Kenalog Injections for Hay Fever: What UK Patients Need to Know

For one in four people in the UK, spring and summer mean itchy eyes, sneezing fits, and disrupted sleep. While many find relief with antihistamines or nasal sprays, around 10% of sufferers don’t – prompting them to explore stronger options like Kenalog injections. But what is Kenalog really? Why was it so popular? And why has the NHS moved away from it? In this article, we’ll answer all those questions and more, helping you make an informed, safe decision about your hay fever care.

What Is Kenalog ,How Does It Work and Why the NHS No Longer Recommends It?

Kenalog is the brand name for triamcinolone acetonide, a type of corticosteroid (steroid) medication. Unlike the antihistamine pills or steroid nasal sprays, you might use daily for hay fever, Kenalog is given as a single intramuscular injection (usually into the buttock). Once injected, the steroid is gradually released from the muscle over the course of 3 to 8 weeks, circulating throughout the body. This slow-release action dampens the body’s immune response to allergens (like pollen), thereby reducing inflammation and relieving hay fever symptoms. In simpler terms, Kenalog “turns down” your immune system’s overreaction to pollen for an extended period. Many anecdotal reports and patients have noted significant improvements in their hay fever symptoms after this injection – for some, it can provide relief for an entire allergy season with no need for daily tablets or sprays. Because of these effects, Kenalog injections were historically seen as a convenient “one-and-done” solution for severe hay fever. In past decades, it was not uncommon for GPs in the UK to administer this steroid jab to patients who struggled with seasonal allergies. In fact, the NHS used to offer Kenalog injections routinely to severe hay fever sufferers, and many patients found it extremely effective at the time. About 10 years ago, however, the NHS stopped prescribing Kenalog for hay fever, as guidelines determined that the potential risks do not justify the benefits. To understand this change, we need to look at why medical experts grew concerned about Kenalog’s safety.

• Not licensed for hay fever treatment in the UK – considered an off-label use.

• National guidelines (NICE, BSACI) advise against routine use due to the unfavourable risk-to-benefit ratio.

• The MHRA and Advertising Standards Authority caution against its casual promotion.

Safer and effective alternatives exist, so Kenalog is reserved for very specific, severe cases.

Although Kenalog can be effective, UK health authorities have strong reasons for not recommending it as a first-line hay fever treatment today. According to official UK guidelines (including those by NICE and allergy specialist groups), long-acting “depot” steroid injections have an unfavorable risk/benefit profile in hay fever and are not recommended. In other words, while one injection might clear up your symptoms, the potential for side effects and long-term harms outweighs the convenience for most patients. The consensus is that most hay fever sufferers can get good relief through other safer methods (we’ll discuss those alternatives later), so exposing someone to the higher risks of a steroid shot isn’t usually justified. It’s also important to note that Kenalog is not licensed for the treatment of hay fever in the UK. It is a prescription-only medicine licensed for other inflammatory conditions (like arthritis) but using it for seasonal allergies is an off-label use. This means when it was given for hay fever, it was being used outside its official approved purpose, under a doctor’s discretion. Regulators have taken notice as well. In 2022, the UK’s Medicines and Healthcare products Regulatory Agency (MHRA) and Advertising Standards Authority highlighted that Kenalog should only be used (if at all) on a case-by-case basis by a qualified prescriber, not marketed as a quick fix for anyone with hay fever. The bottom line from the NHS and regulators is clear: Kenalog injections are not part of routine hay fever care in the UK , due to safety concerns and the availability of other effective treatments.

Risks and Side Effects

While many people tolerate it well, Kenalog is not risk-free:

• Mild to moderate side effects: mood changes, weight gain, fluid retention, headaches, insomnia.

• Immune suppression: increased risk of infections, flare-ups of dormant viruses (e.g. shingles).

• Injection site effects: pain, dimpling, or fat loss at the site.

• Serious risks with repeated use: bone thinning (osteoporosis), high blood pressure, diabetes, avascular necrosis (bone tissue death).

• Not suitable for people with:

-Diabetes

-Active infections

-Glaucoma or uncontrolled hypertension

-History of steroid sensitivity or mental health side effects

Like any potent steroid, Kenalog can cause side effects – and these must be considered carefully. It’s crucial to balance this discussion: many people who received the injection in the past had no serious issues, and clinics that still offer Kenalog often point out that a single 40 mg dose is relatively low. However, no medical treatment is risk-free, and Kenalog’s method of dispersing a steroid through the entire body for weeks means side effects can occur anywhere in the body. • Common side effects: Kenalog’s steroid can cause a long list of mild-to-moderate effects. Patients have reported issues like raised blood pressure, fluid retention (bloating), headaches, dizziness, insomnia, increased appetite leading to weight gain, and mood changes (irritability, anxiety, or low mood). These effects are generally temporary, but they can be unpleasant. Because the steroid stays in your system for weeks, any side effect may persist during that time (and there’s no way to “undo” the injection once given).

Immune suppression and infections: By design, the injection suppresses your immune system’s activity. While this is how it eases allergic symptoms, it also makes you more susceptible to infections during those weeks. For example, you might catch colds, flu, or other bugs more easily than usual. In rare cases, dormant infections like shingles or tuberculosis could flare up. It’s a bit like taking down your body’s defences temporarily – usually not a big issue if nothing else attacks you, but a risk if something does. (Importantly, you should not have a Kenalog shot if you already have an active infection for this reason.) •

Injection site reactions: The procedure itself is a quick intramuscular shot, which most patients tolerate well. Still, you might have some pain, redness, or soreness at the injection site. There’s a small risk of an “unsightly dimple or scar” on your buttock . This happens if the tissue or fat under the skin is irritated or atrophies (wastes away) from the steroid, leading to a dent. While not dangerous to your health, it’s a cosmetic consideration.

Steroid-related health risks: Prolonged or high-dose steroid use is known to cause issues like osteoporosis (bone thinning), diabetes, high blood pressure, glaucoma/cataracts in the eyes, stomach ulcers, and others. With a single Kenalog injection, these serious effects are rare. However, if someone takes steroid injections repeatedly (year after year), the cumulative exposure increases these risks. Bone health is a particular concern – repeated steroids can lead to weaker bones and even fractures. There’s also a phenomenon called avascular necrosis, an extremely rare but severe complication where blood supply to a bone (often the hip) is compromised, causing the bone tissue to die. This has been reported in a few cases of patients who received depot steroid injections for allergies over multiple years. For instance, one published case report in the BMJ described a man who developed avascular necrosis of both hip joints after receiving yearly Kenalog/Depo-Medrone injections for 11 years.

Who should not get Kenalog: There are certain conditions where this injection is particularly risky. If you have diabetes, steroids can spike your blood sugar; if you have a history of stomach ulcers, steroids could aggravate them; if you have an ongoing infection or severely weakened immune system, Kenalog could worsen your ability to fight it. People with glaucoma or uncontrolled high blood pressure, or those who’ve had mental health reactions to steroids in the past, also need extreme caution. This is why Kenalog injections must be prescribed on an individual basis by a doctor – they’ll screen for contraindications. It’s not suitable for everyone, and no one should be getting it without a proper medical consultation. Overall, the risks of a single Kenalog injection for most healthy people are low to moderate – serious side effects are rare. Many individuals in the past got the jab and felt only minor issues, if any.

However, because hay fever tends to recur every year, the concern is that people might start relying on an annual steroid injection, compounding their risk over time. The NHS stance is that it’s better to avoid that path and use other treatments that don’t carry these systemic side effects. As one Drug and Therapeutics Bulletin review succinctly concluded in 2020: even though one injection will likely relieve hay fever symptoms, uncertainty remains about the safety of repeated injections, so this treatment should not be used routinely. It’s a “last resort” option, not a go-to remedy.

Who Might Still Benefit from Kenalog?

Kenalog is not for the average hay fever sufferer, but in rare and severe cases, it might be considered:

• Patients unresponsive to standard medications and already under specialist care.

• Those with contraindications to regular hay fever treatments.

• Exceptional, one-off scenarios: important life events where other treatments have failed.

Such use must be under the guidance of a medical professional, with informed consent and full risk discussion.

Given the above, you might wonder: Why would anyone still consider this injection? The fact is, Kenalog can be a lifesaver for a small group of patients – those who truly suffer from severe, debilitating hay fever that fails to respond to all other therapies. Imagine someone who has tried every combination of high-dose antihistamines, prescription nasal steroids, decongestants, and even immunotherapy, yet each summer they are bedridden by allergy symptoms. Or think of a patient with severe allergic rhinitis and coexisting asthma exacerbated by pollen, who ends up in hospital during peak pollen season despite maximal treatment. In such scenarios, a doctor might judge that a Kenalog injection is worth the risk, to prevent major impacts on the patient’s life or health. Official guidelines do allow room for clinical judgment. For example, the British Society for Allergy & Clinical Immunology (BSACI) guidelines and experts suggest that in very severe or intractable cases, a short course of systemic steroids (usually oral prednisone) can be considered. By extension, some allergy specialists may consider a depot steroid injection if a patient absolutely cannot adhere to or tolerate oral steroids. Kenalog is generally not recommended for anyone with “ordinary” hay fever symptoms that respond to conventional treatments. But for those rare cases where hay fever is truly severe and unmanageable, Kenalog could be an option under strict medical supervision. So, who exactly might be in this select group? Potential candidates could include:

Patients who have tried and failed all standard therapies: This means you’ve used high-strength antihistamines (like fexofenadine), regular intranasal corticosteroids, saline rinses, maybe Montelukast pills, etc., and possibly even allergen immunotherapy, yet you still have severe symptoms. Such patients should ideally be under the care of an allergy specialist. After exhausting other options, a specialist might agree to use Kenalog as a last resort to get them through a particularly bad season.

Patients who cannot use other treatments: For instance, someone who experiences severe adverse reactions or allergies to most hay fever medications, or who has medical contraindications to them, might have no other viable relief except a steroid injection. This is uncommon, but not impossible.

Exceptional circumstances: Occasionally, a one-off situation might warrant considering Kenalog – for example, a patient with severe hay fever who has an impending critical life event (say, major exams, a wedding, or a sporting event) and who has not found relief through usual means. A doctor might administer Kenalog once to ensure the patient can function during that important period, with the understanding that this is not to be repeated regularly. It must be emphasized that the decision to use Kenalog in these cases is made on an individual basis, carefully weighing pros and cons. Clinics like Est-Ethics (and any responsible healthcare provider) will only offer Kenalog after thorough assessment and informed consent, ensuring the patient understands the risks. Any patient receiving it should be monitored, and the goal should always be to revert to safer long-term treatments if possible.

Kenalog in the UK vs Global Use

• Kenalog is still used in some countries, but global guidelines are trending away from it for hay fever.

• The UK’s cautious stance aligns with most other developed countries: systemic steroids should only be used when absolutely necessary.

  
  

  The global trend favours caution: Kenalog injections for hay fever have largely fallen out of favour in high-resource healthcare systems due to safety concerns. The UK’s stance is among the most restrictive, but it is very much in line with other Western countries’ best practices. If you read international allergy guidelines, you’ll see a common theme: focus on preventive and topical treatments for hay fever, save systemic steroids for only the toughest situations. Alternative Treatments for Hay Fever The good news for hay fever sufferers is that there are many effective treatments available – and you often get the best relief by using them in combination and proactively. If you’re not getting enough relief, it’s worth reviewing your regimen with a healthcare professional, because sometimes simple changes (like starting medications earlier in the season or using a nasal spray correctly) can make a big difference.

  
  

Effective and Safer Alternatives

Most people don’t need Kenalog – try these first:

Over-the-Counter (OTC) Remedies:

Over the counter (OTC) medications: Oral antihistamines are usually the first thing people reach for. Non-drowsy options like cetirizine or loratadine can help sneezing and runny nose. There are also antihistamine eye drops (e.g. sodium cromoglicate drops) for itchy eyes, and anti-allergy nasal sprays. OTC nasal sprays include steroid sprays (e.g. fluticasone, beclometasone) and antihistamine sprays (like azelastine). Often, a combination of a daily antihistamine pill plus a nasal spray works better than either alone. Many of these are available cheaply at pharmacies. About 90% of hay fever sufferers do find relief with such remedies – so ensure you’ve tried these basics, possibly in combination, before considering anything more invasive.

• Non-drowsy oral antihistamines (e.g., cetirizine, loratadine).

• Nasal steroid sprays and antihistamine sprays.

• Eye drops for allergic conjunctivitis.

Prescription Treatments:

If pharmacy meds aren’t enough, doctors can prescribe stronger options. These include higher-dose or different antihistamines such as fexofenadine, combination nasal sprays (for example, Dymista, which combines a steroid and antihistamine in one), or leukotriene receptor antagonists like Montelukast (which can help if you have allergic asthma or persistent nasal symptoms). For those with severe nasal blockage, a short course of a nasal decongestant spray or even a brief course of oral steroids (prednisolone tablets for 5-7 days) might be used at peak season – under medical guidance – to get things under control. The key is that these treatments can be stopped or adjusted quickly if side effects occur, unlike a long-acting injection.

• Stronger antihistamines (e.g., fexofenadine).

• Combination sprays (e.g., Dymista).

• Montelukast (especially helpful in asthma-related hay fever).

• Short courses of oral steroids for emergency flare-ups.

  
  

Immunotherapy:

This is a highly effective long-term treatment for severe hay fever. Immunotherapy involves exposing your immune system to tiny amounts of the allergen (e.g. grass pollen) in a controlled way to “train” it to be less reactive. It can be done via injections (subcutaneous immunotherapy) or sublingual tablets/drops that dissolve under the tongue. Immunotherapy is typically administered over 3 years and can greatly reduce symptoms for many years after. It’s the closest thing to a “root cause” treatment for allergies. In the UK, immunotherapy is usually offered by specialists for patients with bad hay fever that isn’t controlled by conventional meds. Guidelines recommend immunotherapy for those who don’t respond to standard treatments, rather than resorting to repeated steroid injections. While immunotherapy requires patience (it’s not a quick fix and can be expensive), it has a strong safety profile and can significantly improve quality of life without the systemic risks of steroids.

Some people benefit from using saline nasal irrigation (rinse) to clear pollen from their nostrils. Others explore natural remedies like butterbur or quercetin, though evidence is limited – always discuss with a doctor before trying supplements. If hay fever triggers asthma, ensure your asthma inhalers are optimised too. And if eye symptoms are severe, prescription eye drops (mast cell stabilizers or stronger antihistamines) can be added. The mainstay of hay fever management remains oral antihistamines, nasal corticosteroid sprays, and eye drops as needed. These can be personalised – for example, some patients might need a non-drowsy antihistamine in the morning and a different one at night, plus a steroid nasal spray daily. It can take some trial and error, but most patients can get good relief with the right regimen. If you’re consistently miserable every hay fever season, don’t give up – ask your GP or a specialist about stepping up your treatment or starting immunotherapy.

• Subcutaneous (injections) or sublingual (tablets) treatments.

• Treats the root cause of hay fever over time.

• Best for long-term control in severe cases.

  
  

Self-Help & Lifestyle:

Allergen avoidance and self-help measures: These are easy wins. During high pollen count days, try to limit exposure: keep windows closed, shower and change clothes after coming indoors, wear wrap-around sunglasses to protect your eyes, and consider applying a bit of petroleum jelly (Vaseline) inside your nostrils to trap pollen. Avoid mowing the lawn or walking through tall grass if grass pollen triggers you. These steps won’t eliminate symptoms, but they can reduce the intensity and give your medications a fighting chance to work.

• Avoid high pollen exposure.

• Use saline rinses, wraparound sunglasses, and Vaseline in nostrils.

• Optimise indoor environments (e.g., HEPA filters, shower after being outside).

Conclusion: Personalised, Safe, and Effective Hay Fever Care

Hay fever might be incredibly common, but that doesn’t mean you have to suffer in silence — or resort to drastic options without exploring safer, evidence-based solutions first.

Kenalog (triamcinolone) injections can offer dramatic relief. For some, it feels like a “miracle jab” that makes summer bearable again. But as we’ve discussed, this relief comes with serious caveats. Due to safety concerns and the wide availability of effective alternative treatments, the NHS and UK allergy experts no longer recommend Kenalog as a routine option for hay fever.

For most people, a well-tailored combination of antihistamines, nasal sprays, and possibly immunotherapy can keep hay fever symptoms well controlled — without the long-term risks associated with systemic steroids.

But if you’re someone who has truly exhausted conventional treatments and is still struggling, don’t give up. The answer may not be in a stronger drug, but in a smarter, more personalised approach. This might include:

• Reviewing your current treatment plan

• Exploring advanced prescription options

• Considering immunotherapy

• Or, in rare and severe cases, discussing Kenalog with full understanding of the risks.

  
  

At Est-Ethics Wellness Clinic, your safety and well-being are at the heart of every recommendation we make. We understand how disruptive hay fever can be, especially when it affects your sleep, productivity, and ability to enjoy life outdoors. That’s why we stay up to date with the latest treatments and clinical guidance — so we can offer solutions that are not only effective but also safe and sustainable.

Whether you need help fine-tuning your current medications, are curious about immunotherapy, or are considering Kenalog under proper supervision, our medical team is here to guide you - Don’t let hay fever control your summer! With the right treatment plan, you can get back to enjoying the outdoors — without the sneezing, itching, or dread.

Book a consultation today