Start before the pollen, not after

Spring hasn't arrived yet. That is exactly the point.

Hay fever writes off a few weeks of the year for a lot of people. Sneezing, a blocked nose, eyes that won't stop watering. The most useful thing you can do about it happens now, before the pollen is in the air.

More common than most people assume

Allergic rhinitis is the proper name for hay fever. It affects around 18% of people across Australia and New Zealand, children and adults alike. That figure comes from the Australasian Society of Clinical Immunology and Allergy (ASCIA), the peak body for allergy specialists in both countries.

Despite the name it isn't caused by hay and it doesn't cause a fever. It happens when the nose and eyes meet something in the environment they react to. Pollen from grasses, trees and weeds is the obvious one. Dust mite, mould spores and animal dander do it too.

The symptoms ASCIA lists will be familiar to anyone who gets it: sneezing, an itchy or runny nose, itchy and watery eyes, an itchy throat or a constant need to clear it, and a blocked nose that can lead to mouth breathing and snoring.

They also overlap almost completely with a cold. The difference is that a cold clears on its own. Allergy symptoms tend to keep going unless they are treated properly.

Timing matters more than the medication

For seasonal hay fever the most useful change most people can make is when they start treatment rather than what they take.

ASCIA recommends intranasal corticosteroid sprays as first-line treatment, either alone or combined with an antihistamine. These are the preventer sprays. They behave like an asthma preventer rather than a painkiller. Allergy & Anaphylaxis Australia advises that it takes about a week of daily use before they start working and that they don't work if they aren't taken every day.

Which is why waiting for the first sneeze is the wrong strategy. For people whose symptoms arrive only in pollen season, Allergy & Anaphylaxis Australia advises starting the daily spray in the weeks before the season begins and continuing through it. It puts that season at roughly September to December in Australia. ASCIA notes that the grasses responsible across southern Australia mainly flower from October to December.

Antihistamines still have their place. They work well on sneezing and itchy eyes and can be taken as needed rather than daily. They are less effective against a blocked or runny nose.

Two cautions are worth knowing. Decongestant sprays shouldn't be used for more than a few days at a stretch. Used longer they can make congestion worse rather than better. Decongestant tablets can raise blood pressure, so anyone diagnosed with hypertension should check with a doctor or pharmacist before taking them. Saline sprays and rinses are safe by comparison and help clear allergens from the nose.

The asthma connection

Hay fever and asthma are more closely linked than most people realise. ASCIA's clinical update for health professionals describes them as upper and lower airway expressions of the same inflammatory process. It reports that 20 to 30% of people with allergic rhinitis also have asthma, and that 50 to 80% of people with asthma also have allergic rhinitis.

Left untreated, allergic rhinitis increases the risk of developing asthma and means more frequent symptoms for people who already have it. ASCIA's advice for anyone who wheezes during spring or summer is to see their doctor. Keeping both under control matters more than treating either one on its own.

Pollen counts tend to be worse on hot windy days and after thunderstorms, and better in wet weather.

When it's worth a conversation

Most hay fever is managed well without ever seeing a specialist. That matters in a district where specialist appointments mean travel. Mild symptoms that don't interfere with your day can often be sorted with pharmacy advice and the right spray, used properly and started early enough.

The line ASCIA draws is symptoms that affect day-to-day function: broken sleep, daytime tiredness, headaches, trouble concentrating. Past that point, allergy testing to identify the specific trigger may be worthwhile. That is where a referral to a clinical immunology or allergy specialist comes in. For severe allergic rhinitis there is also allergen immunotherapy, a long-term treatment that usually runs three to five years and would need a specialist to start it.

If last spring was a write-off, this is the fortnight to do something about the next one. Book a check-up and bring along whatever you've tried before, including the things that didn't work.

Source

Australasian Society of Clinical Immunology and Allergy (ASCIA), Allergic Rhinitis (Hay Fever) patient information, content updated February 2024. Allergic Rhinitis Clinical Update, 2024. Pollen Allergy, content updated February 2024. All at allergy.org.au. Allergy & Anaphylaxis Australia, Allergic rhinitis (hay fever) management and treatment, updated October 2025, at allergyfacts.org.au.

This article is general information and is not a substitute for individual medical advice. If hay fever is affecting your sleep, work or breathing, please make an appointment to discuss it.