Hay fever can look trivial from the outside, but it can cause miserable sleep, poor concentration, itchy eyes, blocked nose, coughing, fatigue and asthma flare-ups. The good news: most people can get much better control with the right plan.
Quick Answer
Start treatment early, use it regularly during your season, and match the treatment to the symptoms: tablets for itch/sneeze/runny nose, nasal sprays for blocked or inflamed nose, and eye drops for itchy watery eyes.
Non-medicine steps still matter. Read the companion quick note: Hay fever without medicines: simple things that help.
Why Won't My GP Just Prescribe Something?
In many parts of the UK, GPs are advised not to routinely prescribe medicines that are available to buy over the counter for short-term or self-limiting conditions, including hay fever.
This does not mean hay fever is not real. It means the first step is usually advice from a pharmacist and using over-the-counter treatment correctly. A GP review is still appropriate if symptoms are severe, treatment is not working, asthma is affected, symptoms are unusual, or there are extra considerations such as pregnancy, young children or other medical conditions.
The Treatment Ladder
Reduce pollen exposure
Use pollen forecasts, sunglasses, petroleum jelly around nostrils, showering after outdoor exposure and bedroom pollen control.
Antihistamine tablets
Useful for sneezing, itching and runny nose. Common non-drowsy options include cetirizine, loratadine and fexofenadine.
Nasal steroid spray
Often the key treatment for blocked nose and nasal inflammation. It works best when used every day and started before symptoms peak.
Eye drops
Antiallergy eye drops can help itchy, watery or gritty eyes. Avoid contact lenses if eyes are very irritated unless advised otherwise.
Nasal Spray Technique Matters
Nasal sprays often fail because they are used too late, too occasionally, or sprayed straight onto the middle wall of the nose.
Keep your head gently tilted forwards rather than back.
Use the opposite hand for each nostril and aim towards the ear, away from the centre of the nose.
Steroid sprays need regular use and can take several days to build their full effect.
What If Standard Antihistamines Are Not Enough?
Standard adult doses commonly used for hay fever include cetirizine 10mg once daily, loratadine 10mg once daily or fexofenadine 120mg once daily. Always check the packet and ask a pharmacist if you are unsure, especially for children, pregnancy, breastfeeding or other medicines.
In practice, if standard doses are not enough, clinicians sometimes advise a higher or twice-daily dose of a non-drowsy antihistamine for a short period. This can include medicines such as cetirizine, loratadine or fexofenadine. This is off-label for hay fever, so it is usually discussed in the context of the person's symptoms, medical history and other medicines.
What About The Hay Fever Injection?
You may see private clinics advertising a hay fever injection, often referring to Kenalog, which is a long-acting steroid injection called triamcinolone.
This is not routinely offered in NHS general practice for hay fever. The main reason is that it gives a whole-body steroid dose that can last for weeks. Unlike a nasal spray, it is not targeted just at the nose, and once it has been given it cannot simply be stopped if side effects occur.
Steroid injections can affect blood pressure, blood sugar, mood, sleep, infection risk, bones, eyes and the body's own steroid system. For most people, safer and more targeted options are preferred: pollen reduction, antihistamines, nasal steroid sprays, eye drops, and sometimes specialist immunotherapy for severe cases.
If you are considering paying privately for a hay fever injection, it is worth asking exactly what medicine is being offered, whether it is licensed for hay fever, what the risks are for you personally, and whether asthma, pregnancy, diabetes, glaucoma, infection risk, mental health history or other medicines have been considered.
Common Mistakes
Starting too late
If you know your season, start early rather than waiting until symptoms are raging.
Only using tablets
If your main problem is a blocked nose, a nasal steroid spray may be more useful than changing tablets again.
Stopping too soon
Many treatments work best when used consistently through the pollen season.
Ignoring asthma
Hay fever can worsen asthma. Wheeze, chest tightness or breathlessness deserves review.
When Should I Ask For Help?
Speak to a pharmacist if over-the-counter treatment is not working, you are not sure what to choose, or you need advice for a child, pregnancy, breastfeeding or other medicines.
Ask for GP help if symptoms are severe, persistent despite good treatment, affecting sleep or work significantly, causing sinus or ear problems, linked with wheeze or breathlessness, or if you are needing asthma reliever inhalers more often.
Very severe hay fever that does not respond to usual treatment may sometimes need referral for specialist allergy advice or immunotherapy.
Five Things To Remember
- Hay fever treatment often works best when started early and used consistently.
- Pharmacists are usually the first port of call because most treatments are available over the counter.
- Nasal steroid sprays are often the missing piece for blocked or inflamed noses.
- Eye drops can be added if eyes are the main problem.
- Hay fever and asthma are linked, so wheeze or breathlessness needs review.
Dr Mel's Notebook
Did you know?
The best hay fever plan is usually not one magic tablet. It is matching the treatment to nose, eye and chest symptoms.
Try this today
If you use a nasal spray, check your technique: head slightly forward, aim outwards, and use regularly.
The evidence
NHS advice recommends speaking to a pharmacist first. NHS England guidance supports self-care for hay fever because many treatments are available over the counter.
Useful Sources
NHS England: Over-the-counter items not routinely prescribed in primary care
emc: Kenalog Intra-articular / Intramuscular Injection Summary of Product Characteristics
Last updated: 10 July 2026