Diagnosis & Specialist Care of Allergy & Clinical Immunology - Since 1982
About Symptomatic Medication
When it comes to managing allergy symptoms, symptomatic medications such as antihistamines and steroids are often highly effective when used correctly. However, the key to success lies in understanding how and when to use these treatments to maximise their benefits.
Timing and Proper Use
For example, if you suffer from seasonal allergies like hay fever, starting a topical nasal steroid spray 2-3 weeks before the pollen season begins can significantly reduce your symptoms. It’s not just about taking medication when you start to feel symptoms; it’s about planning ahead and using the medication consistently for the best results.
Antihistamines: Finding What Works for You
Antihistamines are a common and reliable option for treating allergies. However, different antihistamines can have different effects, and it’s important to find the one that works best for you.
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There are two main types of antihistamines: sedating and non-sedating.
Sedating Antihistamines
These can be beneficial if your allergy symptoms are disrupting your sleep, as they can help you rest. However, they may cause drowsiness during the day, which makes activities like driving, cycling, or operating machinery unsafe.
Non-Sedating Antihistamines
These newer antihistamines, such as loratadine, cetirizine, and fexofenadine, are less likely to cause drowsiness, making them more suitable for daytime use. However, it's important to note that individual responses to these medications can vary. Some people may still experience some level of sedation even with non-drowsy options.
Most antihistamines can pass into breast milk, so if you’re breastfeeding, it’s best to consult with your healthcare provider before starting any antihistamine treatment.
Steroids: Powerful but use with caution
Steroids are another powerful tool in the treatment of allergies, available as nasal sprays for daily use or perhaps a prescription for a short course of high dose treatment following a severe flare up.
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Nasal Steroid Sprays: These are generally low-dose and are very effective when used regularly to prevent symptoms from developing, particularly during allergy seasons.
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High-Dose Steroid Tablets: These are typically reserved for more severe allergy symptoms, such as flare-ups of urticaria (hives), angioedema (swelling), or intense hay fever. While effective, long-term use of high-dose steroids is not recommended due to the risk of serious side effects.
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​​Some patients request steroid injections like the Kenalog injection for hay fever, but this is not recommended. In fact, Kenalog was discontinued as a hay fever treatment by the NHS in 2018 due to its side effects and the lack of evidence regarding its long-term efficacy. Kenalog injections are not a licensed treatment for hay fever in the UK.
Alternatives When Antihistamines Aren’t Enough
While antihistamines are often the first line of defence against allergies, they aren’t always sufficient. In such cases, there are other options:
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Immunotherapy (Desensitisation): This long-term treatment can help reduce the severity of allergic reactions over time by gradually desensitising the immune system to the allergen.
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Omalizumab Therapy: This treatment is used for chronic urticaria and angioedema when antihistamines fail to control symptoms.