Diagnosis based on presenting symptoms is usually straightforward, but a more formal diagnosis may be required for severe cases, unusual patterns or if there are complications – typically sinusitis or otitis media. A diary of symptoms, including time of day and place experienced, may add to the picture, but GPs will refer a patient for allergy testing if there is a lack of response to treatment or the allergic rhinitis persists.

Skin prick tests look for a reaction when various pollens are pricked onto the skin surface with a needle. Patients should not be taking any allergy medication prior to the test, as this may suppress any response. Eczema can also make detection difficult. If a skin prick test is not suitable, a blood test can be used to measure IgE antibodies. NHS Choices advises against the use of commercial home allergy testing kits, saying: “The testing is often of a lower standard than that provided by the NHS or accredited private clinics. It’s also important that the test results are interpreted by a qualified professional who has detailed knowledge of [the patient’s] symptoms and medical history.”