What is allergic rhinitis?
Allergic rhinitis, also known as hay fever, is an allergic reaction. You have an allergy when your body overreacts to things that don’t cause problems for most people. These things are called allergens. Your body’s overreaction to the allergens is what causes symptoms.
There are 2 forms of allergic rhinitis:
- Seasonal (hay fever): Caused by an allergy to pollen and/or mold spores in the air. Pollen is the fine powder that comes from the stamen of flowering plants. It can be carried through the air and is easily inhaled. Symptoms are seasonal and usually occur in spring, late summer, and fall.
- Perennial: Caused by other allergens such as dust mites, pet hair or dander, or mold. Symptoms occur year-round.
Hay fever is the most common form of allergy. Symptoms of hay fever are seasonal. You will feel worse when the pollens that affect you are at their highest levels.
Symptoms of allergic rhinitis
Your symptoms can vary, depending on the severity of your allergies. Symptoms can include:
- Itching (mostly eyes, nose, mouth, throat and skin).
- Runny nose.
- Stuffy nose.
- Pressure in the nose and cheeks.
- Ear fullness and popping.
- Sore throat.
- Watery, red, or swollen eyes.
- Dark circles under your eyes.
- Trouble smelling.
Allergic rhinitis can last several weeks, longer than a cold or the flu. It does not cause fever. The nasal discharge from hay fever is thin, watery, and clear. Nasal discharge from a cold or the flu tends to be thicker. Itching (mostly in the eyes, nose, mouth, throat, and skin) is common with hay fever but not with a cold or the flu. Sneezing is more prominent with hay fever. You may even have severe sneeze attacks.
What causes allergic rhinitis?
You have an allergy when your body overreacts to things that don’t cause problems for most people. These things are called allergens. If you have allergies, your body releases chemicals when you are exposed to an allergen. One type of chemical that your body releases is called histamine. Histamine is your body’s defense against the allergen. The release of histamine causes your symptoms.
Hay fever is an allergic reaction to pollen. Pollen comes from flowering trees, grass, and weeds. If you are allergic to pollen, you will notice your symptoms are worse on hot, dry days when wind carries the pollen. On rainy days, pollen often is washed to the ground, which means you are less likely to breathe it.
- Allergies that occur in the spring (late April and May) are often due to tree pollen.
- Allergies that occur in the summer (late May to mid-July) are often due to grass and weed pollen.
- Allergies that occur in the fall (late August to the first frost) are often due to ragweed.
Allergens that can cause perennial allergic rhinitis include:
- Mold. Mold is common where water tends to collect, such as shower curtains and damp basements. It can also be found in rotting logs, hay, and mulch. This allergy is usually worse during humid and rainy weather.
- Animal dander.Proteins found in the skin, saliva, and urine of furry pets such as cats and dogs are allergens. You can be exposed to dander when handling an animal or from house dust that contains dander.
- Dust. Many allergens, including dust mites, are in dust. Dust mites are tiny living creatures found in bedding, mattresses, carpeting, and upholstered furniture. They live on dead skin cells and other things found in house dust.
How is allergic rhinitis diagnosed?
If your symptoms interfere with your daily life, see your family doctor. Your doctor will ask you questions about your symptoms and medical history and perform a physical exam. Keeping a record of your symptoms over a period of time can help your doctor determine what triggers your allergies.
Your doctor may want to do an allergy skin test to help determine exactly what you are allergic to. During an allergy skin test, tiny amounts of allergens are applied to your skin. Your doctor will observe and record the way your skin reacts to each allergen.
Your doctor may also decide to do a blood test, such as the radioallergosorbent test (RAST). This test identifies antibodies in your blood that determine what you’re allergic to. Once your allergens are identified, you and your doctor can decide the best treatment.
Can allergic rhinitis be prevented or avoided?
Allergic rhinitis cannot be prevented. You can help your symptoms by avoiding the things that you are allergic, including:
- Keeping windows closed. This is especially important during high-pollen seasons.
- Washing your hands after petting animals.
- Using dust- and mite-proof bedding and mattress covers.
- Wearing glasses outside to protect your eyes.
- Showering before bed to wash off allergens from hair and skin.
You can also avoid things that can make your symptoms worse, such as:
- aerosol sprays
- air pollution
- cold temperatures
- irritating fumes
- tobacco smoke
- wood smoke.
Allergic rhinitis treatment
Several medicines can be used to treat allergies. Your doctor will help you determine what medicine is best for you depending on your symptoms, age, and overall health. These medicines help prevent symptoms if you use them regularly, before you’re exposed to allergens.
- Antihistamines help reduce the sneezing, runny nose, and itchiness of allergies. These come in pill form and as nasal sprays. Many are available over the counter. Some require a prescription.
- Decongestants, such as pseudoephedrine and phenylephrine, help temporarily relieve the stuffy nose of allergies. Decongestants are found in many medicines and come as pills, nose sprays, and nose drops. They are best used only for a short time. Nose sprays and drops shouldn’t be used for more than 3 days because you can become dependent on them. This causes you to feel even more stopped-up when you try to quit using them. You can buy decongestants without a doctor’s prescription. However, decongestants can raise your blood pressure. Talk your family doctor before using them if you have high blood pressure.
- Cromolyn sodium is a nasal spray that helps prevent the body’s reaction to allergens. This medicine may take 2 to 4 weeks to start working. It is available without a prescription.
- Nasal steroid sprays reduce the reaction of the nasal tissues to inhaled allergens. This helps relieve the swelling in your nose so that you feel less stopped-up. They are the most effective at treating patients who have chronic symptoms. Many nasal steroids are now available without a prescription. You won’t notice their benefits for up to 2 weeks after starting them.
- Eye drops. If your other medicines are not helping enough with your itchy, watery eyes, your doctor may prescribe eye drops for you. Some are available over the counter.
- Allergy shots or sublingual tablets (also called immunotherapy) are an option for people who try other treatments but still have allergy symptoms. These shots or dissolvable tablets contain a very small amount of the allergen you are allergic to. They’re given on a regular schedule so that your body gets used to the allergens. This helps decrease your body’s sensitivity to the allergens. Over time, your allergy symptoms will become less severe.
Living with allergic rhinitis
Living with the symptoms of allergic rhinitis can affect your daily life. Nasal symptoms can be worse when lying down. This can disturb your ability to sleep well. Fatigue and headaches can affect your ability to function at school and work. There are many medicines and treatments that can help you manage your symptoms. Talk to your doctor as soon as you feel that your symptoms are getting worse or are not easy to control. He or she can help you come up with the right plan to control them so they don’t affect your ability to live your normal life.
Questions to ask your doctor
- Could anything else, such as a cold or the flu, be causing my symptoms?
- How do I figure out what I’m allergic to?
- Is my allergy seasonal?
- I am allergic to _____. Am I at risk for any other allergies?
- What changes can I make at home to help relieve my symptoms?
- Will any over-the counter medicines help relieve my symptoms?
- What should I do if my symptoms get worse or don’t respond to the treatment you’ve prescribed?
- Do I need to see an allergy specialist (called an allergist or immunologist)?
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.