Allergies & Respiratory

Allergies and respiratory conditions are among the most common reasons UK adults visit their GP or pharmacist. This guide explains hay fever (allergic rhinitis), asthma, chronic obstructive pulmonary disease (COPD), and sinusitis in plain UK English, including the medicines your clinician may consider, what to expect from treatment, and when a symptom is a red flag that needs urgent review rather than a repeat prescription.

What allergies and respiratory conditions actually are

The umbrella of allergic and respiratory disease covers several distinct problems that often overlap. Allergic rhinitis (hay fever) is an immune reaction to airborne triggers such as tree, grass or weed pollen, house dust mite, or animal dander. It typically causes sneezing, a blocked or runny nose, itchy eyes and throat, and disturbed sleep. Asthma is a chronic inflammatory condition of the airways that causes them to narrow and produce excess mucus, leading to wheeze, cough, chest tightness and breathlessness that varies from day to day. Chronic obstructive pulmonary disease (COPD) is a longer-term, progressive airflow obstruction most commonly related to smoking history. Acute sinusitis is inflammation of the sinus lining, most often triggered by a viral upper respiratory infection.

These conditions can share symptoms — a persistent cough, for example, may reflect uncontrolled asthma, post-nasal drip from hay fever, or something quite different — which is why a clinician's assessment is important before self-medicating for weeks on end. For an in-depth walk-through of pollen-driven symptoms and how the medication ladder works, our overview of hay fever antihistamines, nasal sprays and eye drops is a useful next read.

Who is affected and when to consider treatment

Hay fever affects roughly one in four UK adults at some point, with peak symptoms during the grass pollen season from late May to July. Many people first develop symptoms in childhood or adolescence, but adult-onset hay fever is not unusual. Asthma affects several million people in the UK across all age groups, and can be triggered or worsened by allergens, viral infections, exercise, cold air, workplace exposures, and some medicines. COPD is largely a condition of adults over 40 with a history of smoking or significant occupational dust exposure, and remains under-diagnosed.

Treatment is generally considered when symptoms interfere with sleep, work, school, exercise, or quality of life — or when there are objective signs that the airways are inflamed. For hay fever, that usually means starting antihistamines and, where appropriate, a steroid nasal spray a couple of weeks before the reader's usual peak season, rather than waiting until symptoms are already severe. For asthma, national guidance (from the National Institute for Health and Care Excellence and the British Thoracic Society) recommends starting a regular preventer inhaler as soon as a diagnosis is confirmed, rather than relying on a reliever inhaler alone.

The UK medical pathway

For mild, seasonal hay fever, a community pharmacist can usually advise on antihistamines, nasal sprays and eye drops without a GP appointment. If symptoms are severe, persistent, or not settling on the usual treatments, the GP may review the diagnosis, consider a stronger steroid nasal spray, or refer for allergy testing. Skin-prick testing and specific IgE blood tests are available through NHS allergy services in more complex cases, particularly where multiple allergens are suspected or immunotherapy is being considered.

For asthma, diagnosis in adults typically involves a combination of history, spirometry, and objective tests such as fractional exhaled nitric oxide (FeNO) or peak flow variability. Once confirmed, most adults are managed in primary care with an annual asthma review, a written personal asthma action plan, and inhaler technique checks. Suspected COPD is usually confirmed with post-bronchodilator spirometry, and management focuses on smoking cessation, inhaled therapy, pulmonary rehabilitation, and vaccinations. Because COPD care depends on hands-on assessment, a face-to-face GP or respiratory review is essential — this is not a condition to try to manage through online routes alone.

Common treatment categories

Antihistamines

Oral antihistamines are the mainstay of hay fever treatment. Non-sedating options such as cetirizine, loratadine and fexofenadine are usually preferred over older sedating antihistamines because they are less likely to affect concentration or driving. Cetirizine and loratadine are widely available from pharmacies; fexofenadine is available in higher strengths that may be considered when standard doses are not enough. Clinicians generally suggest taking them daily during the reader's peak season rather than only when symptoms flare, and starting one to two weeks ahead of the expected pollen surge where possible.

Steroid nasal sprays

Intranasal corticosteroids such as fluticasone, mometasone and beclometasone reduce nasal inflammation and are often more effective than antihistamines for persistent blockage, post-nasal drip and loss of smell. They need to be used regularly for one to two weeks before full benefit is felt, which is why they underperform when used only on bad days. Correct technique — aiming the spray slightly outward, away from the nasal septum — is important to avoid nosebleeds and irritation.

Eye drops and combination therapy

Antihistamine or mast-cell stabiliser eye drops (such as sodium cromoglicate or olopatadine) are helpful when itchy, watery, gritty eyes are the dominant symptom. Many patients end up on combination therapy — an oral antihistamine plus a steroid nasal spray plus eye drops as needed — particularly during peak pollen weeks.

Asthma inhalers: reliever, preventer and MART

Short-acting beta-agonist (SABA) inhalers such as salbutamol relieve symptoms quickly but do not treat the underlying inflammation. Relying on a SABA more than three times a week, or getting through more than one or two SABA inhalers a year, is a sign that asthma is not well controlled. Preventer inhalers contain an inhaled corticosteroid (ICS) and are used every day to reduce airway inflammation. Recent UK guidance increasingly recommends a MART (Maintenance And Reliever Therapy) approach for adults, where a combination ICS/formoterol inhaler is used both daily and as needed — this has been shown to reduce exacerbations compared with SABA-only rescue. Your clinician will decide which approach is right based on your history, previous attacks and inhaler technique.

Sinusitis and when to wait

Most acute sinusitis is viral and settles within two to three weeks without antibiotics. Simple measures — saline nasal irrigation, paracetamol or ibuprofen for pain, decongestants for short-term use, and a steroid nasal spray if symptoms are dragging on beyond ten days — are typically first-line. Antibiotics are reserved for symptoms lasting longer than ten days without improvement, or where there are signs of bacterial infection. NHS resources on sinusitis outline this stepped approach clearly.

What to expect from treatment

For hay fever, most people notice a reduction in sneezing and eye symptoms within a day or two of starting a non-sedating antihistamine, but full benefit from a steroid nasal spray typically takes one to two weeks of consistent daily use. Side effects are usually mild — dry mouth, occasional drowsiness with cetirizine in sensitive individuals, minor nosebleeds or throat irritation with sprays. For asthma, a well-chosen preventer regimen should reduce reliever use, improve exercise tolerance, and cut night-time symptoms within two to four weeks; ongoing review is important because control drifts over time. For COPD, treatment slows decline and reduces exacerbations rather than reversing damage, which is why smoking cessation remains the single most important intervention.

If you are also managing other long-term conditions or lifestyle factors alongside allergies, our general wellbeing hub collects related patient guides on migraine, insomnia, cholesterol and smoking cessation that may be relevant.

When to seek urgent review

Some symptoms should not wait for a routine appointment. Seek same-day medical review — or call 999 in the UK — if you experience severe breathlessness that stops you from finishing a sentence, blue lips or fingertips, chest pain with breathlessness, a reliever inhaler that is not lasting four hours, or peak flow readings dropping well below your personal best. For sinusitis, urgent review is needed for severe one-sided facial pain, swelling around the eye, visual changes, or a stiff neck with fever. For any suspected allergic reaction with facial swelling, difficulty breathing or collapse, this is anaphylaxis and requires an immediate 999 call and adrenaline if prescribed.

How Farmeci fits in

Farmeci is a UK GPhC-registered online pharmacy providing patient education and a free clinician-led consultation route for suitable conditions. This blog category exists to help you understand your options before or alongside speaking with a clinician — it does not replace an in-person review, particularly for asthma diagnosis, COPD care, or any red-flag respiratory symptoms. If you would like to discuss whether a specific hay fever regimen is right for you, our clinical team can review your history through the standard consultation process. Trusted external sources such as NHS.uk and the British National Formulary remain valuable references for anyone wanting to read further.