.
 
Comment From Guest
What is the best over the counter remedy for a streaming nose? 
How can I tell if my daughter has an allergy or just a cold?
 
Dr Farooque & Dr Custovic: 
Timing of symptoms - colds tend to occur more frequently in September, when kids go back to school, and during the winter months.
 
Comment From May 
My 12 son suffers from eczema quite badly. I have asked doctor for an allergy test but am always refused. Surely an allergy test would be able to identify the cause. He takes an anti-histamine to help with the itching.
 
Dr Farooque & Dr Custovic: 
It is a common misconception that eczema is predominantly an allergic disease. It is likely, however, that eczema puts children at higher risk of developing allergies. One needs to be very careful when interpreting results of allergy tests in patients with eczema - both children and adults - as there may be some false positive results.
 
Comment From Guest 
What treatment do you recommend for post-nasal drip?
 
Dr Farooque & Dr Custovic: 
Post-nasal drip is caused by too much nasal mucus, or the mucus is too thick. Some people are very aware of it because of increased sensitivity. Post-nasal drip as the dominant symptom is rarely due to allergy. There are two main treatment options. The first is to rinse your nose out with a salt water preparation that you can buy over the counter. This can be very effective and has the advantage of being ''drug-free.'' The second option is to approach your GP for a spray that will dry up the nasal secretions.
 
Comment From Guest 
Are there any home remedies you’d recommend to treat hay fever?
 
Dr Farooque & Dr Custovic: 
Not really, apart from nasal douching.
 
Comment From Guest 
Is coughing a normal reaction to pollen exposure? I rarely have any other symptoms.
 
Dr Farooque & Dr Custovic: 
Coughing alone is rarely a reaction to pollen exposure. However, when combined with other allergy symptoms the possibility of seasonal asthma needs to be considered.
 
Comment From Guest 
I find loratidine doesnt work for me, why are some antihistamines better than others?
 
Dr Farooque & Dr Custovic: 
We don't know why some people respond better to one than another. We suggest you try Cetirizine or Fexofenadine.
 
Comment From Guest 
I heard that drinking nettle tea regularly helps with allergies? Is this true? Has there been any clinical evidence of this?
 
Dr Farooque & Dr Custovic: 
No, there is no evidence for this.
 
Comment From Guest 
Is a mild steroid nasal spray useful for hay fever, over an antihistamine
 
Dr Farooque & Dr Custovic: 
Nasal steroids sprays are strongly recommended in patients who have significant symptoms despite taking antihistamines and for many people the best approach is to use both. 

In practice, many people quit using nasal steroid sprays after a few days because of the lack of immediate results or only use their spray "as and when"; leading to treatment failure. Therefore, when starting a nasal steroid spray, you should factor in that it may take a week or two to really work and start using it BEFORE the pollen-season kicks in e.g. one week in advance.

Comment From Guest 
WHICH NASAL SPRAY IS BETTER FLIXONASE OR BACONASE?
 
Dr Farooque & Dr Custovic: 
Flixonase may be more potent, but the best nasal steroid spray is the one you use regularly. If you find that over-the-counter sprays are unhelpful, talk to your GP, as they will have more options to offer you.
 
Comment From Guest 
Nytol the sleeping tablet shares some ingredients with some hayfever tablets, does this mean it would also help users with hayfever ?
 
Dr Farooque & Dr Custovic: 
No, the tablet uses old-style antihistamines to put you to sleep. That's why we never advise the use of such antihistamines for hay fever.
 
Comment From Gemma 
is it true you go through cycles of seven years in your life of being allergic to things like hayfever?
 
Dr Farooque & Dr Custovic: 
We answered this early in our web chat - in short, no!
 
Comment From Guest 
I am pregnant, can I still use hayfever relief tablets-certizine or loratadine or Benadryl (Diphenhydramine)
 
Dr Farooque & Dr Custovic: 
Surprisingly, studies have shown that in pregnancy symptoms of hay fever have been reduced with three times daily nasal douching with saline! However, if medication is needed, drugs like sodium cromoglicate are the safest recommended drug in the first 3 months of pregnancy. Nasal steroids also have a place and Beclamethasone, Fluticasone proprionate and Budesonide have good safety records and are widely used in pregnant asthmatic women and could be prescribed.
 
Dr Farooque & Dr Custovic: 
I'm afraid that's all the time we had with Dr Farooque & Prof Custovic. Thanks so much for participating!