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The problem with pollen

Try running a hay fever event in your pharmacy

With one in five people in the UK suffering from hay fever, it’s not surprising that this is a key pharmacy category. We sum up the latest product news and guidance

Thousands of people battle with itchy eyes, sneezing and nasal congestion every year between March and September. Over a quarter of people are more likely to cancel an engagement when suffering from hay fever, according to a recent Nelsons Pollenna survey. Similarly, just under a quarter said they would avoid outside events like barbecues, garden parties or sports events, and one in 10 even admitted that they were likely to take time off work due to their symptoms.

Most people can treat their hay fever symptoms themselves using a combination of OTC products and self-help measures, but many need advice from a pharmacist to choose the right product. “Pharmacists have a key role to play in supporting allergy sufferers and those with both seasonal and perennial hay fever symptoms to make informed choices about their treatment options,” says Holly Shaw, nurse advisor at Allergy UK. “Offering patients choice and expert advice on symptom management is key.”

So how can pharmacists promote themselves as a ‘one-stop-shop’ for hay fever products and advice? According to Max Wiseberg, owner of HayMax, pharmacists should be recommending a ‘hay fever toolkit’. “Things to include, depending on the client, would comprise a non-sedating antihistamine, steroid nasal spray, an allergen barrier balm to reduce the allergen load, and a suitable ocular remedy,” he says. “This will help the client to get a better result whilst giving the pharmacy an opportunity to sell more than one item.”

Trigger avoidance

The severity and timing of the pollen seasons vary from year to year, and it’s difficult to predict pollen counts too far in advance. To help avoid high pollen counts, pharmacy customers can keep up-to-date with the daily forecast through the Met Office or Benadryl’s free Social Pollen Count. This will make them aware of risky periods when their symptoms are likely to flare up.

Pharmacists are ideally placed to offer tips on pollen avoidance. And according to Cathy Crossthwaite, Numark’s marketing coordinator, it may be worth stocking a ‘hay fever in the home’ range. “Ensure advice is on hand about their choice of treatment, but also about making lifestyle adjustments to help them manage their symptoms, such as cleaning the home and their body regularly, understanding the pollen calendar and peak times to avoid the outdoors,” she says. “Include key household cleansing items such as Dettol Antibacterial Surface Cleanser, dust-catching cloths, etc. Consideration could be given to setting up an allergy-testing service. Or try running a hay fever event in your pharmacy. Encourage customers to come in-store to discuss symptoms and remedies with each other. They may find it beneficial to discuss their troubles with others and work out ways to try to reduce their symptoms.”

OTC medicines are the first-line treatment for hay fever, but it often takes trial and error to find the most effective. “It’s good practice for the pharmacist advising on medication choices to adopt a holistic approach, as one medication doesn’t suit all needs,” says Ms Shaw. “The age of the patient, route of administration and expense of the medication/preparation are all important factors to consider. It’s often necessary to start medication before the hay fever season has commenced, so being well prepared is vital.”

Tailored treatments

According to Bea Warner, brand manager at Omega Pharma, the best treatment is one tailored to a customer’s needs at a specific time. “Someone who has only recently been exposed to an allergen, and is not presenting with symptoms, could be recommended a barrier treatment such as Prevalin Allergy,” she says. “But someone in the early phase response, with an itchy or runny nose and/or sneezing, has the option of using an antihistamine tablet or allergen barrier or, for further relief, both together. New for 2016 is Prevalin Allergy Plus, which acts as an allergen barrier and mast cell stabiliser. It provides fast relief at the onset of allergy symptoms and can reduce sensitivity to allergens, thanks to a unique ‘anti-allergic’ oil.”

Most medication-free products can be used alongside conventional treatments. “Non-medical measures include the use of a barrier balm that can be applied around the nostrils to act as a pollen trap,” says Ms Shaw. “In addition, saline water nasal douches may be effective.”

Other medication-free options include:

  • New HayMax Kids – joins the HayMax family of organic, drug-free allergen barrier balms for the 2016 season
  • New Stérimar Stop & Protect Allergy Response nasal pump – proven to not only provide rapid and effective relief from the symptoms of allergic rhinitis, but also
    provides reinforced protection against further allergen attacks
  • The Puressentiel range of respiratory aids – ideal for hay fever sufferers who experience nasal congestion, with a natural nasal spray (directly into the nose) and respiratory air spray (in the air or on a handkerchief for inhalation).

Susanne Haar, from Nelsons Pharmacy, says there are a number of homeopathic remedies that can help to soothe hay fever symptoms, including Allium cepa and Nelsons Pollenna. “Nelsons Pollenna is a homeopathic medicinal product used within the homeopathic tradition for the symptomatic relief of hay fever and other symptoms of allergic rhinitis, such as sneezing, itchy eyes, and blocked and runny nose. It is non-drowsy and suitable for adults, the elderly and children over 12 years.”

Associated symptoms

Around 80 per cent of asthma sufferers find that pollen aggravates their symptoms. So having an up-to-date asthma management plan in place is vital to ensure asthma symptoms are well-controlled during the season. Hospital admissions for asthma peak one to three days after high pollen levels have been recorded. According to Asthma UK, too often people with asthma don’t recognise the warning signs of an attack, especially when asthma and hay fever symptoms are so similar, and both are triggered by pollen.

Some people with an allergy to pollen (especially tree pollens) may be affected by cross-reactions between their pollen allergy and particular foods. For example, they may find that when eating certain fruits, vegetables or tree nuts, especially raw, they get an itchy mouth or throat. Dr Lauri-Ann Van der Poel, consultant paediatric allergist, says she is struck by the lack of awareness of pollen food syndrome (PFS), with its typical symptoms of immediate itching and sometimes swelling of the lips, tongue, mouth and soft palate.

“However, whilst we can treat symptoms, there is currently no cure, although there is usually no need to carry an adrenaline pen for PFS alone,” says Dr Van der Poel. “Luckily, as the pollen cross-reacting proteins are broken down by cooking, patients can usually still enjoy cooked foods, symptom-free. Having an explanation for the symptoms, and understanding foods that trigger a reaction is a huge relief to patients. That’s one of the reasons I direct patients towards FoodMaestro, a simple-to-use app developed in partnership with Guy’s and St Thomas’ Trust. It puts patients in control of searching, scanning and excluding foods which can trigger food-related conditions.”

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