Hay fever sufferers are being warned that the condition is not just a spring problem, with specialists saying that symptoms can persist well into autumn and even winter depending on location and triggers.
Allergic rhinitis, commonly known as hay fever, is caused by the nose coming into contact with environmental allergens such as pollens, dust mites, moulds and animal dander. Despite its name, it is not caused by hay and does not cause a fever.
Ear, nose and throat (ENT) surgeon Dr Rhydian Harris of ENT Care Hub, a Doctify specialist, says many Australians underestimate how long pollen exposure can last.
“Pollination times vary depending on the plant and the region,” Dr Harris said.
“Trees typically pollinate in late winter and early spring, while grasses and weeds can flower from August through to May. In some parts of Australia, people can experience symptoms almost year-round.”
Untreated allergic rhinitis is not trivial. Dr Harris says it can lead to sleep disturbance, daytime fatigue, headaches, poor concentration and recurrent sinus or ear infections. It is also strongly linked with poor asthma control.
“We now understand allergic rhinitis as part of a unified airway disease. It’s not just a nasal issue. Ongoing inflammation in the nose can affect overall airway health,” he said, adding that one of the biggest issues he sees is incorrect or inconsistent treatment.
“The most common mistakes are over-reliance on decongestant sprays for quick relief, using steroid nasal sprays reactively instead of preventively, and stopping treatment too early because people don’t feel immediate results.”
Decongestant sprays such as oxymetazoline or xylometazoline can provide short-term relief but should not be used for more than five days.
“Overuse can lead to rhinitis medicamentosa, where the nose becomes inflamed and dependent on the spray,” Dr Harris said.
“It can result in congestion that is worse than the original problem.”
Intranasal corticosteroid sprays are considered first-line therapy but need to be used regularly and with correct technique to be effective.
Dr Harris recommends medical review if symptoms persist despite appropriate treatment or if specific warning signs occur. Red flags include:
· Symptoms lasting more than two to three months despite treatment
· Persistent one-sided nasal blockage
· Recurrent sinus infections, facial pain or pressure
· Sleep disturbance, snoring or mouth breathing
· Worsening asthma control
· Daily reliance on decongestant sprays
“These patients may benefit from formal allergy testing and discussion about long-term strategies such as allergen immunotherapy,” Dr Harris said.
Several under-recognised factors can amplify symptoms, including smoking or vaping, pets in bedrooms, drying laundry outdoors on high pollen days, open windows overnight and outdoor exposure around thunderstorms.
“These factors don’t cause hay fever on their own, but they can significantly worsen symptoms,” Dr Harris said.
He said there are some myths worth debunking including little evidence that eating local honey improves hay fever symptoms.
“Light rain can actually increase the distribution of airborne pollen fragments rather than clearing them,” he said.
He also notes that allergic rhinitis can develop at any age, including adulthood.
“You don’t have to live with hay fever,” Dr Harris said.
“For selected patients, allergen immunotherapy is a genuine long-term strategy that can reduce symptom severity and reliance on medication.”
Practical steps that help include:
· Using saline nasal rinses before steroid sprays
· Showering and changing clothes after outdoor exposure
· Keeping pets out of bedrooms
· Washing bedding weekly in hot water
· Using HEPA air purifiers in bedrooms
· Elevating the head slightly during sleep
“These measures don’t replace medication, but they can significantly improve symptom control and sleep quality,” Dr Harris said.
