What is Hay Fever?
Hay fever (seasonal allergic rhinitis/conjunctivitis) is a condition where the body has an allergic reaction to pollen dispersed during specific seasons. In Japan, approximately 1 in 3 people (estimated prevalence 38.8%) suffer from cedar pollen allergy, and when Japanese cypress, grasses, and ragweed are included, it can be called a national disease.
Symptoms typically include sneezing, runny nose, nasal congestion, and itchy eyes, but if left untreated, it can significantly lower quality of life, leading to sleep disorders, decreased concentration, and reduced work efficiency. Significant improvement can be expected with appropriate treatment, and sublingual immunotherapy is also available as a fundamental cure.
Our Clinic's Strengths
As a clinic with both internal medicine and dermatology departments, we can provide comprehensive examination for the nose, eyes, throat, and skin (pollen dermatitis). We identify the causative pollen with the View39 test and offer a wide range of treatments, from medication to sublingual immunotherapy.
Hay Fever Symptoms
Main Symptoms
| Area | Symptoms |
|---|---|
| Nose | Continuous sneezing, clear and watery nasal discharge, nasal congestion |
| Eyes | Itchiness, tearing, redness, foreign body sensation, eyelid swelling |
| Throat/Ears | Itchiness, post-nasal drip, cough, ear itchiness |
| Skin | Redness, itchiness, dryness of the face (especially around the eyes) and neck (pollen dermatitis) |
| Systemic Symptoms | Fatigue, decreased concentration, heavy-headedness, low mood |
Hay Fever vs. Common Cold
| Item | Hay Fever | Common Cold |
|---|---|---|
| Nasal Discharge Quality | Clear, watery | Yellow to green, viscous |
| Sneezing | Continuous | Occasional |
| Itchy Eyes | Present (characteristic) | Usually absent |
| Fever | Absent | Often present |
| Sore Throat | Mild | Moderate to severe |
| Duration | Several weeks to several months | Usually 1 to 2 weeks |
| Annual Recurrence | Annually at the same time | Irregular |
Main Pollen Dispersal Seasons in Kanto Region
There are multiple types of pollen that cause hay fever, and each has a different dispersal season. Knowing your allergic triggers is the first step in treatment.
| Pollen | Dispersal Season | Characteristics |
|---|---|---|
| Cedar | February - April (peak March) | Largest cause of hay fever in Japan. Kyushu to Tohoku |
| Japanese Cypress | March - May (peak April) | Approximately 70% of cedar pollen sufferers also react to Japanese cypress |
| White Birch | April - June | Mainly Hokkaido/Tohoku. Associated with oral allergy syndrome |
| Grasses (orchardgrass, timothy, etc.) | May - October (peak May - July) | Common in riverbeds and park grasslands |
| Ragweed | August - October | Representative of autumn hay fever. Native to North America |
| Mugwort | August - October | Beware of cross-reactivity with celery family foods |
| Japanese Hop | August - October | Urban weed |
Complications and Related Conditions
- Pollen dermatitis: Redness, itchiness, and dryness of the face and neck caused by pollen adhering to the skin
- Allergic conjunctivitis: Itchy eyes, redness, tearing
- Worsening of bronchial asthma: Pollen triggers respiratory symptoms
- Oral allergy syndrome (OAS): Itchy mouth when eating fruits (apples, peaches, etc.) for those with white birch pollen allergy
- Sinusitis (chronic rhinosinusitis): Develops from prolonged nasal congestion
- Sleep disorders, decreased concentration: Due to nasal congestion and medication effects
Three Pillars of Treatment
Hay fever treatment is based on three pillars: ① medication to suppress symptoms, ② avoidance therapy to prevent pollen exposure, and ③ fundamental treatment to change one's constitution (sublingual immunotherapy).
Medication
| Category | Representative Drugs | Characteristics |
|---|---|---|
| Second-generation Antihistamines | Bilastine (Bilonoa) Fexofenadine (Allegra) Desloratadine (Desalex) Rupatadine (Rupafin), etc. |
Less drowsiness, minimal impact on driving and work (first choice) |
| Leukotriene Receptor Antagonists | Montelukast, Pranlukast | Effective for nasal congestion, for cases with concomitant asthma |
| Nasal Steroid Sprays | Fluticasone, Mometasone, Dexamethasone, etc. | Most effective for nasal congestion and sneezing, local action |
| Eye Drops | Olopatadine, Levocabastine, Ketotifen, etc. | For itchy eyes |
| Anti-IgE Antibody (Xolair) | Omalizumab subcutaneous injection | For severe cedar hay fever, age 12 and older |
| Herbal Medicine | Shoseiryuto, Kakon-to-ka-senkyu-shin-i | For watery nasal discharge and cold types |
For those who prefer less drowsiness from medication
Even if you've experienced drowsiness from hay fever medication before, there are second-generation drugs that cause particularly little drowsiness (bilastine, fexofenadine, desloratadine, rupatadine). If you want to minimize the impact on your work or driving, reviewing your medication choices can often resolve the issue.
Initial Therapy (Pre-season Treatment)
For cedar hay fever sufferers: start treatment "2 weeks before pollen dispersal begins"
Taking antihistamines before pollen dispersal begins can significantly reduce symptoms during the season (initial therapy). In Tokyo, Saitama, and Kanagawa, the目安 is to start in early to mid-February. This is especially recommended for those who suffer severe symptoms every year.
Sublingual Immunotherapy (Fundamental Treatment)
This is the only fundamental treatment for cedar pollen and dust mite allergens. It changes the body's constitution by taking medication under the tongue daily for 3 to 5 years.
| Type | Target | Start Time |
|---|---|---|
| Cedarcure (Cedar pollen) | Cedar pollen allergy | June - December (cannot start during pollen dispersal season) |
| Miticure (Dust mites) | Perennial allergy due to dust mites | Can start year-round |
Key Points of Sublingual Immunotherapy
- Target is 5 years and older (children can also receive it)
- Administer daily by holding under the tongue for 1 minute
- Continuous treatment for 3 to 5 years is recommended
- About 80% of people experience improvement, with 20% having almost complete symptom disappearance
- Effect can be felt in 2 to 3 months, full effect in 1 to 2 seasons
- Cedar and dust mite treatments can be done simultaneously
- Start month restriction: Cedar cannot be started during pollen dispersal season (late January to May)
Regarding Side Effects
Side effects of sublingual immunotherapy may include itchiness, discomfort in the mouth, and swelling of the lips. These usually subside within a few weeks as the body adjusts, but anaphylaxis can occur in very rare cases. Therefore, the first dose is administered at a medical institution, and patients are monitored for 30 minutes afterward.
Examinations and Tests at Our Clinic
Allergy Tests
| Test | What it reveals | Estimated Cost |
|---|---|---|
| View39 (Specific IgE test) | Simultaneous testing for 39 types of allergens with a single blood draw | Approx. 5,000 yen with insurance (30% co-pay) |
| Individual Specific IgE test | Selective testing for specific allergens (up to 13 items) | Covered by insurance |
| Total IgE | Overall assessment of allergic constitution | Covered by insurance |
Insurance Coverage and Costs
Hay fever consultations, medications, and tests are all covered by insurance. For the first visit, including tests, the estimated cost with a 30% co-pay is around 5,000 to 7,000 yen (varies depending on test content).
Daily Measures to Avoid Pollen
When Going Out
- Pollen masks and glasses (those that cover gaps around the eyes)
- Smooth-textured outerwear (wool attracts pollen)
- Avoid going out during peak pollen dispersal hours (11 AM - 2 PM, 5 PM - 7 PM)
- Brush off pollen from clothes before entering home
After Returning Home
- Wash hands, gargle, wash face
- Nasal rinse (saline solution) to remove pollen from the nose
- Bathe and wash hair promptly
Indoor Environment
- Keep windows closed, ventilate early in the morning or after rain (when pollen is low)
- Utilize air purifiers (with HEPA filters)
- Dry laundry and futons indoors or use a dryer
- Regular cleaning (pollen accumulates on floors)
Features of Hay Fever Treatment at Our Clinic
- View39 (39-item allergy test) to accurately identify causative pollen
- Appropriate use of second-generation antihistamines with less drowsiness
- Nasal steroid sprays and eye drops optimized for specific areas
- Supports sublingual immunotherapy (Cedarcure, Miticure)
- Also provides simultaneous dermatological examination for pollen dermatitis (pollen-induced facial skin irritation)
- Supports initial therapy before the season
- Referral to anti-IgE antibody (Xolair) treatment facilities for severe cases
- No appointment needed, same-day visits OK / Open daily 9 AM - 9 PM / 1-minute walk from Jujo Station
It's not too late even after pollen season has begun
If you've been "enduring it every year," please consult us. We can comprehensively optimize your medication choices, sublingual immunotherapy, and skin irritation measures. Your symptoms might be completely different next season.
