The treatment modalities for hay fever include avoidance of exposure to pollens, medical treatment and immunotherapy (allergy vaccines). Avoidance of allergens means reduction of amount of pollen to be inhaled, and of the pollen that is deposited on the clothes and hair while staying out of the house during pollination. The best avoidance measure for hay fever is leaving the area where pollination is taking place, which may be difficult.
Medical treatment is usually necessary to control symptoms, and it includes antihistamines, as nasal sprays or in tablets, and nasal steroid sprays. Antihistamines should be of the newer generation, which do not cause sedation; such treatment shows more efficacy on runny nose, sneezing and nasal itch than on nasal stuffiness. The first generation antihistamines cause severe sedation and drowsiness, and may affect quality of life, work and school performance more than the disease itself. Nasal steroids are more potent in improving nasal patency than antihistamines, and are at least as potent in the control of all other nasal and ocular symptoms. Nasal patency may be improved by nasal or oral decongestants, but such treatment should be reduced to as short period as possible, as after few days of use of nasal decongestants rebound congestion may occur and patients remain with a need for nasal decongestants to improve nasal airways even after pollination is over.