Hay Fever Treatments

Allergic rhinitis is an immune system overreaction to airborne allergens. When these substances enter the body through breathing, the immune system mistakenly identifies them as threats and releases histamine, causing sneezing, congestion, runny nose, itchy eyes, and other symptoms.

Allergic rhinitis comes in two main forms: perennial (year-round), triggered by constant allergens like dust mites, pet dander, and mould — the most common form in Thailand — and seasonal (hay fever), triggered by pollen during specific seasons.

Symptoms can be grouped by the body area they affect.

🤧 Nasal symptoms — Repeated sneezing, especially in the morning or upon allergen exposure / nasal congestion and difficulty breathing / clear, watery runny nose / nasal itching and frequent nose rubbing

👁️ Eye symptoms (allergic conjunctivitis) — Intense eye itching and frequent rubbing / red, puffy eyes with watering / gritty or sandy feeling in the eyes / light sensitivity / swollen eyelids, especially in the morning

🩹 Skin symptoms — Hives and itchy red rashes / dry, sensitive skin

😴 Other symptoms — Poor sleep due to congestion / daytime fatigue and drowsiness / headaches / reduced concentration affecting work and study

In Thailand, the most common triggers include:

🦠 Dust mites — The number one trigger in Thailand. Found in mattresses, pillows, blankets, carpets, and stuffed toys.

🌫️ PM2.5 and air pollution — A major issue in Thai cities and during the annual haze season. Significantly worsens allergy symptoms.

🌿 Pollen and grass — More common during seasonal transitions.

🐱 Pet dander — Especially from cats and dogs. The actual trigger is the animal's skin flakes and saliva, not the fur itself.

🍄 Mould and spores — Found in damp areas, bathrooms, and poorly maintained air conditioners.

🚬 Cigarette smoke, incense, chemicals, strong fragrances — Irritants that provoke allergy flare-ups.

Telfast is a second-generation antihistamine containing Fexofenadine. It works by blocking H1 histamine receptors, preventing the body from responding to the histamine released during allergic reactions.

Advantages of Telfast — Non-drowsy (unlike older antihistamines such as Chlorpheniramine, which cause significant drowsiness) / fast-acting, working within 1-3 hours / long-lasting 24-hour effect — take once daily / reduces sneezing, congestion, runny nose, nasal itching, itchy eyes, allergic conjunctivitis, and hives

Nasonex is a corticosteroid nasal spray containing Mometasone Furoate. It works by reducing inflammation directly on the nasal lining, relieving congestion, reducing discharge, and improving breathing.

Advantages of Nasonex — Considered the most effective treatment for nasal allergy symptoms according to clinical guidelines / acts locally with minimal systemic absorption, resulting in very few side effects / non-drowsy / spray once or twice daily depending on severity / full effect typically within 1-2 weeks

Correct spraying technique — Shake the bottle before use / tilt head slightly forward, insert nozzle into nostril / aim the spray outward (away from the nasal septum) / press 1-2 sprays per nostril while breathing in gently / do not blow your nose forcefully after spraying

Both have distinct strengths depending on your symptoms.

Oral antihistamine (Telfast) — Best for widespread symptoms including sneezing, runny nose, itchy eyes, allergic conjunctivitis, and hives / fast-acting, ideal for sudden flare-ups / convenient once-daily tablet

Nasal corticosteroid spray (Nasonex) — Best for persistent nasal symptoms, especially chronic congestion / more effective than oral medication for nasal congestion specifically / ideal for daily long-term use / minimal side effects due to local action

Using both together — If you have symptoms across multiple areas — nose, eyes (allergic conjunctivitis), and skin — you can use both Telfast and Nasonex simultaneously for the best results. Consult a pharmacist for an optimal plan.

Allergic conjunctivitis is an allergic reaction affecting the eyes, commonly occurring alongside allergic rhinitis. It happens when allergens contact the eye's conjunctiva, causing intense itching, redness, puffiness, watering, and a gritty sensation.

Treatment options — Oral antihistamines (Telfast) help reduce eye itching and redness / antihistamine eye drops provide targeted relief / cold compresses help reduce swelling and itching / avoid rubbing your eyes, as this worsens inflammation

See an eye specialist if — Eyes are very red with pain or blurred vision / yellow or green discharge is present (may indicate infection, not allergy) / symptoms don't improve with antihistamine treatment

Many people confuse these because symptoms overlap.

Allergic rhinitis — No fever / discharge stays clear and watery / rapid repeated sneezing / itchy nose and itchy eyes / symptoms last weeks or months / recurs in patterns when exposed to triggers

Common cold — May have low-grade fever / discharge starts clear, then turns thick yellow or green / less intense sneezing / rarely itchy eyes / resolves within 7-10 days / doesn't recur in predictable patterns

Distinguishing correctly matters because treatments differ. Allergies need antihistamines, while colds are viral and resolve on their own — antibiotics are not needed (read more about antibiotics).

Beyond medication, environmental adjustments make a huge difference.

🛏️ Bedroom — Use dust mite-proof mattress and pillow covers / wash bedding in hot water (60°C) weekly / reduce stuffed toys and carpets in the bedroom / use an air purifier with a HEPA filter

🏠 Home — Vacuum regularly with a HEPA-filter vacuum / clean air conditioners every 1-2 months / reduce indoor humidity to prevent mould growth

😷 Outdoors — Wear an N95 mask when PM2.5 levels are high / avoid going outside during peak pollen times / shower and change clothes when returning home to remove allergens

👃 Nasal irrigation — Rinsing the nose with saline solution flushes out allergens very effectively. Recommended as a daily routine.

Most allergic rhinitis can be managed with medication and lifestyle changes. However, see a doctor if:

🚨 Symptoms don't improve after 2 weeks of medication / you also experience asthma symptoms (wheezing, chest tightness) / recurrent sinusitis (facial pain, thick yellow-green discharge) / severe allergic conjunctivitis with eye pain or blurred vision / symptoms significantly impact sleep, work, or study / you want allergy testing to identify your specific triggers