The difference between hay fever and a cold

Dr Daniel Fenton is the Clinical Director at the Private GP Clinic, London Doctors Clinic and below he gives us his top tips on surviving spring Hay fever. 

It's only April, it can't be hay fever, it must be a cold! This is a comment I hear commonly in clinic. The sneezing, snotty nose, scratchy throat and streaming eyes can provide a huge deal of confusion at this time of year, as these are almost exactly the same symptoms you can experience with a common cold.

However, tree pollen blossoms in the early part of the year and therefore hay fever or "allergic rhinitis" can strike anywhere from February onwards.  Confusingly, the remedies we use for hay fever can help with the common cold!

What are the differences?

Generally, your common cold will fully resolve within 7-10 days, with coughing typically being the last symptom to settle. Hay fever, on the other hand, is persistent and characterised by:

  • Conjunctivitis - red, itchy or watery eyes
  • Rhinitis - a runny nose, associated with sneezing and nasal congestion
  • An itchy throat
  • Occasionally itching inside the ears and wheezing. 

You should not get a fever or chills with hay fever but may do so with a common cold. Hay fever can really be debilitating.  It can affect concentration, sleep and truly make you feel miserable! 

Hay fever cannot trigger a cold. However, coughs and colds can make Hay fever feel 10x worse. Stick to the below treatments and things will improve.

What are the best ways to treat both colds and hay fever?

Treat your cold in the good old-fashioned way, with rest, plenty of fluids and paracetamol or ibuprofen. Nasal sprays and decongestants are helpful when used for 2-3 days max. 

Hay fever should be tackled in a step wise approach:

  1. Over the counter antihistamines: Loratidine and Cetirizine are excellent non-drowsy treatments. Chlorpheniramine works quickly but may make you a little drowsy.
  2. Over the counter steroid Nasal Sprays: Very good for the runny and blocked nose. These work far better than the decongestants, but to be effective must be used regularly!
  3. Eye drops: soothing and helpful for red, itchy eyes, refrigerating them will provide cool relief. 

If 1,2 and 3 fail, it is time to see your GP. There are a constellation of treatments including:

  • Prescribed antihistamines such as Fexofenadine, a great non-drowsy antihistamine. 
  • Fluticasone and mometasone, steroid based nasal sprays 
  • Prescribed Eye drops, such as sodium cromoglicate or olopatidine

When should you seek medical attention?

You should always speak to a doctor if over the counter remedies have not worked. Other treatments which may help include:

  • Ranitidine, a well-known antacid treatment which also acts as a great antihistamine
  • Montelukast, often used in asthma which is great for rhinitis symptoms

If all else fails, you may wish to consider a less well known, but hugely effective treatment, the Hay fever injection. The steroid based treatment should help to dampen down your symptoms for the hay fever season but requires careful consideration.