September sinuses are not a personality

Fynbos and grass pollens ramp up from late August. The rain we have just had leaves damp walls, damp car boots and mould spores that peak as things dry out. Then the south-easter arrives and moves all of it around at speed, including sand and salt.

That is why so many people here get 'a cold every September' that never becomes a proper cold.

Allergy: itchy eyes, nose and palate, sneezing in runs, clear runny nose, worse outdoors or on windy days, no fever, and it lasts weeks.

Viral: sore throat first, thicker discharge after a few days, aches, sometimes fever, and it is gone in about a week. Being able to tell them apart saves you buying the wrong thing twice.

Saline spray or a rinse physically removes pollen, dust and salt from the nose. It is cheap, it is safe in pregnancy and in children, it works alongside everything else, and it is the single most under-used thing in the shop.

Use it after a beach walk, after a session, and before bed. Rinse with the right solution and clean water, and clean the device.

Non-drowsy oral antihistamines for sneezing, itch and runny nose. Older sedating antihistamines are still around and are a poor choice if you are driving, working or cycling.

Steroid nasal sprays are the most effective option for a genuinely blocked, inflamed nose, and they need consistent daily use for a week or two before you judge them. Technique matters — ask us to show you, most people spray it straight at the septum.

Antihistamine eye drops for the itch nobody else can see.

Decongestant sprays: short-term only. More than a few days and the nose rebounds worse than it started. We get several of those every spring.

Which of these suits you depends on your blood pressure, your other medicines, pregnancy and age. That is a counter conversation.

Children get age-specific doses and formulations — do not split adult products. Saline is fine at any age.

Visitors from a European winter often react hard to a first Cape spring. Come in, tell us what you take at home, and we will find the local equivalent that does not clash with your repeats.

Blocked on one side only, facial pain with fever, discoloured discharge lasting more than ten days, wheeze or breathlessness, a nosebleed that keeps returning, or hayfever treatment that is not working after two weeks — book a consult or see a doctor.