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Britain has one of the highest rates of hay fever in the world, with around 15 million people affected by sore itchy eyes, a runny or blocked nose, and incessant sneezing for several weeks, or even months, each year. Last year saw the worst hay fever season for decades, as the long cold winter delayed pollen release and led to a sudden late surge in troublesome symptoms over the summer months.

A survey of 2,000 UK adults on behalf of Opticrom Hayfever Eye Drops revealed that the worst month for 63 per cent of hay fever sufferers is June, but one in five people still felt symptoms into September. Nearly a quarter of sufferers felt their symptoms had worsened in the previous 12 months.

For most sufferers, dealing with symptoms can become unbearable and extremely irritating, especially for those studying during the peak grass pollen season. According to the Opticrom survey, one in 10 people said their hay fever had ruined their performance in an exam, while 17 per cent thought it affected their ability to carry out their job properly. And 14 per cent of workers even admitted to taking a sick day due to the severity of their symptoms.

Pharmacy advice

The pharmacy is the first port of call for many hay fever sufferers. According to a Care survey last year, over 55 per cent of adults buy OTC products from a pharmacy to treat their hay fever, compared to only around seven per cent who consult their GP for the same symptoms.

Galpharm consumer research revealed that being able to get advice from the pharmacy is important for customers. “The pharmacist/pharmacy assistant has a unique advantage in being well positioned to offer valuable advice to customers, compared to the supermarket self-select environment,” says Ruth Giles of Galpharm International. “Hay fever/allergy symptoms may necessitate a ‘distress’ purchase, where effective trustworthy treatment is required quickly. This gives the pharmacist an opportunity to communicate and build a relationship with the customer, which will generate repeat pharmacy business.”

It’s important to stock a range of products to help customers manage their symptoms in different ways. “The hay fever category is a crowded market and pharmacy teams need to be aware of the differences between brands and product formats and the role they play, recognising that not all hay fever treatments are the same,” says Stuart White, marketing manager for Omega Pharma’s hay fever portfolio.

Pollen blockers

A number of drug-free products designed to prevent symptoms by limiting pollen exposure are now available, and many are suitable for young children and pregnant or breastfeeding women. “To stop pollen reaching the inside of the nose, use a barrier balm around the nostrils or buy barrier filters that you stick up the nostrils,” says Maureen Jenkins, director of clinical services at Allergy UK. “There are also nasal sprays that coat the inside of the nose.” HayMax pollen barrier balms work by keeping sufferers below their ‘trigger’ level – the amount of allergen their body can tolerate before they experience an allergic reaction. Customers dab a small amount of the balm around their nostrils morning and evening to form an invisible barrier to pollen, dust and pet allergens.

“There are now an increasing number of drug-free remedies with genuine evidence behind them, such as pollen barrier balms,” says Max Wiseberg, managing director of Haymax. “The opportunity for the pharmacy lies in the findings of an Australian study, that most (60 per cent) hay fever sufferers felt that their remedies worked, but worked poorly. So pharmacists are starting to suggest a drug-free remedy to use alongside a pharmaceutical treatment.”

Care Allergy Defence is a powder nasal spray that reacts with moisture within the nose, creating an invisible, thin, protective gel barrier. It is suitable for children as young as 18 months, as well as pregnant and breastfeeding women.

Nasalguard Gel creates a positively-charged gel that blocks negatively-charged pollen allergens on contact, before they enter the nose. The lightweight, transparent gel forms an invisible barrier that can be worn over or underneath make-up. Ashok Wahi, inventor of NasalGuard Gel, says that pharmacists should be discussing prevention versus cure with their customers. “NasalGuard Gel is clinically proven and is a preventative treatment that brings additional buyers into the category,” he says. “Thirty to forty per cent of people who bought this product hadn’t bought any allergy treatment products in the past.”

Treatment options

Antihistamine tablets are the treatment mainstay. According to Hannah Allchin, Piri brand manager at GSK, a 2012 YouGov poll revealed that 24 per cent of allergy sufferers wait until their symptoms are severe before treating them. “This provides a good opportunity for pharmacists and pharmacy staff, as customers need to treat their symptoms when they first occur,” she says. “Piriteze is suitable for mild to moderate sufferers as it offers all-day relief and is ideal for new hay fever sufferers when they come in asking for advice.”

New Galpharm Hayfever and Allergy Relief (10mg cetirizine) and Galpharm One-a-Day Allergy Relief (10mg loratadine) are now available in packs of 30 tablets. Both products will also continue to be available in smaller pack sizes of seven and 14. “The two new Galpharm hay fever and allergy pack sizes are in the new larger maximum allowable 30-tablet sizes available as GSL in the UK,” says Ruth Giles. “We know from consumer research that pack size is important in purchasing decisions and larger pack sizes are valued by consumers. We will continue to supply smaller sizes as well, to offer customers choice and convenience.”

Omega Pharma is launching BecoAllergy (once-a-day cetirizine tablets) for the 2014 season. “Our research suggests over two thirds of hay fever sufferers use tablets for symptom relief,” says Mr White. “We hope the introduction of BecoAllergy tablets to our existing hay fever portfolio – Prevalin Allergy and Beconase nasal sprays – will provide the opportunity to boost sales in this category. No one-a-day hay fever tablet works faster than BecoAllergy, which is clinically proven to relieve symptoms in less than an hour.”

Ms Jenkins says that OTC corticosteroid nasal sprays are very effective for moderate to severe hay fever symptoms, as long as they are used regularly. Therefore, customers who are not experiencing relief with antihistamine tablets should be advised to trade up to the nasal sprays.

Driving purchases

“The main purchase driver is efficacy, and research shows that half of users are not satisfied with their current hay fever medication,” says Ms Allchin. “The YouGov survey showed that 78 per cent of allergy sufferers are up to trying something new for their symptoms. Pharmacists should make sure they have the full range of Piri products in stock, and moderate to severe sufferers need to be shown Pirinase, as it can both treat and prevent hay fever symptoms.”

If customers experience eye symptoms – allergic conjunctivitis – they can use sodium cromoglicate eye drops (eg, Murine Hayfever Relief Eye Drops and Opticrom Hayfever Eye Drops) in addition to other treatments. Otrivine Antistin narrows the blood vessels in the eye, relieving red, itchy eyes. Washing out the eyes with an eyewash or eye drops, such as Optrex Soothing Eye Drops for Itchy Eyes, can help to relieve any irritation caused by pollen and dust. Saline nasal sprays, such as Aquamaris and Stérimar, can help to clear a stuffy nose and wash away any allergens. “OTC corticosteroid nasal sprays can cause nose bleeding if they aren’t used properly, so people may stop using them before they have any effect,” says Surrey allergy consultant Dr Adrian Morris. “Saline nose sprays are a good recommendation for people who don’t want to use chemicals.”

Nelsons brand manager Alessandra Godio says that category management means offering the right selection of products, including alternatives to conventional treatments, such as Nelsons Pollenna. “Nelsons Pollenna had a great year in 2013,” she says. “Forty-four per cent of adults have suffered from some form of allergy and 93 per cent of them looked for a treatment. As consumers are becoming increasingly open to exploring natural and homeopathic treatments on offer, we are confident more consumers will try Nelsons Pollenna.”

A Vogel’s nutritional therapist Alison Cullen suggests that people arm themselves for the season by eating lots of fruit and vegetables, which are high in immune-boosting vitamin C. “Taking Pollinosan tablets – a natural remedy containing seven tropical herbs – a month before the season begins, can also help people get ahead of hay fever, so they can go out and enjoy the summer,” she says.

Erin McCann, nutrition consultant to Unbeelievable health, also recommends a more holistic approach. “Various nutrients have antihistamine actions in the body, including vitamin C and querceten,” she says. “Bee propolis contains a broad spectrum of vitamins, minerals and phytonutrients and is high in phenolenic compounds – potent antioxidant substances which have anti-inflammatory properties. An effective combination for immune modulation and antihistamine supplementation would be Bee Prepared Immune Support Max Strength, which contains therapeutic doses of bee propolis extract, elderberry extract and reishi mushroom extract. The Bee Prepared Daily Defence is also helpful for helping manage seasonal allergies.”