Summer's Two Hottest Topics - Hay Fever and Sunburn
Summer is officially here! However, for many of us, summer can bring with it some health concerns such as Hay Fever and Sunburn.
What is hay fever?
Hay fever is an allergic condition which spoils the Spring and Summer for many people. It is an allergy to pollen that causes the symptoms of a runny, itchy and often blocked nose, sneezing and itching watering eyes. It can also cause an itchy throat. What a lot of people don't appreciate is that it is not just hay but many other grass, tree or flower pollens which cause this condition.
What is pollen?
Pollen is the fine dust produced by plants to fertilise other plants and is carried through the air in the Spring and Summer. It is a protein, and many people react badly to it when they inhale it into their upper airways. The lining of the nose, upper airway/throat and eyes produces histamine in response to the pollen(s). This causes inflammation of these linings and the swelling, congestion, itching and production of mucous is directly as a result of histamine being released. It is for this reason that Anti histamines are the first line of treatment for this condition...they are supposed to neutralise or dampen the natural response of the body and therefore relieve the symptoms. They are effective, but do work better for some people more than others.
How many people are affected by hay fever?
Hay fever affects 20% of the population so is a very common condition. It is more common in people with other allergic conditions like asthma and eczema, and it does tend to run in families.
The suffering (morbidity) cannot be underestimated. It can affect people both day and night, although day time symptoms are more common, and work and school are often impacted by this condition.
Can I be tested for hay fever?
There isn't a blood test for Hay fever as such, but, in very allergic people, testing with various allergens can be undertaken in an attempt to best manage the condition. This is not commonly done however and the diagnosis is generally made by a Doctor or nurse who takes a history and confirms the clinical findings and history match up with the diagnosis.
What treatments are available?
Treatments are wide and varied, with many being tried and tested by good clinical research, and others that people swear by but have no clinical evidence to back them. Attempts at avoiding the Allergens are usually rather futile as it is almost impossible to avoid pollen(s) in the spring and summer but it is clearly important to avoid things like cutting the grass if you are a sufferer. At the core of treatment is an antihistamine drug. They usually are used every day from early spring until late summer. They come as tablets, liquid medicine, nasal drops and sprays, and eye drops. Steroids may also be used in the form of nose drops and sprays and eye drops, and for many years some people have depended on an injection of steroids. This has been questioned quite seriously in the past 10 years or so following the publishing of trial work which called into question the safety of these injections. For this reason opinion is split on the use of steroid injections, and only the most serious sufferers should consider this, and only where the benefits outweighs the significant risks to Adrenal glands, skin, bone etc.
Oral steroids are occasionally used in serious sufferers, but only for a short course of about 5 days and only where benefits outweigh the risks of side effects and harm from continued steroid use. Salt water washouts of the nose and eyes also seem to help the symptoms to a degree.
The antihistamine drops and sprays may take some time to build up their effect, but the tablets and medicines usually work within hours of being taken. It is worth persevering with any of the treatments for a period of time before trying something different.
There is some evidence coming through that a new group of Asthma drugs can be useful in treating Hay Fever. These have a similar effect on Histamine although in a different way to traditional Antihistamines. They are called the Leukotriene receptor antagonists.
One final treatment option is desensitisation treatments with small quantities of the allergen being injected into the patient. Homeopathy is based on a similar idea only it uses tiny quantities of the allergen diluted in liquid and taken orally.
In summary, this chronic and recurring condition causes suffering and misery to many, but there are many and varied treatments available and these should be discussed with your Doctor, Nurse or Pharmacist.
How do we get sunburn?
Too much exposure to sun light is damaging to the skin. Our skin produces a pigment called Melanin to help to protect it from the harmful effects of sunlight. This is the pigment which makes skin look tanned. It also explains why fair skinned, blue eyed and freckled people are more at risk from sun damage as they have less Melanin to protect them.
Sunlight has both of the Ultraviolet rays UV A and UV B and the UV A can penetrate deeper into the skin and is therefore more damaging than UV B. Any burning of the skin is a warning that the skin is getting damaged and so it is at this point that the skin should not be exposed further to the sun. Everyone is potentially at risk from sun exposure, and it is not just those people who sunbathe who are at risk. People who work outdoors are at risk, but perhaps on different parts of their body like nose ears and hands.
What are the effects of sunburn?
Sunburn itself is immediately harmful as it causes pain, may cause blistering and peeling and therefore suffering. What is more worrying though is that the skin damage is often more than just superficial burning. Damage to the deeper layers can damage to the elasticity of the skin causing premature ageing, but much more worrying is that this deeper damage can cause damage to the skin cell nucleus and the DNA in the nucleus, which can lead to abnormal cell formation and cancerous tumour formation.
Can sunburn lead to cancer?
About 9 in 10 skin cancers that are not a melanoma are caused directly by excessive sun exposure and about 6 out of 10 Melanomas are directly as a result of excessive sun exposure. This is why Doctors have been trying to impress on people that they must be responsible when in the sun and should protect their skin with sun protective factor (SPF) creams and covering up where possible. It is literally a matter of life and death. The low factors like SPF 15 are hardly worth using at all, and the medical profession would encourage people to apply factor 50 (UV A protection) or higher. This means that it will take longer to get a tan but it will be safer and probably will lead to a longer lasting tan on return home!
How often should I apply sun cream?
Creams should be regularly applied, about every 2 hours, especially if you are in and out of water. Don't forget your lips, nose and ears, and if you are thinning on top or bald, protect your scalp too! It is of note that you can burn, sometimes even more, when in water, and also wet clothes are less protective that dry clothes! Clearly covering up and avoiding direct exposure to strong sunlight, (and certainly at the heat of the day), is to be commended. Wide sun hats, loose fitting baggy T shirts and wraparound sunglasses are all a good idea.
Remember that it is not the heat but the sun's rays that do the damage, and the damage can be devastating!
One last piece of information - Sunlight helps our mood and lifts our spirits and Seasonal Affective disorder (SAD) is directly related to too little sun exposure, AND, Sunlight is the main source of Vitamin D in our bodies as it is not present to any great degree in our diets so the Sun does do us some good - it is estimated that we all need 2-3 exposures to the Sun every week, lasting 20-30 minutes. I guess it is all about moderation, even with respect to sun exposure!