ALLERGIC RHINITIS – TYPES, CAUSES & TREATMENT
Allergic rhinitis may sound like an unpleasant medical diagnosis. However, it’s simply the medically recognized name for the condition you probably know as hay fever. Up to 30 percent of people worldwide are affected by allergic rhinitis,1 which means you’re certainly not alone if you experience allergy symptoms.
WHAT CAUSES ALLERGIC RHINITIS?
Allergic rhinitis refers to a range of inflammatory symptoms, primarily in the nose and eyes, caused by the reaction of your immune system to the presence of an allergen. An allergen is any normally harmless substance that your body mistakes for a hazard, triggering the immune response that creates your symptoms.2
SYMPTOMS OF ALLERGIC RHINITIS
The most common symptoms of allergic rhinitis include:
- Sneezing
- Runny or itchy nose
- Itchy, watery eyes
- Nasal congestion
Other symptoms may include fatigue, a cough caused by post-nasal drip, swollen eyelids, itching in the mouth or throat, headaches, or even skin rashes and hives.2,3
Many of the symptoms are similar to those you would get from a cold or the flu, but there are some key differences between allergy, cold and flu symptoms. For example, allergies tend to last longer than colds or the flu, and you won’t experience a fever with allergic rhinitis.
Many of the symptoms are similar to those you would get from a cold or the flu, but there are some key differences between allergy, cold and flu symptoms. For example, allergies tend to last longer than colds or the flu, and you won’t experience a fever with allergic rhinitis.
TYPES OF ALLERGIC RHINITIS
There are two main types of allergic rhinitis – ‘seasonal’ and ‘perennial’ – distinguished by when and for how long you experience symptoms. They are usually caused by different types of allergens.
SEASONAL ALLERGIC RHINITIS
If you only experience allergy symptoms at certain times of year, you’re most likely suffering from seasonal allergic rhinitis. Commonly known as hay fever, these allergies usually occur when your body reacts to plant pollen or other airborne allergens such as mold spores, which you’ve inhaled or which has come into contact with your skin. In response, your immune system releases a variety of substances meant to protect you from the perceived “invaders” – but which also cause the inflammation which produces your allergy symptoms.4
Because different plants produce pollen in different seasons, you may only experience symptoms for a few weeks or months a year. For example, trees produce pollen in spring, so if you’re sensitive to tree pollen, you may experience sneezing, congestion and other symptoms then. In summer, grass pollen is usually the culprit, whereas in the fall it’s ragweed and other weeds.5 Read more about different pollen seasons and seasonal allergy triggers.
PERENNIAL ALLERGIC RHINITIS
If you are experiencing chronic allergic rhinitis symptoms for longer periods of time, you may be dealing with perennial allergic rhinitis. Symptoms are similar to those of seasonal allergic rhinitis, but vary in frequency, occurring for at least one hour on most days throughout the year.6
Perennial allergic rhinitis occurs when your immune system overreacts to allergens that are present in your environment throughout the year. This is why your symptoms appear on a longer-term basis, rather than just during particular seasons.
The most common allergens that trigger perennial allergic rhinitis are dust mite droppings and animal dander – especially from household pets like cats and dogs. Other possible triggers include mold, houseplants and carpeting.5,6 .
Your doctor or an allergist can help determine what’s causing your allergies by looking at your symptoms and performing allergy tests. They can also rule out other conditions.4,5
RISK FACTORS, COMPLICATIONS AND OUTLOOK
Allergic rhinitis is a common condition – around eight percent of Americans experience some of the symptoms.3 If you have a family history of allergies or inflammatory conditions such as eczema or asthma, you’re more likely to suffer from allergic rhinitis.2,3
Once an allergen begins to trigger your symptoms, it’s likely you will experience the same effect for the rest of your life. However, in some cases children with allergies will outgrow the condition in later life, although not always.4 Find out more about managing allergies in children.
Sometimes allergic rhinitis can be complicated by certain medical conditions, such as nasal polyps or a deviated septum. Your doctor can advise whether you need to see a specialist for treatment.5
Fortunately, in most cases allergic rhinitis symptoms can be controlled through medication and avoiding triggers.
MANAGING ALLERGIC RHINITIS SYMPTOMS
You can help reduce your allergy symptoms by avoiding the allergens that trigger them. Here are a few tips:5
- During pollen season, monitor local pollen counts and stay indoors on days when pollen levels are high.
- Keep windows and doors closed and avoid drying laundry outdoors to reduce the amount of pollen you bring into your house.
- Wear a hat and sunglasses outdoors to prevent pollen from getting into your eyes and making them itch, or consider a pollen filter mask for outdoor activities such as gardening.
- Avoid contact with animals if they trigger your allergies or at least wash your hands well after. If you have a pet, try restricting them to certain rooms of the house to cut down on your exposure.
- Use anti-allergen bedding to cut down on the number of dust mites and wash regularly in hot water (130 degrees Fahrenheit or more).
- Replace carpet with hard floors, which are easier to keep free of dust and animal hair.
- Clean surfaces with a damp rag or mop rather than sweeping or using a duster, to avoid spreading allergens into the air.
- Use a dehumidifier to reduce the humidity in your home and help prevent the growth of mold.
Read more about avoiding pollen and reducing indoor allergens in your home.
You may find that certain other substances, such as cigarette smoke, strong perfume, hairspray, cleaning products and car exhaust also bring on your symptoms or make them worse.5
TREATMENT FOR ALLERGIC RHINITIS
A variety of medicines are useful in treating allergic rhinitis. Depending on the type and severity of your allergies, different options are available both over the counter and from your doctor on prescription.
Here are a few treatments you may consider:
Antihistamines
Antihistamines are one of the most popular allergy medicines and are widely available over the counter, often as pills or syrups. They work by helping to block histamine, one of the substances released by your immune system cells in response to an allergen and which contributes to causing your symptoms.5
Antihistamines can counteract symptoms such as itchy and watery eyes, runny nose and sneezing, but single-ingredient antihistamines do not treat nasal congestion.7 All antihistamines have an adequate safety profile, but some may cause drowsiness, dry mouth and other side effects.5
Decongestants
Decongestants help relieve swelling within the tissues of the nose so are helpful in reducing nasal congestion, stuffiness and sinus pressure. However, they will not help with itching and other symptoms of allergic rhinitis.5
Both prescription and over-the-counter decongestants are available as sprays, pills or liquids. As some decongestants may raise blood pressure, you should check with your doctor before taking them if you suffer from high blood pressure or any condition affecting your heart.5 Note that you should also not use decongestant nasal sprays for longer than a few days at a time.
Corticosteroid nasal sprays
Corticosteroid nasal sprays such as the FLONASE product range are effective because, unlike most allergy pills,* these once-daily nasal sprays treat nasal congestion as well as sneezing, itchy nose, runny nose, and itchy, watery eyes.† While most allergy pills only block histamine, FLONASE nasal sprays block six key inflammatory substances released by your immune system cells.**
These allergy sprays have an adequate safety profile for long-term use and can be purchased over the counter.8
Immunotherapy
Your doctor may recommend you try allergy shots, a form of immunotherapy. These shots deliver a diluted extract of the allergens that are triggering your symptoms. The goal of this is to build up tolerance over time to the effects of the allergen and reduce the intensity of the symptoms caused by its exposure.2
Another form of immunotherapy is sublingual tablets, which are placed daily under the tongue several months before allergy season begins.2
*vs single-ingredient antihistamines that do not treat nasal congestion.
**Mechanism vs. most over-the-counter (OTC) allergy pills. FLONASE acts on multiple inflammatory substances (histamine, prostaglandins, cytokines, tryptases, chemokines, and leukotrienes). The exact number and precise mechanism are unknown.
†FLONASE SENSIMIST is indicated for itchy, watery eyes in adults and children 12 years of age and older.
Sources:
1. AAAAI. Allergy Statistics. http://www.aaaai.org/about-the-aaaai/newsroom/allergy-statistics.aspx Accessed October 16, 2018.
2. WebMD. Understanding Hay Fever – the Basics. https://www.webmd.com/allergies/understanding-hay-fever-basics. Accessed August 22, 2019.
3. Healthline. Allergic Rhinitis. https://www.healthline.com/health/allergic-rhinitis. Accessed August 22, 2019.
4. NIH. Allergic Rhinitis. http://www.nlm.nih.gov/medlineplus/ency/article/000813.htm. Accessed October 16, 2018.
5. ACAAI. Allergic Rhinitis. https://acaai.org/allergies/types/hay-fever-rhinitis. Accessed October 16, 2018.
6. ENT Health. Rhinitis. https://www.enthealth.org/conditions/rhinitis/. Accessed October 16, 2018.
7. NIH. Perennial Rhinitis. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1112817/. Accessed October 16, 2018.
8. NIH. Nasal corticosteroid sprays. https://medlineplus.gov/ency/patientinstructions/000404.htm. Accessed August 22, 2019.
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