In hay fever, allergens enter the body primarily via the mucous membranes of the nose and throat. The body therefore sensitizes antibodies at the corresponding sites. This leads to the development of the symptoms typical of allergic rhinitis. It is therefore a defensive reaction of the body.
Allergic rhinitis does not usually occur alone. It is often accompanied by other respiratory diseases, e.g. inflammation of the sinuses or asthma. In addition, allergenic substances can enter the eyes and trigger conjunctivitis.
Like 90 percent of all allergic reactions, grass allergies are type 1 allergies, the so-called immediate type.

Hay fever usually occurs in spring, but can also affect quality of life at other times of the year © Africa Studio #147281051 | AdobeStock
Grass pollen allergy is an overreaction of the immune system to certain grasses. The immune system has the task of fighting pathogens. In the case of pollen allergy, the immune system classifies the harmless proteins in flower pollen as dangerous and fights them. As a result, an inflammatory reaction is triggered by special inflammatory messengers - histamines and leukotrins.
The allergy is therefore based on a malfunction of the so-called IgE antibodies. Grass allergy sufferers have more of these antibodies located on the mast cells, which react to contact with the pollen. The IgE antibodies stimulate the mast cells to release histamine and other inflammatory mediators.
As a result, the typical immediate allergic reactions develop within a few minutes.
In most allergy sufferers, grass allergy begins in early childhood and continues for decades. Why the immune system reacts so extremely to the actually harmless pollen has not yet been conclusively clarified.
A genetic predisposition appears to play a role in many cases. For example, children of allergy sufferers often also develop an allergy to grasses.
Excessive hygiene measures in childhood can also have a negative impact on the immune system.
However, external factors can also promote the development of the disease. These include air pollution in cities and increasing exposure to pollutants.
Allergies are particularly prevalent in highly developed industrialized countries and are therefore considered a disease of civilization. Researchers assume that the frequency and severity of allergic rhinitis will increase in the future as a result of global warming.
Cross-allergies also play a role with increasing age. Here the IgE antibodies respond not only to their specific grass allergen, but also to allergens from other sources. For example, people with a grass pollen intolerance are often also allergic to
- various cereals,
- peppermint,
- peanuts,
- potatoes,
- tomatoes,
- kiwis or
- melons.
In Europe, most pollen allergy sufferers react to:
- meadow grass,
- common ryegrass,
- perennial ryegrass,
- Kentucky bluegrass,
- timothy.
Pollen calendars provide hay fever sufferers with precise information about which pollen is in the air at which time.
The symptoms of hay fever occur depending on the time of year : Mainly in spring, when the flower pollen starts to fly. However, there can be exceptions in the winter months of December and January, when temperatures remain mild. Then, for example, the alders start to flower and their pollen flies earlier.
In addition, many sufferers react very sensitively to other stimuli. These include, above all, odorous substances such as
- perfume,
- dust and
- tobacco smoke and
- changes in temperature.
Experience has shown that dry days and high winds worsen the symptoms. Periods of rain, on the other hand, contribute to an improvement.
House dust mite allergies are characterized by similar processes. The disease is triggered by inhaling the excrement of house dust mites. Here too, the immune system fights the allergen (the excrement).
Allergy to grasses can manifest itself in different ways. Initially, many patients confuse the allergy with a cold, as the symptoms are sometimes very similar.
Due to an allergy-related inflammation of the nasal mucosa, allergy sufferers suffer from an irritated and itchy nose. It is constantly blocked and runny during the pollen season. At the same time, the nasal mucous membranes dry out very quickly.
Many allergy sufferers have severe sneezing attacks several times a day. The symptoms of grass allergy can also spread to the eyes, throat, pharynx and lungs. Irritation of the conjunctiva of the eyes leads to watery, burning and itchy eyes. Conjunctivitis with very red and painful eyes is also possible.
The characteristic signs of hay fever are
- tingling, itchy or blocked nose,
- Runny nose and runny nose,
- obstruction of nasal breathing,
- dry nasal mucosa,
- frequent sneezing,
- impaired sense of smell and taste,
- a scratchy feeling in the throat,
- burning sensation in the throat and sore throat,
- irritation of the throat,
- sore throat,
- reddened and watery eyes,
- swollen eyelids,
- Itching of the skin,
- disturbed sleep at night and tiredness during the day,
- flu-like symptoms such as fatigue and aching limbs.
In severe cases, sufferers may experience shortness of breath or asthmatic attacks . The transition from hay fever to allergic asthma is also referred to as a stage change. Allergy-induced swelling of the mucous membrane of the airways and a simultaneous contraction of the bronchial muscles cause the typical asthma attack with
- cough,
- shortness of breath and
- tightness in the chest.
A dry, whistling sound can be heard when exhaling. The exhalation is very long and causes great difficulty for those affected. During the course of the attack, an agonizing cough develops with thick mucus that is difficult to cough up. The attack is accompanied by restlessness and anxiety.
The typical characteristics of allergic rhinitis vary in severity among those affected. They mainly depend on the amount of pollen in the air.
In the case of mite allergy, the symptoms occur all year round. House dust mites and therefore also their excrement are mainly found in mattresses, but also in upholstered furniture.
In both types of allergy, different symptoms often coincide. The chronic illness can then cause considerable psychological stress in the long term. The quality of life of those affected is severely restricted over a longer period of time.
The doctor will first carry out an allergy test to determine the exact trigger of the allergic rhinitis. Treatment should then begin as early as possible. Otherwise, there is a risk of other illnesses, such as asthma, developing.
Ideally, the allergy-triggering pollen should be avoided as much as possible. However, as grass pollen now flies almost all year round, this is rather difficult.
Basically, the treatment of grass allergy can be divided into two areas:
- Drug therapy
- Specific immunotherapy
Medication-based hay fever therapy
The first pillar of allergy therapy is treatment with medication. Antihistamines are primarily used here. They prevent the inflammatory messenger histamine from exerting its effect. Antihistamines can block the receptors to which histamine binds in the body. Antihistamines can be used locally in the form of nasal sprays or systemically in tablet form.
First-generation antihistamines often have a strong tiring effect. This undesirable side effect is generally no longer seen with the newer generation of antihistamines. These medications also have the advantage that they often take effect after just one hour. Antihistamines are available from pharmacies without a prescription.
Cromones such as cromoglicic acid are also effective locally. These medicines can stabilize the mast cells and thus inhibit the release of histamine. However, the onset of action is delayed, so cromones must be used at least one week before the pollen season.
For very severe symptoms, the body's own hormone cortisone is used. The effect of cortisone is many times more anti-inflammatory than that of antihistamines. Glucocorticoids are the most effective form of drug treatment for nasal congestion. They are usually applied locally.
Systemic corticosteroids should only be administered for a limited period of time due to the risk of side effects.
Although decongestant nasal sprays or nasal drops relieve nasal congestion, they should also only be used on a short-term basis. Prolonged use can otherwise lead to drug-induced inflammation of the nasal mucosa.
Nasal rinses are another treatment option for allergic rhinitis. They have the advantage over nasal sprays that they do not dry out the nasal mucous membranes.
Specific immunotherapies
The second area of hay fever therapy is specific immunotherapies such as hyposensitization.
The doctor administers the grass allergen to the patient in increasing doses. The aim is for the body to become accustomed to the allergen over time and no longer classify it as a potential danger.
A distinction can be made between subcutaneous and sublingual forms of specific immunotherapy:
- Subcutaneous immunotherapy is administered in a controlled manner by the doctor using injections.
- In sublingual immunotherapy, the patient administers the allergens via drops or tablets.
The duration of treatment for both therapy methods is up to three years and should have a treatment effect lasting several years.
Proven alternative methods can also help with hay fever. Acupuncture can alleviate the unpleasant symptoms associated with hay fever and noticeably improve quality of life. This can often reduce the use of medication.
Studies on laser acupuncture therapy have also been underway at Dresden University Hospital since 2015. Initial studies have shown that this pain-free treatment has a longer-lasting effect than the traditional form of acupuncture.
In the case of allergic rhinitis, there are some immediate measures that can at least reduce allergic symptoms.
At the beginning of the pollen season, it is advisable to place a protective fleece in front of the bedroom window. During this time, patients should sleep with the window closed if possible. It is best to air the room in the early hours of the morning when it is cooler and there is less pollen in the air.
Vacuum cleaners with a HEPA filter, which retains even the smallest pollen particles, have proven effective for cleaning carpets.
Ventilation and air conditioning systems can be fitted with a pollen filter to reduce pollen exposure while driving. When planning your vacation, it is best to choose regions where pollen counts are low. This mainly includes high mountains and islands where there are no birch trees, whose pollen most frequently triggers hay fever.
The symptoms of house dust mite allergy can be alleviated by regularly changing the bed linen. Wash the linen at 60°. It is also helpful to cover mattresses with a special encasing protective cover. In this way, you have no contact with the mites and their excrement.
Reducing the humidity in the bedroom has proven to be effective in reducing the mites' ability to survive.