Rhinitis, including hay fever, is the most common of all the allergic diseases. The typical symptoms such as blocked nose, watery eyes, & running nose may persist all year round (perennial rhinitis) or may be seasonal. Even though it’s often undiagnosed and its symptoms often thought of as harmless, the impact perennial rhinitis can have on a person’s overall quality of life can be significant.
What is rhinitis?
Rhinitis is inflammation of the nose. It may, or may not, be caused by an allergy.
Another symptom of perennial allergic rhinitis is post-nasal drip, where mucous runs down the back of the nose and then into the throat and the airways, producing a persistent phlegm cough.
Causes of allergic rhinitis
Allergic rhinitis is caused by exposure to an airborne allergen. Common allergens include:
What happens when the allergen is breathed in
In allergic rhinitis, blood flow is increased, the mucous membranes swell and there is increased mucous production, all occurring in response to histamine production on exposure to the allergen. The result is nasal congestion, nasal blockage, and/or a runny nose.
Allergic rhinitis diagnosis
A simple description of your symptoms and their seasonality may be all that is required to diagnose rhinitis.
If confirmation and/or identification of an allergic cause is needed, then a skin prick test can be used. A tiny drop of allergen extract is placed on the skin at either the arm or the back. If you are allergic to the substance, a small red weal will appear within a short period.
Allergic rhinitis can be reduced by avoiding exposure to allergic triggers, for example:
House dust mite
Medical treatments for allergic rhinitis
If your symptoms are mild, you can use a long-acting non-sedating antihistamine such as Claritin (loratadine), NeoClaritin (desloratadine), Zyrtec (cetirizine), Xyzal (levocetirizine) or Allegra (fexofenadine). These are available without a prescription, but you should always consult your pharmacist before use.
The older antihistamines like chlorpheniramine (Piriton) and hydroxyzine (Atarax) have a significant sedating effect and should not be used if you are driving, operating machinery, or studying. These older drugs also interact with alcohol so having even a small amount to drink may significantly affect performance.
If rhinitis mainly affects your eyes, antihistamine eye drops, such as Otrivine (antazoline) may help.
In addition to an antihistamine, a nasal decongestant (drops or a spray) may also be helpful in clearing a blocked nose. Some of these decongestants are corticosteroids, which act by reducing inflammation including Beconase (beclomethasone) and Flixonase (fluticasone). Non-corticosteroid nasal decongestants include Otrivine/Sudafed (xylometazoline). All of these can be bought without a prescription. However, only use a decongestant for as short a time as possible, as the nose tends to stop responding to these medications over time.
In general, antihistamines and topical nasal steroids are most effective against seasonal allergic rhinitis/hay fever but may still help with perennial allergic rhinitis.
Can an air cleaner help?
While numerous manufacturers of ‘air cleaners’ / ‘air filters’ claim to be able to clear those allergens leading to rhinitis from the air, they can only reduce, not eliminate, the problem, because:
Dr Wyatt blogs on his lifetime's experience of Indoor Air Quality Issues.