If you are one of the estimated 15 million Brits whose lives are made a misery by hay fever (that's 25% of the population) you'll be painfully aware that the pollen season is upon us. Most of us simply pop a few antihistamine tablets and wheeze through to the autumn, annoying the pants off everyone else as we go. But there may be more proactive ways to tackle your seasonal scourge.

Recent scientific breakthroughs mean that for extremely severe sufferers, a newly developed form of immunotherapy, which involves dissolving tablets under the tongue, may be available (talk to your GP for a referral). Asthma UK has also launched an online resource offering bespoke Asthma Trigger Tips (5.2 million people in the UK are affected by asthma and 79% of people with asthma say their symptoms are triggered by pollen).

Precisely when the hay fever season starts will, of course, depend on your own particular nasties. For many sufferers, birch tree pollen marks the beginning of the torment (around March in the south of England). Grass pollen then kicks in around early May, peaking in the summer months. Mugwort and hybrids such as chrysanthemum take over in the autumn, as do mould spores at harvesting time.

Most hay fever sufferers turn to over-the-counter drugs for solace. These can be helpful, but only if you use them properly. Antihistamine tablets have a high success rate. "Make sure you take them as directed by the pharmacist, so that the levels of the drug remain high in your system, otherwise they won't work," advises Maureen Jenkins, allergy nurse consultant for West Sussex allergy services and spokeswoman for Allergy UK.

Eye drops and nasal sprays can also ease the symptoms. Antihistamine nasal sprays may stop your nose running and nasal steroid sprays can unbung your nose by reducing inflammation in the cells. A third kind of nasal spray uses a drug called sodium cromoglicate, which can prevent the symptoms from happening in the first place. "It is a mast cell stabiliser," explains Jenkins. "The white blood cells contain histamine [a substance that causes runny noses, swelling, sneezing, itching, narrowed airways]. The spray stabilises the cells so they don't burst and release histamine." However, she says, "these will only work if you start to use them two weeks before your allergy begins, and you have to use them four times a day, which many people find hard".

As well as remembering to take the pills, you may want to also address your nasal spraying technique. "Most people don't spray properly," says Jenkins. "You have to tilt your head forward slightly and over to the side on which you are spraying. Spray, then wait 30 seconds with your head on that side so the drug can get into your sinuses."

The risks and side-effects of these medications are "minimal" she says. "Drowsiness is the only real concern and usually this is only with the older drugs." But if the thought of chemicals is still off-putting, it might be worth trying some alternative approaches. According to Daniel Maxwell of The British Acupuncture Council, "acupuncture is great for the symptoms of hay fever due to the significant effect it has on modulating the immune system". Anna Butterworth, 36, head of campaigns at Which?, was a "massive" hay fever sufferer for 10 years. "I tried just about everything I could lay my hands on, but I became concerned not just about the cost, but about the effects of pumping my body full of chemicals from May to September each year."

Though the acupuncture treatment initially seemed "hokey", it took just five sessions to rid her of her symptoms. Since then, she has needed no more acupuncture and has revelled in three hay fever-free summers. "Last week people in my office were sniffling and I thought there was a cold going round - I had genuinely forgotten it was the start of the hay fever season," she says.

This could be a fluke - a psychosomatic result, perhaps. Clinical trials on acupuncture and hay fever are, says Edzard Ernst, professor of complementary medicine at Exeter University, "highly contradictory". Some trials show very promising results on both adults and children, others no effect at all.

Nutritional supplements have even less evidence to back them up. Health-food stores will flog you anything from vitamin E to fish oils, herbal drops or Reishi mushrooms as hay fever cures. In fact, says Ernst, there is no solid clinical evidence for the efficacy of most nutritional supplements (the herb Butterbur is the only one to show "promising results" in clinical trials). Likewise, there is no clinical evidence that dietary changes will do any good. Trials of homeopathic treatments "are promising", he says, but - as is the case with most complementary medicines - "there are too few trials to be sure".

However, before you start stockpiling steroidal sprays, you might want to give hypnosis a go. A recent Swiss study found that self-hypnosis could reduce the symptoms of hay fever and potentially cut the amount of drugs people need. The theory is that hypnosis might have an effect on the blood vessels that swell during an allergic reaction. So, look into my (swollen) eyes and repeat after me: "I will not itch or wheeze".

How to manage your hay fever

Prevention

Smear Vaseline inside your nostrils.

Vacuum and dust your house regularly with a damp cloth to remove lingering pollen or spores.

Smoking or breathing in cigarette smoke irritates the lining of your nose, eyes, throat and airways, exacerbating symptoms.

Sponge the cat down if it has been in the grass - pollen spores cling to animal fur.

Keep windows closed morning and early evening when pollen rises and falls.

Choose low pollen-count days for gardening or picnics.

Wear wraparound sunglasses and a hat.

Strip off your pollen-dusted clothing before you go inside.

Treatment

Splash cold water on your eyes regularly to wash away the allergens, and soothe swelling.

Talk to your GP if over-the-counter remedies are not working, if you can't afford them, have asthma (hay fever can worsen asthma) or if the sufferer is a child. There are several good antihistamines available only on prescription.

Ask your pharmacist for generic medications - they are the same as the pharmaceutical companies' brand names, but can be up to four times cheaper.

Always ask for non-sedating medication - crashing the car is a far bigger health risk than spraying weak steroids up your nose.

· Asthma UK: for trigger tips go to asthma.org.uk.
Call the adviceline on 08457 01 02 03, or email an asthma nurse at asthma.org.uk/adviceline.