Surviving SA’s Peak Pollen Season: Antihistamine and other Hay Fever Treatments

hay fever

If you’re suffering from sniffles, snuffles and itchy, burning eyes – you are not alone. Around the world, a higher percentage of people are affected by hay fever than ever before.

Here we consider why this is the case. We also outline what hay fever treatments are available if you’re among the many South Africans struggling with allergies this spring.

Global warming linked to higher pollen production

According to scientists, global warming is one factor behind the rising incidence of seasonal allergic rhino-conjunctivitis, allergic rhinitis or – as it’s more commonly known – hay fever.

Rising temperatures and high levels of CO2 mean that plants, grasses and trees are growing bigger and faster. As a result, they’re producing more pollen – and that’s bad news for allergy sufferers.

According to Cape Town scientists, pollen counts are likely to quadruple over the next 20 to 30 years.

In the Cape: Heavy rains equate to a high pollen count

In the Cape, a severe drought followed by heavy winter rains have resulted in a “bumper” hay fever season.

The pollen count is the highest it has been in over a decade.

Hay fever treatments in South Africa

Hay fever treatments aren’t likely to eliminate all your hay fever symptoms overnight. However, prescribed and over-the-counter medicines, along with some practical DIY measures, can provide relief and help keep symptoms manageable.

Antihistamines for hay fever

Antihistamines are available as tablets, nasal sprays and eye drops. They neutralise the effects of histamine. It’s this chemical that’s released during an allergic reaction.

Histamine triggers the typical hay fever symptoms – a runny nose, scratchy eyes and irritated throat. Inhibiting the production of histamine helps prevent the onset of hay fever symptoms.

Antihistamines work best if you start taking them about four weeks before pollen season starts.

Drowsy versus non-drowsy antihistamines

Older antihistamines, such as diphenhydramine (the antihistamine in benedryl), phenergan and chlorpheniramine, cause drowsiness.

Newer “non-drowsy” antihistamines are less likely to make you sleepy. Popular examples are:

  • loratadine
  • cetirizine
  • fexofenadine.

All antihistamines can have side effects and may interact with other medications. It’s best to speak to your GP or a pharmacist so you can make an informed choice.


Nasal decongestants are useful for clearing blocked, stuffy noses. However, you shouldn’t use them for more than seven days in a row.

Use them for too long and you may experience rebound congestion.

For hay fever sufferers, an over-the-counter decongestant is useful for clearing the nose before using a nasal corticosteroid spray. Then the corticosteroid spray can penetrate better.

Nasal corticosteroid spray for hay fever

A nasal corticosteroid spray is one of the most effective ways to treat the streaming nose associated with hay fever. It reduces inflammation and congestion.

You’ll need a prescription. Also, it can take a week or so of use before you notice the benefits.

An example of a widely used steroid treatment for hay fever is fluticasone. This is the key ingredient in the nasal spray sold as Flonase.

Oral corticosteroids for hay fever

Hay fever symptoms can become severe. If they interfere significantly with your day-to-day activities, especially over a long period, a doctor might prescribe an oral corticosteroid.

This can calm your immune system and reduce or even get rid of allergic symptoms.

However, oral corticosteroids can also have very serious side effects if used long term. Used for three months or longer, these can include osteoporosis, high blood pressure, diabetes, glaucoma, and thinning of the skin, among others.

Specific immunotherapy for hay fever

Immunotherapy, or hay fever shots, involve gradually exposing the body to small amounts of the allergens that cause allergic reaction. Over time, your body then develops a tolerance to the allergens.

Immunotherapy doesn’t always work and, even when it does, it involves a long process. Typically, it takes three years or so before the best results are achieved.

Conventional immunotherapy involves being given small doses of one allergen at a time, usually at three-monthly intervals.

A vaccine for hay fever?

Potentially good news for hay fever sufferers is a single shot, or hay fever “vaccine”, that is having promising results.

The “vaccine” takes the form of a cocktail of six common allergens.

Administered in increasing dosages over a period of several weeks, it acts in the same way as immunotherapy. However, it targets multiple allergens at once.

Natural hay fever treatments

People swear by a wide range of different natural or homeopathic hay fever treatments, some more effective than others.

Peak hay fever season lasts for many weeks, so it’s certainly worth experimenting with safe alternatives to pharmaceutical remedies.

Two of the best natural hay fever treatments:

  • use a saline nose spray or flush the nose with a saline solution – this helps dry out mucous and clears out allergens
  • try butterbur – a herbal alternative that compares favourably to antihistamines in scientific studies; it’s the active ingredient in Petadolex.

Sadly, it appears to be a myth that locally sourced honey can help cure hay fever.

Along with using hay fever treatments, take steps to reduce your exposure to pollen. For example:

  • when possible, stay indoors during peak pollen times (mid-morning and early evening)
  • shower after you get in from outdoors
  • consider investing in air conditioning; modern air conditioners filter most allergens out of the air they direct into a room
  • when symptoms get really bad, wear a surgical face mask for a period; some sufferers swear by this simple strategy.

Do medical aid schemes in South Africa cover hay fever medicines?  

If you’re subscribed to a medical aid option with a savings component, the scheme will usually cover day-to-day medical expenses, like hay fever treatments, from your available savings.

Among the leading medical aid providers in South Africa that include plans with savings options are Discovery Health, Bonitas, Fedhealth, Medshield, Genesis, Liberty, Ingwe, Momentum, Resolution Health and Health Squared.

At IFC, we offer informed, objective advice about South African medical aid schemes, and can assist you in joining the scheme that best suits your needs and budget. Contact us for more information or to discuss your needs.