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Hay fever affects around one in four people in the UK and the number of sufferers is rising each year. However, 2025 is expected to be a bumper season, writes Victoria Goldman…

For some people, hay fever is merely a mild inconvenience, with occasional sneezing and a runny nose.

But many hay fever sufferers struggle with troublesome symptoms, including wheezing, nasal congestion, coughing and itchy eyes, for weeks – or even months – each year.

Severe hay fever symptoms can affect sleep, education, work and relationships, with complications including headaches, fatigue, sinusitis and ear infections.

Makes their asthma harder to control

According to Allergy UK, around 80 per cent of asthma patients also have hay fever, which makes their asthma harder to control.

Even if hay fever symptoms aren’t particularly severe, these can still be irritating and affect day-to-day activities. Therefore, effective preventative measures and treatments are essential.

“We tend to have a lot of discussions with hay fever sufferers about itchy eyes,” says Lindsey Fairbrother, the superintendent pharmacist at Good Life Pharmacy in Hatton, Derbyshire.

“This can be worrying for drivers, in particular, if they can’t focus properly. A scratchy throat is another symptom that prompts customers to ask for hay fever products, as this can affect their sleep, which in turn can affect work the next day.”

Rising pollen levels

According to the Met Office in March 2025, the tree pollen season began early this year – in February in some parts of the country – and birch pollen allergies are expected to be worse over the coming weeks.

This is largely due to warm temperatures during last spring and summer when pollen was forming on trees.

“Increasingly warmer June temperatures are occurring due to climate change, and this is particularly affecting the central regions of the UK,” says Dr Beverley Adams-Groom, senior palynologist and pollen forecaster at the School of Science and Environment, University of Worcester.

“Southern and Eastern regions are being affected much less, due to periods of cold winds in the spring that tend to reduce the amount of pollen released during the season.”

Grass pollen seasons are getting earlier each year 

It’s too early to estimate whether the grass pollen season will be significant this year, but according to the Pollen Research Unit at the University of Worcester, grass pollen seasons are getting earlier each year but not more severe.

“January temperature can be an indicator of severity, with warmer temperatures often leading to a more severe season, and vice versa,” says Dr Adams-Groom.

“Since it was quite cold in January 2025, and with the winter being on the cooler side in general, this suggests the onset will occur around average or be slightly delayed.”

Dymista Control marketing manager Charleigh Heathcote said: “As we move into peak allergy season, pharmacy teams play a crucial role in supporting patients with moderate to severe hay fever.

“For patients whose symptoms interfere with sleep, work, or daily life, it’s important for pharmacists to recognise when escalation is appropriate. Pharmacists can advise the patient of combination therapies like Dymista Control when single-ingredient treatments no longer suffice.”

She revealed the results of a new survey commissioned by Viatris Healthcare UK Ltd that highlighted the significant burden hay fever places on quality of life.

Over half (55 per cent) of sufferers reported missing key life events or commitments due to symptoms and more than a third (34 per cent) have missed workdays.

“These insights reinforce the need for proactive, evidence-based guidance at the pharmacy counter,” she said.

Pollen predictions

Pollen is very difficult to avoid, but hay fever experts recommend that patients use weather reports, websites such as the Met Office and the University of Worcester, and smartphone apps to track local pollen levels.

“People can then put measures in place to decrease their exposure to higher pollen counts,” says Dr José Costa, senior allergy consultant at www.thechildrensallergy.co.uk, “while also knowing they might need to step up their preventative medication or speak to their allergist seeking advice on how to manage worsening symptoms.”

According to the UK Health Security Agency (UKHSA) website blog in February 2024, research is looking into improving pollen forecasts by using molecular genetics that give more precise information on specific grass pollen types.

Maps being developed by the Met Office and UKHSA show the locations of key allergenic plants.

It is hoped that, in the future, more detailed source maps, along with wind direction and precipitation patterns, could be used to improve local warnings for hay fever sufferers. 

Effective pharmacy treatments

Following NHS guidance in March 2024, GPs can’t prescribe treatments for mild to moderate hay fever, which means more patients are visiting community pharmacies for symptom management.

The main over-the-counter treatments are non-sedating antihistamine tablets, corticosteroid nasal sprays and sodium cromoglicate eye drops, with increasing choice for pharmacy customers due to the launch of new products and drug-free options.

“A lot of people prefer to take antihistamine tablets but are having to supplement these with corticosteroid nasal sprays and eye drops,” says Lindsey.

“Fexofenadine 120mg was switched from POM to P a couple of years ago. We have been recommending this for people who don’t have any symptom control on loratadine or cetirizine.

“This year, there’s also a 180mg fexofenadine tablet if other antihistamines, eye drops and nasal sprays aren’t working.”

This year also sees the launch of the first over-the-counter prescription-strength nasal spray containing both a corticosteroid (fluticasone propionate) and antihistamine (azelastine hydrochloride) for moderate to severe eye and nasal symptoms. This was previously available only on prescription.

“Newer nasal sprays containing corticosteroids with antihistamines are effective for more severe hayfever and suitable for people who don’t like taking tablets,” says Dr Adrian Morris, allergy consultant at Surrey Allergy Clinic.

Some pharmacy customers prefer drug-free approaches

Some pharmacy customers prefer to use drug-free approaches – these include allergen balms and saline nasal sprays and/rinses.

“This year, some people are asking for eye wipes for allergy symptoms,” says Lindsey.

“We’re also finding that customers are interested in drug-free single-use eye drops (15 ampoules in a pack), which are particularly convenient for ‘on the go’.”

Stronger approaches

A newer generation of antihistamines (desloratadine and levocetirizine) are now available on prescription if pharmacy treatments haven’t worked.

Montelukast (a leukotriene receptor antagonist) may be prescribed to relieve hay fever in people with asthma.

If hay fever sufferers still aren’t achieving symptom relief, they may be eligible for immunotherapy – tree pollen or grass pollen extracts in the form of injections or sublingual tablets or drops placed under the tongue.

Eventually, immunotherapy may become a standard treatment for all hay fever sufferers, but at the moment it can be difficult to access on the NHS.

“The average cost of immunotherapy treatment per patient is £4,500 over three years (plus the cost for the start of treatment and follow-up appointments),” says Dr Costa.

“But if immunotherapy was made available to all eligible sufferers on the NHS, there would actually be an 80 percent saving per person versus conventional treatments over their lifetime, after the end of the treatment.

“This saving would be even greater if sublingual immunotherapy was the choice versus subcutaneous injection.”