Hay Fever

Hay fever (allergic rhinitis) is an allergy that causes sneezing, a runny, itchy or blocked nose, and itchy, watery eyes. Triggers include grass and tree pollen (worst in spring and early summer), dust mites, mould and pets. It affects about 1 in 5 Australians. It can also trigger thunderstorm asthma, even in people without asthma.

Treatment options

Ratings show how strong the research is.

• Strong evidenceSteroid nasal spraysSuch as budesonide (Rhinocort), fluticasone (Flixonase) or mometasone (Nasonex). The most effective treatment, especially for a blocked nose. Use daily; full effect takes a few days.
• Strong evidenceCombination nasal spraysA steroid plus an antihistamine, such as azelastine with fluticasone (Dymista). Works better than either alone.
• Strong evidenceAllergen immunotherapy (desensitisation)Tablets or drops under the tongue, or injections, for 3 to 5 years. Reduces symptoms and medicine use for years afterwards. For proven allergy not controlled by sprays. Started by an allergy specialist.
• Moderate evidenceNon-sedating antihistaminesSuch as cetirizine, loratadine or fexofenadine. Help sneezing, itch and watery eyes, but do little for a blocked nose. Antihistamine eye drops also help.
• Limited evidenceSalt-water (saline) sprays or rinsesSafe and cheap. They wash pollen out and may ease symptoms.
• Limited evidenceDecongestantsNasal sprays (such as oxymetazoline) work fast, but after 3 days the nose gets more blocked. Tablets (such as pseudoephedrine) can raise blood pressure.
• Limited evidenceMontelukastLess effective than steroid sprays. Can cause mood and sleep changes.
• Not recommendedSedating antihistaminesSuch as promethazine or dexchlorpheniramine. Next-day drowsiness affects driving, work and learning.
• Not recommendedSteroid injections or courses of steroid tabletsSuch as a "hay fever injection". Risks include weakened bones, raised blood sugar and mood changes, and safer treatments work.
• Not recommendedUnproven allergy testsIgG food tests, kinesiology, hair analysis and Vega testing are unreliable.

What you can do

• Check pollen counts and thunderstorm asthma forecasts in spring. Stay indoors with windows closed before and during storms on high-pollen days.
• Start your steroid spray a couple of weeks before your usual season, and keep using it daily.
• Wear wraparound sunglasses outside, and shower after time outdoors.
• For dust mites: wash bedding weekly in hot water and use mite-proof covers.

See your GP if

• Symptoms aren’t controlled after a few weeks of daily steroid spray
• You have a cough, wheeze or tight chest, especially in spring: you may have asthma
• You have a blocked nose on one side only, nosebleeds, or loss of smell
• You’d like allergy testing or to ask about immunotherapy

Call 000 for trouble breathing, wheeze or a tight chest that isn’t quickly relieved by a reliever puffer. Thunderstorm asthma can start fast during or after a spring storm, even if you’ve never had asthma. If you have asthma, take your preventer every day through pollen season and always carry your reliever.

Evidence and more information

• ASCIA: Allergic rhinitis (hay fever)
• ASCIA: Allergic rhinitis treatment plan
• National Asthma Council: Thunderstorm asthma
• Healthdirect: Hay fever

Reviewed October 2026. General education, not personal medical advice. Treatment depends on your situation, so talk to your GP or pharmacist.

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