SERVER 1 COMPLETE
Allergic rhinitis is the inflammation of nasal passageways that occurs when your immune system overreacts to allergens such as pollen, pet dander, or dust mites that are in the air. When it’s pollen causing the nasal inflammation, allergic rhinitis is referred to as hay fever or seasonal allergies.
In people with allergic rhinitis, exposure to allergens can trigger uncomfortable symptoms like sneezing; runny or stuffy nose; red or watery eyes; and itchiness around the mouth, nose, and eyes.1
More than 400 million people worldwide experience allergic rhinitis. Treatments, including over-the-counter (OTC) and prescription medications and allergen immunotherapy, can help control symptoms and reduce their impact on your daily life.
Types of Allergic Rhinitis
There are two main types of allergic rhinitis: seasonal and perennial. The type of allergic rhinitis you have depends on how frequently you experience symptoms and how long the symptoms last.3
Seasonal Allergic Rhinitis
Also known as hay fever—though it is not specific to hay and does not cause a fever—seasonal allergic rhinitis occurs at specific times of the year when pollen counts are high. People with allergies to pollen from grasses, weeds, and trees can experience seasonal allergic rhinitis, usually in the spring and fall. In addition to hay fever, seasonal allergic rhinitis may be referred to as seasonal allergies.4
Perennial Allergic Rhinitis
The word “perennial” means year-round. As such, perennial allergic rhinitis refers to allergy-related nasal inflammation that can last year-round. People allergic to dust mites, pet dander, cockroach debris, and mold spores can have perennial allergic rhinitis.3
Allergic Rhinitis Symptoms
Symptoms of allergic rhinitis develop shortly after exposure to a substance to which you are allergic and can include:
Runny nose with clear-colored mucus
Sneezing
Red, watery eyes
Itchy eyes, nose, or mouth
Untreated or prolonged allergic rhinitis can lead to additional symptoms, such as:13
Nasal congestion (stuffiness)
Postnasal drip (mucus drainage down the back of the throat)
Cough
Sore throat
Headache
Reduced sense of smell
Clogged ears or ear-popping sensations
Sinus pressure (pressure around the cheeks and nose)
Fatigue
Facial puffiness
Dark circles under the eyes
Difficulty sleeping
Causes
Allergic rhinitis develops when the immune system overreacts to an allergen, which are normally harmless substances like pollen or dust mites that trigger an immune response in people with allergies.
When people with allergies breathe in an allergen, the immune system mistakenly identifies it as a threat, triggering the release of histamine and other chemicals.1 Histamine causes inflammation in the lining of the nose and increases mucus production, leading to symptoms of allergic rhinitis.1
Common allergens that trigger allergic rhinitis include
Pollen from grasses, weeds, and trees
Pet dander from furry pets like dogs and cats
Dust mites
Mold spores
Cockroach debris
Risk Factors
Several factors can increase your risk of developing allergic rhinitis, including:
Family history: If you have a family member with allergies, you’re more likely to experience allergic rhinitis.
Eczema: People with eczema, a chronic inflammatory skin condition, are more prone to allergies and allergic rhinitis.
Early life exposures: Exposure to air pollution, indoor allergens like dust mites, secondhand smoke, and antibiotic use in early childhood can increase the risk of allergic rhinitis.
Lifestyle habits: Smoking and having poor sleep quality are associated with an increased risk of allergic rhinitis.
Diagnosis
When you visit a healthcare provider for symptoms of allergic rhinitis, they will likely begin by reviewing your medical history and asking about your symptoms. They may ask about the following:5
What triggers your symptoms
How frequent and severe your symptoms are
Whether anyone else in your family has a history of allergies
What your work and home environments are like, such as whether you have a pet at home or your workplace involves exposure to chemicals
Your healthcare provider will probably perform a physical examination and may recommend allergy testing to identify what is triggering your allergic rhinitis symptoms.
The most common type of allergy test is a skin prick or scratch test. This involves scratching or pricking (poking) small amounts of possible allergens into your skin and observing whether an allergic reaction occurs in response. If you are allergic to one of the tested allergens, you will likely develop a raised itchy bump where your skin was scratched with that allergen.
Your healthcare provider may also have you do an allergy blood test, such as an ImmunoCAP test. Allergy blood tests measure the amount of immunoglobulin E (IgE) in your blood. IgE are antibodies your body makes against specific allergens. Higher IgE levels can mean you have an allergic disorder like allergic rhinitis.
Treatments for Allergic Rhinitis
The goal of allergic rhinitis treatment is to manage symptoms so you can reduce discomfort and improve your quality of life. Your healthcare provider will develop a treatment plan based on the type of allergic rhinitis you have (seasonal vs. perennial) and the severity of your symptoms.
Medications
Several over-the-counter (OTC) and prescription medications effectively reduce allergic rhinitis symptoms. These include:5
Nasal steroid sprays:
Intranasal corticosteroid sprays are the most effective medication for allergic rhinitis. These sprays help reduce inflammation and swelling in the nose, making it less stuffy. They also relieve symptoms like a runny nose, sneezing, and itchiness. Daily use of nasal steroid sprays typically yields the best results, and it may take up to two weeks to notice improvements in your symptoms.11
Antihistamines: These medicines block the action of histamine to help reduce symptoms like sneezing, itchiness, watery eyes, and runny nose. They come in many forms, including eye drops, oral tablets, syrups, and nasal sprays. Antihistamines are most effective when taken before exposure to an allergen and on a short-term basis; many people find they become less effective over time or as pollen counts increase in the air.
Decongestants:
These medicines, available in nasal spray or pill form, temporarily relieve nasal congestion to help make breathing easier. Decongestants work quickly and can relieve stuffiness for hours, but you should only use them three days at a time.12 Overusing nasal spray decongestants can cause rebound swelling and worsen nasal congestion after you stop using them.
Leukotriene pathway inhibitors: Prescription medications such as Singular (montelukast) block leukotrienes, which are inflammatory chemicals the body releases during an allergic reaction to help reduce symptoms such as runny nose and congestion.