A pollen pill to fight hay fever?
Question: A friend recently told me there is now a tablet, possibly containing small amounts of pollen, for hay fever that you put under your tongue daily for three years. Is this true?
Answer: This is true, the product is called Grazax and it contains small amounts of timothy grass pollen extract in a tablet which dissolves under the tongue. How it works is not fully known but it does induce some resistance to the effects of pollen on the nose in the hay fever season.
Although it sounds very attractive there are some significant problems. It has to be started two to three months before the start of the hay fever season and, for full effects, taken daily over three seasons. Because the tablet is being given to allergic subjects and contains the very thing they are allergic to, it is important that the first dose is given in a supervised setting by a specialist in allergy medicine.
In research trials the tablet does have a significant benefit but this is only modest and offers little in addition to the standard treatments (steroid nasal sprays and antihistamines). It is also expensive so the cost/benefit ratio is not favourable. For these reasons many clinical commissioning groups (CCGs) do not encourage its use.
Waxing and waning
Question: For years I’ve had to have my ears syringed due to a build-up of wax, but now I find I have to go more and more frequently. Is there any way to slow down or stop ear wax being produced? The nurse suggested putting a few drops of olive oil in once a week, which seemed sensible, but the bottle warns of hypersensitivity with overuse of the oil. What would you suggest?
Answer: Wax is a normal product of the skin of the ear canal and there should normally be some present. It offers some protection to the skin surface from moisture and infection so that patients who consistently remove the wax by any means can leave themselves open to infections.
A build-up of wax is common, and more likely as you get older, this may be due to changes in the skin surface with age, leading to changes in the consistency of the wax. There is no known way of reducing wax production so you must rely on changing the consistency of the wax by adding oil, as your practice nurse sensibly suggests. It is very unlikely that you will develop any problems with hypersensitivity if you are only using the drops once a week.
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