Hay fever and allergies in South Africa

South Africa does not have one allergy season. Inland, grass pollen peaks through the summer rainfall months and the Highveld gets a long, heavy season. In the Western Cape the pattern is closer to a Mediterranean one, with tree and grass pollen through the winter rains and into spring, and the wind carrying it a long way.

Plenty of people who think they have hay fever actually react to house dust mite, which does not have a season at all. If your symptoms are worst first thing in the morning and never really go away, that is the usual explanation.

Antihistamines are the mainstay, and the single most useful thing to know is that they split into two generations. The older ones cross into the brain and cause real sedation; the newer ones largely do not.

cetirizine (Zyrtec) is the one people most often ask about by brand. It is a newer antihistamine, but it is mildly sedating in a minority of people — if it makes you drowsy, loratadine or fexofenadine usually will not.

• A steroid nasal spray, used every day through the season rather than only on bad days. It takes several days to reach full effect, which is why people who use it occasionally conclude it does not work.
• Saline rinses to clear pollen out of the nose, especially in the evening.
• Closing windows on windy afternoons, when pollen counts are highest, and drying washing indoors during your peak season.
• For dust mite: hot-washing bedding weekly and using mattress and pillow covers. This matters far more than anything you do to the rest of the house.

See a doctor if symptoms are only on one side of the nose, if there is blood-stained discharge, if you have facial pain and fever suggesting sinus infection, or if allergy symptoms are triggering asthma attacks.