Allergic Rhinitis: Symptoms, Causes & Treatment

Allergic rhinitis is inflammation of the lining of the nose that happens after contact with allergens. Common triggers include dust, pet dander, pollen, and certain plants.

Allergic rhinitis is usually more common in the spring and fall. However, symptoms can happen at any time of year when a person is exposed to something that triggers their allergy.

Treatment for allergic rhinitis may involve lifestyle changes, such as avoiding allergens in mild cases. For recurring flare-ups, an allergist may recommend antihistamines or nasal corticosteroids.

Allergic rhinitis symptoms

The main symptoms of allergic rhinitis are:

• Frequent sneezing

• Stuffy or runny nose

• Itching in the nose, throat, mouth, eyes, or skin

• Red, watery eyes

• Increased mucus in the nose and throat

• Headache

• Facial pressure

• Dark circles under the eyes

In addition, allergic rhinitis can cause mucus to drip down the throat, known as postnasal drip, which can lead to a sore throat.

According to the American Academy of Allergy, Asthma & Immunology, allergic rhinitis can affect both the nose and eyes, which is why symptoms may include nasal congestion as well as eye irritation.

Symptoms of allergic rhinitis are more common in spring and fall, but they can appear at any time of year when a person comes into contact with the substance that triggers the allergy.

How long does an allergic rhinitis episode last?

An allergic rhinitis episode may last only a few hours, but it can also last for several days, depending on how long the person continues to be exposed to the allergen.

Once contact with the allergen ends, symptoms usually start to improve. However, some people may only feel better after a few days of using medication.

Confirming a diagnosis

Allergic rhinitis is usually diagnosed by a primary care provider, allergist, or an ear, nose, and throat specialist (ENT), based on an evaluation of symptoms.

In addition, the doctor may recommend allergy testing to identify what is causing the symptoms.

Possible causes

The main causes of allergic rhinitis are:

• Dust mites, found in dust, mattresses, pillows, and bedding

• Pollen from trees, flowers, and plants

• Pet hair and dander, such as from dogs and cats

• Fungi and mold, found in damp environments

• Chemicals and pollution, such as cigarette smoke, perfumes, cleaning products, pool chlorine, and air pollution

Some people may also have allergic rhinitis triggered or worsened by changes in the weather, such as cold air, wind, or dry air.

Treatment options

Treatment for allergic rhinitis should be guided by a doctor, based on the intensity and frequency of symptoms, and may include:

1. Antihistamines

Antihistamines block histamine, a substance released by the body during an allergic reaction, helping to relieve symptoms such as itching, sneezing, and a runny nose.

Some examples of antihistamines include loratadine, cetirizine, fexofenadine, and levocetirizine, which are effective for mild symptoms.

In addition, a healthcare provider may recommend antihistamine nasal sprays, such as azelastine or olopatadine.

2. Nasal irrigation

Nasal irrigation with saline solution helps remove mucus and allergens from the nose. It can be useful for mild allergic rhinitis and as a complement to treatment with medication.

3. Decongestants

Decongestants help clear a stuffy nose and can be used as nasal sprays or drops, such as oxymetazoline and phenylephrine. They are mainly recommended for fast, temporary relief of congestion.

However, they should only be used for short periods, usually 3 to 5 days, because prolonged use can cause rebound congestion or dependence.

4. Corticosteroids

Nasal corticosteroids are the most effective treatment for allergic rhinitis. They reduce inflammation and relieve nasal congestion, and are mainly used for moderate to severe cases.

This medication starts to work within a few days, but the full effect usually appears within 1 to 2 weeks. Examples include fluticasone, budesonide, and triamcinolone, which may also be combined with antihistamines.

5. Immunotherapy

Immunotherapy can be given in the following ways:

• Subcutaneous injections: small doses of the allergen are injected under the skin, teaching the immune system not to overreact. Treatment usually lasts 3 to 5 years.

• Sublingual tablets: the allergen is placed under the tongue daily to stimulate the immune system to recognize the substance as harmless and reduce the allergic reaction over time.

Immunotherapy is recommended for people with persistent allergic rhinitis who do not respond well to medication or who have frequent and intense symptoms.

Based on guidance from the American Academy of Pediatrics, people with moderate to severe or difficult-to-control allergic rhinitis may be referred to an allergist for diagnostic testing and additional treatment options, including immunotherapy.

Home remedies

Natural treatment for allergic rhinitis can be especially useful during flare-ups and may be used to complement the treatment recommended by a healthcare provider.

One option is nasal irrigation with saline solution or with 10 oz (300 mL) of mineral water and 1 teaspoon of salt. To do this, inhale a small amount of the mixture, gently massage the nose, and then spit it out.

In addition, inhaling steam from eucalyptus tea before going to sleep may also help prevent symptoms the next day.

Does allergic rhinitis have a cure?

Allergic rhinitis has no cure, but its symptoms can be well controlled. With a combination of allergen avoidance, medication, and, in some cases, immunotherapy, it is possible to reduce symptoms and improve quality of life.

Prevention measures

Some simple tips that help prevent allergic rhinitis are:

• Removing dust from furniture or floors only with a damp cloth, avoiding feather dusters or brooms

• Avoiding curtains, carpeting, rugs, throw pillows, and other decorations that collect dust

• Keeping rooms well ventilated to reduce the growth of dust mites and fungi

• Wearing a mask when cleaning closets, shelves, and wardrobes

• Using fragrance-free or neutral-fragrance cleaning and personal hygiene products

• Changing bedding once a week and let the mattress air out in the sun

• Avoiding being outdoors on very windy days, especially in spring and fall

For people who live with pets, it is recommended to keep the animal’s fur trimmed and clean. For people who have birds, it is also recommended to clean the cage twice a week.