Ask an expert: How does immunotherapy treatment for hay fever work?

Written by: Dr Raghu Raju
Edited by: Sophie Kennedy

For many hay fever sufferers, over the counter medications provide only short-term relief or are ineffective against troublesome symptoms, such as wheezing, itchy eyes and coughing. Immunotherapy treatment, however, can offer a longer term resolution of these symptoms and in some cases may even result in full remission, impacting significantly on patients’ quality of life. In this detailed guide, leading consultant in respiratory medicine and allergy Dr Raghu Raju offers expert insight on how immunotherapy treatment for hay fever works and how effective its results are in the long term.



How does immunotherapy for hay fever work?


Immunotherapy, also known as allergy shots, is the only treatment that can modify the course of the disease in hay fever sufferers. Allergy occurs due to the immune system falsely recognising a harmless substance as dangerous. Immunotherapy tends to get the immune system to develop tolerance to the allergen by exposing it in small quantities over a long period of time. This leads to fewer allergy symptoms and may reduce or stop the need for medication.



What is involved in the immunotherapy treatment for hay fever?


Hay fever is predominantly caused by one of the common inhaled allergens such as grass pollen, tree pollen, house dust mite or pets. To treat this, a dose containing the allergen e.g. grass pollen is given to the person regularly either in the form of a tablet or solution that is placed under the tongue (sublingual) or by injection. Sublingual tablets are the most popular option because of the convenience of home treatment and their excellent safety profile.



Is immunotherapy for hay fever safe?


Immunotherapy is a safe treatment for hay fever. As most of the treatment these days is given in the form of sublingual tablets, there is no need for injections in the majority of cases. The side effects are minimal and usually improve with time. Most people are able to complete the treatment without side effects.



How effective is immunotherapy for hay fever?


Immunotherapy is highly effective in treating hay fever triggered by certain allergens. It is important to establish the exact allergen that is causing symptoms by carrying out either skin prick tests or blood tests. Once the cause is established, immunotherapy against that allergen or a combination of allergens is effective in reducing medication use and in many cases, stops the need for symptomatic treatment with antihistamines and nose sprays. Consequently, people treated with immunotherapy have a substantial increase in their quality of life after treatment completion.



How long does it take for immunotherapy for hay fever to work?


The effect of immunotherapy is apparent in the first year of treatment. However, incremental benefit is obtained in subsequent years of treatment. If the full course of treatment (usually 3 years) is completed, there is high likelihood of long term remission of hay fever symptoms.




Dr Raju is a renowned consultant in respiratory medicine and allergy. If you suffer from hay fever and think you could benefit from immunotherapy treatment, you can book a consultation with Dr Raju and learn more about him by visiting his Top Doctors profile.

By Dr Raghu Raju
Pulmonology & respiratory medicine

Dr Raghu Raju is a highly skilled consultant in respiratory medicine and allergy based at The Chiltern Hospital in Great Missenden and The Shelburne Hospital in High Wycombe, who specialises in the diagnosis and management of respiratory infections, chronic coughs, and lung cancer, with particular interest in asthma.

He is also an expert in the treatment of allergic rhinitis (hay fever) using immunotherapy. Dr Raju qualified from Rajiv Ghandi University of Health Sciences in 2002 before undertaking his respiratory specialist training at London, Oxford and Yorkshire deanery, which also included a fellowship in lung cancer at Leeds. Dr Raju completed his CCT in Respiratory Medicine from the Royal College of Physicians. Dr Raju was then appointed consultant respiratory physician at Buckinghamshire Healthcare NHS Trust in 2015, where he looks after both general medical and respiratory patients and leads the pleural diseases service of the trust.

He is currently the Clinical Lead for his department. He was awarded the prestigious Hermes Diploma in Respiratory Medicine from the European Respiratory Society in 2016 before going on to receive fellowship to the Royal College of Physicians of Edinburgh in 2018. Dr Raju also has a Diploma in Adult Allergy from Imperial College, London. Following his qualification, he worked as an allergist at Royal Brompton and Harefield Hospitals, acquiring invaluable experience of the management of allergic diseases.

He possesses expertise in both paediatric and adult allergy and runs the paediatric allergy clinics at Amersham hospital. He has particular interest in food allergy, allergic rhinitis, allergic asthma and has experience in immunotherapy for allergic diseases.

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