Patients with seasonal nasal allergies, also known as seasonal allergic rhinitis or seasonal hay fever, often have intermittent nasal symptoms that may become acutely worse while the patient is outside of the house, particularly if it is windy. Symptoms usually consist of some combination of sneezing, itching of the nose, nasal discharge, and congestion. Sneezing may occur in bouts of 5 to 10 or more sneezes that occur sporadically throughout the day. Itching will frequently lead the patient, especially children, to push the nose upward in a repetitive pattern (“allergic salute”). The discharge may come out of the nostrils or may drip down the throat; it is most often clear in color and thin and watery in consistency. If the mucus becomes very thick and starts to acquire a yellowish or greenish color, one must suspect the possibility of an infection. Congestion is a prominent symptom in half of all patients with nasal allergies and is due to a combination of swollen membranes and mucus trapped in the nose. In addition to these four major nasal symptoms, about half of patients with seasonal allergy also have eye symptoms, which consist of itching, redness, and watering.
As symptoms persist during a several week-long allergy season, constant rubbing around the eyes may lead to redness and a thickened appearance of the skin. Along with all of these symptoms, a number of other complaints such as headaches, facial pain, ear blockage, and cough, may also be very bothersome. This constel-lation of seasonal allergy symptoms differs somewhat from patients that have year-round allergic rhinitis, particularly when the allergy is caused by house dust mites. In mite-allergic patients, congestion is usually the biggest complaint, and eye symptoms are much less common.