Hay fever therapy

For hay fever therapy, medicines are available that relieve acute symptoms. Long-term efficacy is the so-called specific immunotherapy (SIT, "desensitization"). In this form of hay fever treatment, the excessive reaction of the immune system, which is typical of allergies, is permanently weakened - and with it the agonizing symptoms. Some patients also rely on alternative healing methods such as homeopathy for hay fever. Read all about hay fever therapy here.

Hay fever therapy: Symptomatic treatment

The annoying symptoms of hay fever can be alleviated in most cases with the help of drugs effectively. The drugs used to target the inflammatory messenger’s histamine and leukotriene’s, which are released as part of the allergic reaction of the

Hay fever therapy

 so-called mast cells and trigger the hay fever symptoms: hay fever drugs block the effect of the inflammatory messengers or their release from the mast cells.

The following medications are used in symptomatic hay fever therapy:

Antihistamines: Antihistamines block the docking sites (receptors) of the inflammatory messenger histamine so that it can no longer develop its effect. The drugs work very fast, usually already after about an hour. Therefore, they are suitable for the relief of existing hay fever complaints.

Antihistamines can be used for both local hay fever therapy in the form of nasal sprays (such as levocabastine) or as eye drops (such as azelastine) or as whole body tablets (such as levocetirizine, loratadine, fexofenadine). In the past, antihistamines were often tiresome, which was very dangerous especially on the road. The presented here "new antihistamines" have this side effect barely, they do not or almost not tired. However, as a precaution, doctors recommend taking antihistamines in the evening before bedtime. Their effect usually lasts about 24 hours. Antihistamines are also available without a prescription at the pharmacy.

Decongestant Nasal Sprays and Nasal Irrigations: Decongestant nasal sprays provide quick relief in hay fever when the nose is swollen. However, they should be applied for a maximum of one week. Otherwise, there is a risk that the nasal mucous membranes dry out, which can aggravate allergic reactions. In addition, decongestants can even trigger inflammation (medicated cold,).

Nasal rinses are also part of the symptomatic “hay fever therapy”: they cleanse the nasal mucosa from the pollen. Nasal sprays with saline are very convenient during the day. Much more effective, however, is the flushing of the nose with a nasal douche, which is available in drugstores and pharmacies. The allergic complaints can thus be significantly alleviated. Also, a dexpanthenol-containing ointment for the care of irritated nasal (mucus) skin is recommended.

Cortisone: Cortisone is an endogenous hormone that performs many functions in the body. For this purpose, cortisone-related substances (glucocorticoids) are used either locally (as nasal sprays) or systemically (as tablets). In the locally acting cortisone preparations (such as beclomethasone nasal spray) is hardly expected side effects. Since glucocorticoids have a very strong effect, they are usually used in hay fever therapy only for very pronounced symptoms.

Mast cell stabilizers: The drug group of the so-called Cromone "stabilizes" the mast cells so that they release no more inflammatory messengers. Mast cell stabilizers (cromoglizic acid or nedocromil) do not work immediately and also do not relieve any allergic reaction that has already occurred. Rather, they should be taken about a week before the expected pollen count. In addition, the duration of action is relatively short, which is why Cromone must be applied several times a day. Their antiallergic effect is not always sufficient, so they are often used in addition to the antihistamines in hay fever therapy. Cromones are not absorbed by the digestive system, which is why they only work locally. They are available in various preparation forms (nasal spray, eye drops, and metered-dose inhalers). Cromoglizic acid capsules also only act locally on the intestinal mucosa, as they are not absorbed.

Leukotriene receptor antagonists: This substance group blocks the action of leukotrienes (inflammatory messengers). Leukotriene receptor antagonists (such as montelukast) are mainly used in allergic asthma but are also suitable for hay fever therapy. They are available by prescription and available as tablets or chewable tablets.

Hay fever therapy: specific immunotherapy (SIT, "desensitization")

The specific immunotherapy (SIT) is currently the only option of hay fever treatment, which mitigates the mechanism of the discomfort - the excessive immune response. The procedure itself, the specific immunotherapy, is also called hay fever hyposensitization, hay fever desensitization or hay fever vaccine, because it gradually increases the immune system to the actually harmless allergens (pollen), so that it ultimately less "sensitive" to respond.

Desensitizing hay fever therapy can greatly reduce the symptoms of pollen allergy in the majority of people treated, so that either no antiallergic drugs are needed at all, or at least much less common. However, specific immunotherapy can be used not only for hay fever but also, for example, for allergies to pets or insect bites. However, their application in the context of hay fever therapy is particularly useful for three reasons:

• 1: The effect of desensitization is very good for hay fever, as several large scientific studies show.
• 2: With hay fever, it is difficult to avoid the allergy-causing substance (allergy avoidance), as the pollen often flies hundreds of kilometers through the air and those affected can hardly protect themselves from it. Desensitization can thus increase the quality of life of allergy sufferers enormously.
• 3: Meanwhile, it is believed that a hay fever after some time in allergic asthma can pass. Through the hay fever desensitization, this so-called floor changes can be avoided.

Desensitizing hay fever: how does it work?

The principle of hay fever desensitization is to introduce the allergenic substance (allergen) in an increasing dose in the body so that the immune system in a sense gets used to the allergen and it no longer fights. How exactly it comes to this habituation is not clear so far. However, the success of desensitization in hay fever is undisputed.

Basically, the allergen can be injected under the skin (subcutaneous immunotherapy = SCIT) or in the form of tablets or drops under the tongue (sublingual immunotherapy = SLIT). SCIT is considered to be more effective but also poses a greater potential for potential adverse drug reactions. If the SCIT is not possible for a variety of reasons or if the patient desires it, the SLIT will be used. For “hay fever therapy”, both methods have been proven effective.

Desensitization in hay fever: who carries it out?

Hay fever desensitization is done by specially trained physicians. Most of these are dermatologists, ear, nose and throat doctors (ENT) or internists specializing in pulmonary medicine. Treatment is usually performed on an outpatient basis in the field. In case of particularly severe allergies or for short-term treatment (see below), in-patient treatment may also be necessary. Since specific immunotherapy may very rarely lead to life-threatening allergic reactions (anaphylactic reactions), the physician must have appropriate knowledge and medicines to treat such an emergency.

Desensitizing hay fever: When and how long will it be performed?

With the hay fever desensitization, one begins a few months before the actual Allergensaison (= preseasonal) and therefore usually already in the autumn. In some cases, desensitization is also carried out throughout the year (= perennial). When exactly hypo sensitization begins depends on which type of pollen you are allergic to. The various plants release their pollen at different times of the year, which must be taken into account in this form of hay fever therapy.

In the weeks leading up to the individual allergen season, the allergens are usually given once a week in increasing doses (increasing dose) up to a maximum dose. During the actual hay fever season, the allergen is given only once a month (maintenance dose). Overall, the duration of this hay fever therapy is at least three years.