Sometimes the season starts as early as mid-April; other times it’s slower to get going. But for Lisa Ventura, June is consistently the cruellest month. “I might get lulled into a false sense of security: ‘Oh, it’s the end of May, it hasn’t started yet’,” she says in a heavy tone. “Then, as if on cue, it’s June the first – and bang.”
Ventura suffers from “debilitating” hay fever. For about three months from early May, she cannot be outside for more than a few minutes before she starts sniffing and sneezing. “When it’s really bad, my eyes look like I’ve gone 10 rounds with a boxer – they are that swollen,” says Ventura.
Summers have been challenging for as long as she can remember. Ventura recalls sitting her GCSEs, taking two antihistamines before an exam, and still “sniffing and sneezing” her way through. “I had the humiliation of being pulled out of the exam hall and placed into a room on my own because, and I quote, I ‘couldn’t be disturbing the other candidates’ – but I couldn’t help it.”
Now Ventura works from home, as a cybersecurity specialist in Worcestershire. But managing her hay fever remains challenging. Antihistamines either make her too drowsy to function, or are incompatible with medication she must take daily to manage her risk of glaucoma. “It’s not as if you can get away from it,” Ventura says. “The pollen is in the air, all around us.”
Hay fever, also known as seasonal allergic rhinitis, is believed to affect 10-15% of children and at least one in four adults in the UK. Perhaps because it is so common, it can be dismissed by non-sufferers as a few summertime sniffles.
“It is taken as a bit of a triviality – but it really affects your quality of life, your sleep, your wellbeing, your concentration and mood,” says Sheena Cruickshank, an immunologist and professor in biomedical sciences and public engagement at the University of Manchester.
Hay fever can also be a risk factor for the development of asthma and other allergies. For many people, the experience is said to be getting worse, driven by the changing climate, land use and increasing individual sensitivity. A 2020 survey by the charity Allergy UK and Kleenex found that 37% of respondents had developed hay fever symptoms for the first time in the last five years.
A large study co-authored by Cruickshank in 2023 found that people living in urban areas experienced symptoms that were roughly twice as severe as those living in rural ones. Higher temperatures and pollution were both relevant, says Cruickshank.
Ventura has noticed the impact of changing weather conditions, not just temperature but also wind and humidity, on her hay fever: “Every year, you just don’t know what it’s going to be like.” Some summers have been so bad, she has had to carry an inhaler.
The impact goes beyond mere discomfort. More than half of hay fever sufferers in the UK say it negatively affects their sleep, with repercussions for wellbeing, mood and performance (and attendance) at work or school. A 2007 study found that students who sat an exam with hay fever symptoms were 40% more likely to drop a grade from their mock results – and 70% more likely after taking antihistamines with a sedative effect. There is also a well-established link between hay fever and anxiety and depression. The physical inflammation associated with those mood disorders increases the intensity of the allergic reaction and vice versa, creating a vicious cycle.
For some, the condition is life-threatening. One eight-year-old from Chesire, featured in HufPost in April 2023, had been hospitalised 15 times since 2019 with severe asthma; the initial trigger had been hay fever. His mother said she had had to give up work to manage her son’s symptoms: “When pollen levels are high, it can be too dangerous for him to leave the house.”
At its most severe, hay fever can cause anaphylactic shock, a life-threatening allergic reaction. According to Allergy UK, hospital admissions for allergies and anaphylaxis more than doubled in the 20 years between 2002-3 and 2022-23; the increase in planting birch trees was flagged as one contributing factor.
The intricacies of the immune system means that one sensitivity can also develop into, or trigger, another. Having “always had hay fever”, Rebecca Usher had her first anaphylactic shock aged 22. Tests revealed that she had become allergic to a range of foods including fruits and vegetables, soya, legumes, peanuts, tree nuts, fish and crustaceans. “I had no history of allergy to anything,” says Usher, now 29, from Dorset.
Over the next three to four months, Usher had a further 20 episodes of anaphylactic shock, which persisted even after she overhauled her diet. She was eventually diagnosed with idiopathic anaphylaxis (meaning occurring without a trigger), asthma and oral allergy syndrome.
Also known as pollen food syndrome, this is a hypersensitivity to the protein structure of many fruits, vegetables and nuts that the body mistakes for pollen. Allergy UK estimates that the “relatively common” condition affects about 2% of adults in the UK, who often also have hay fever.
In most cases of oral allergy syndrome, the effects are limited to an itchy or tingly mouth after eating, which passes without treatment. For Usher, primed to go into shock, a missed ingredient could be fatal. “Even leaving the house, or my heart rate being elevated, could lead to anaphylaxis,” she says.
As well as taking antihistamines twice daily, she carries epipens, along with over-the-counter remedies such as eye drops, eye spray, nasal spray, a fan and a personal oxygen saturation monitor. Managing her triggers is particularly challenging when the tree, grass and weed pollen seasons start at different times of year. “By the time you’ve got over one, another is just around the corner,” Usher says. “It’s a constant change between symptoms.”
The social repercussions through the summer months in particular are profound. Often, Usher will conclude that eating out or travelling to an unfamiliar environment is “just not worth the hassle”, she says. Her friends are understanding, “but it still kind of sucks, as a 29-year-old”.
Worse is the dismissiveness and even scepticism of allergy sufferers out in public, Usher says. Hay fever “is seen as a very trivial issue: you’ve got a runny nose, take an antihistamine and get on with your day,” she says. “Nine times out of 10, when I disclose my allergies, the question is ‘How serious is it?’ – serious enough that I’ve got three epipens on me? … It’s a constant mental toll.”
Allergy UK has pointed to the rise in serious allergies as evidence of the need to prioritise research, treatment and care. It has called on the government to develop a national allergy strategy and appoint an “allergy tsar”.
Cruickshank says UK allergy sufferers are being failed by the national shortage of clinical immunologists in particular. “People aren’t necessarily getting the specialist advice that they need to monitor their allergy and help them manage it effectively,” she says. “It’s incredibly under-resourced, for such a common, chronic condition.”
For Ventura, who has had hay fever all her life, the costs are both small and great. “For example, I’d love to sometimes sit outside with a beer, and take in the sun,” she says, wistfully. Ventura has only ever been able to manage it for about five minutes before her symptoms kick in. “Then I’ve got to retreat inside.”
