Hay fever (allergic rhinitis): symptoms, triggers and treatment
What allergic rhinitis is, the dust, pollen and mould triggers common in India, how allergies are tested, and the sprays and treatments that work.
Also known as: Allergic Rhinitis; Pollen Allergy; Seasonal Allergies
What hay fever is
Hay fever is the everyday name for allergic rhinitis — inflammation of the lining of the nose caused by an allergy. When someone with allergic rhinitis breathes in a trigger such as pollen or house dust mite, the immune system overreacts and releases chemicals such as histamine, causing sneezing, a runny or blocked nose and itchy eyes.
It can be seasonal, flaring when particular plants release pollen, or perennial (year-round), usually from indoor triggers such as dust mites, mould, cockroaches or pets. Despite its name, hay fever does not cause fever and has nothing to do with hay. It is not dangerous, but it can disturb sleep, concentration, school and work, and it often goes with asthma, eczema and sinus problems.
Symptoms
- Sneezing, often in bouts, especially in the morning
- Runny nose with clear, watery mucus
- Blocked nose, mouth breathing and snoring
- Itchy nose, throat, ears or roof of the mouth
- Itchy, watery eyes that may look red or puffy
- Postnasal drip, throat clearing and cough
- Tiredness and poor concentration from disturbed sleep
Children may rub their nose upwards repeatedly (the 'allergic salute') and develop a crease across the nose and dark circles under the eyes. Unlike a cold, symptoms last for weeks or recur at the same time each year, and there is no fever or body ache.
Triggers and who is at risk in India
- House dust mites in bedding, mattresses, carpets and soft toys — the commonest year-round trigger
- Pollen from grasses, weeds and trees, including the invasive weed Parthenium (congress grass) in many regions
- Mould in damp homes, especially during the monsoon
- Cockroaches and pet dander
- Irritants that make symptoms worse: smoke, incense, mosquito coils, perfumes, traffic pollution and dust
- A family history of allergy, asthma or eczema
How it is diagnosed
Allergic rhinitis is usually diagnosed from your symptoms and an examination of the nose. Tests can confirm what you are allergic to, which helps with avoidance and with immunotherapy:
- Skin prick test — tiny drops of common allergens are pricked into the skin of the forearm; a raised itchy bump within minutes shows sensitivity. Antihistamines must be stopped for a few days beforehand, on your doctor's advice.
- Specific IgE blood test — measures antibodies to particular allergens, useful when skin testing is not possible.
- Nasal endoscopy — a thin camera to look for polyps, a deviated septum or sinus disease if symptoms are severe or one-sided.
A positive test shows sensitivity but must match your symptoms to be meaningful. Your doctor will also ask about asthma symptoms, because the two often go together.
Which doctor to see
Mild hay fever can be managed by a general physician or an internal medicine physician. An ENT surgeon helps with persistent blockage, polyps, a deviated septum or sinus problems. Allergy testing and immunotherapy are offered by allergy specialists, ENT surgeons, pulmonologists and some physicians.
You can find ENT surgeons in Bengaluru or internal medicine physicians in Bengaluru on The Doctor Index, each with a registration you can check.
Treatment
- Allergen avoidance — covering mattresses and pillows with mite-proof covers, washing bedding weekly in hot water, reducing damp and mould, keeping pets out of the bedroom, and keeping windows shut on high-pollen days.
- Steroid nasal sprays — the most effective treatment for regular symptoms, especially blockage. They take several days to work fully and are used daily during the season or all year. They are safe for long-term use in the doses prescribed.
- Antihistamines — tablets, syrups or nasal sprays that reduce sneezing, itching and runny nose. Newer types cause less drowsiness than older ones.
- Saline nasal rinses — rinsing the nose with salt water, made with boiled and cooled or sterile water, washes out allergens and mucus.
- Anti-allergy eye drops for itchy eyes, and other tablets your doctor may add if needed.
- Allergen immunotherapy — gradually increasing doses of the allergen, as injections or tablets or drops under the tongue, over three years or so, to make the immune system less sensitive. It is for people with confirmed allergy whose symptoms are not controlled by other treatment.
Decongestant nasal sprays bought over the counter clear the nose quickly but, used for more than a few days, cause rebound blockage that is hard to stop. Long-acting steroid injections for hay fever are not recommended because of side effects. Do not stop prescribed sprays without advice.
Living with hay fever
- Start your nasal spray a couple of weeks before your usual season begins
- Learn the right spray technique: head slightly forward, aim away from the middle of the nose
- Shower and change clothes after time outdoors on high-pollen days
- Wear wraparound sunglasses to protect the eyes
- Treat asthma symptoms if you have them — controlling rhinitis helps asthma too
When it is an emergency
Hay fever itself is not an emergency. Call 112 or 108, or go to the nearest emergency department, if you develop:
- Wheezing, breathlessness or chest tightness that your inhaler does not relieve
- Swelling of the lips, tongue or throat, or difficulty swallowing
- Widespread hives with dizziness or fainting — possible anaphylaxis
Questions to ask at your appointment
- Is this allergic rhinitis or something else?
- What am I allergic to, and do I need tests?
- How should I use my nasal spray, and for how long?
- Which antihistamine will not make me drowsy?
- Could I have asthma as well?
- Am I a candidate for immunotherapy?
Common questions
Questions people ask
- Is it safe to use a steroid nasal spray every day?
- Yes, for most people. Very little steroid from nasal sprays enters the body, which is why they are used long term for allergic rhinitis, including in children at appropriate doses. Your doctor will review whether you still need them and check for nosebleeds or irritation.
- Can allergic rhinitis be cured?
- It cannot usually be made to go away for good, but symptoms can usually be controlled well. Allergen immunotherapy can reduce sensitivity to specific allergens for years after a course is completed. Some children's allergies improve as they grow, while others continue into adulthood.
- Is allergic rhinitis linked to asthma?
- Yes. Many people with allergic rhinitis have asthma or develop it, and uncontrolled rhinitis can make asthma worse. Treating the nose well often helps asthma control. Tell your doctor if you have cough, wheeze or breathlessness.
- Are allergy injections from a local clinic safe for hay fever?
- Allergen immunotherapy given by a trained specialist after proper testing is safe and effective. Single long-acting steroid injections for hay fever, sometimes offered as quick fixes, are not recommended because of side effects such as high blood sugar and bone thinning.
This condition is usually assessed by an ENT surgeon. Every profile shows the doctor’s registration and what has been checked.
ENT surgeons in Bangalore
A few ent surgeons listed on The Doctor Index. They are shown because of their speciality, not a stated interest in Hay Fever; ask the clinic whether the doctor sees it.
Related conditions
All allergy and immunology conditions →
Practical reading
All postsSources
- MedlinePlus, US National Library of Medicine — Hay Fever
- American College of Allergy, Asthma and Immunology — Hay fever
- MedlinePlus, National Library of Medicine — Hay Fever — Public-domain health-topic summary
- Human Phenotype Ontology Consortium — terminology definitions — HPO licence; definitions reproduced without alteration
Hay fever (allergic rhinitis): symptoms, triggers and treatment is original text by The Doctor Index; the compiled source draft was used for research. Source: MedlinePlus, National Library of Medicine. Orphadata Science: Free access data from Orphanet. © INSERM 1999; July 2026 data, CC BY 4.0. This product uses the Human Phenotype Ontology (hp/releases/2026-09-01). Only sources listed for this article apply. Source material has been selected and arranged; HPO definitions are reproduced without alteration. No source organisation endorses this compilation. Köhler S et al. The Human Phenotype Ontology project: linking molecular biology and disease through phenotype data. Nucleic Acids Research 2014;42(D1):D966–D974. doi:10.1093/nar/gkt1026.
General information, not advice about your situation. Errors can be reported through the corrections process. Reference TDI-C-1081.