Hay fever injection: is Kenalog safe?

What is hay fever?

Hay fever is caused by an allergic reaction to pollen. When it comes into contact with the mouth, eyes, nose or throat, the body reacts by making specific antibodies. Hay fever affects people at different times depending on which pollen they are allergic to. The majority of people are allergic to grass pollen, so will experience their worst symptoms between May and June; tree pollen affects people in late spring between March and May; while others are affected by weed and mould pollens in the autumn.

The condition is characterised by sneezing and coughing, a runny or blocked nose, red watery eyes, itchy throat, mouth, nose, eyes or ears, headaches and sometimes a feeling of fatigue or tiredness. Sufferers may also experience a wheeze and tightness in the chest.

Many people manage hay fever symptoms by taking simple steps to stop the pollen reaching them - wraparound sunglasses to protect the eyes, or Vaseline around the nostrils - or by taking over-the-counter antihistamine drops or tablets, and using a nasal spray.

How does the hay fever jab work?

For around one in ten people with hay fever, home and over-the-counter medications aren't enough to relieve their symptoms. In the past, some have turned to the hay fever jab, a steroid injection marketed as Kenalog which works by suppressing the body's immune response to histamines which in turn relieves symptoms.

Dr Farah Gilani, a Medicspot GP, says "This is an injection of a steroid called triamcinolone into a large muscle in the body. Once the steroid is injected, it slowly leaks from the muscle for three to eight weeks and travels throughout the body, theoretically offering relief from hay fever symptoms."

There are many anecdotal accounts by individuals who report significant improvements in their symptoms with this injection. For many, the hay fever jab offers relief when over-the-counter and prescribed medicines aren't enough.

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What are the risks of Kenalog?

The treatment can cause a potentially long list of side effects, including:

• Raised blood pressure

• Headache.

• Dizziness.

• Water retention.

• Skin rashes.

• Muscle weakness.

• Swelling.

• Breathing difficulties.

• Abdominal pain.

• Insomnia.

• Taste disturbance.

• Mental health problems - such as depression and mood swings.

Kenalog can also increase your susceptibility to infections, such as flu, shingles, and chickenpox.

"Once the steroid has been injected, nothing can be done to prevent it from spreading through the body over the following weeks, even if side effects are experienced," states Gilani. "In addition, it is contra-indicated in some patients, such as those who have stomach ulcers, diabetes or an active infection."

Repeated use of steroid medications like the hay fever jab can also lead to bone loss, osteoporosis, and broken bones. Just how high the risk is with one yearly hay fever injection is not yet fully understood.

What are the UK guidelines on Kenalog?

For these reasons, Kenalog is not licensed for treating hay fever in the UK. Charity Allergy UK does not endorse the injection: "The steroid injection is not recommended as it is a high-dose steroid given by an intramuscular injection and once injected, the amount of steroid cannot be removed and it comes with a high side-effect profile.

Chief pharmacist Stuart Gale at Oxford Online Pharmacy adds: "Kenalog is only safe and recommended for use in a small group of people, as intramuscular steroids can exacerbate existing medical conditions. The mainstay of hay fever treatment is oral antihistamines, nasal sprays and eye drops."

The UK government is also clamping down on advertisements for the hay fever injection. In 2022, private clinics offering Kenalog were warned that promotional social media posts would be in breach of the law.

For those who find these treatments ineffective, immunotherapy - which involves injecting a small amount of pollen under the skin to help build up immunity - is recommended. This usually begins in the winter, around three months before the hay fever season starts. Its aim is to desensitise the body to the allergen so it doesn't react so severely. Although it won't cure hay fever, it's effective at making symptoms much milder - and is much safer for your overall health and wellbeing.