Allergic Rhinitis

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KEY POINTS

• Allergic rhinitis is a type of allergic reaction that causes nose, ear, throat, chest, and eye symptoms.
• Some symptoms are so mild that they don’t need treatment. Life style changes and medicines may be used to treat your symptoms including decongestants, antihistamines, steroids, nasal sprays, and nose drops.
• Follow the full course of treatment prescribed by your healthcare provider. Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

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What is allergic rhinitis?

An allergy is your body’s reaction to a substance that is normally harmless. With allergies, your body sees the substance as harmful or foreign and your immune system reacts to the substance. Substances that can cause an allergic reaction are called allergens.

Allergic rhinitis is a type of allergic reaction that causes nose, ear, throat, chest, and eye symptoms. Some allergens are around only during certain seasons, such as pollen from weeds, grasses, and trees. These allergens get into the air and cause a type of allergic rhinitis called hay fever. Other allergens, such as mites in house dust or animal dander, cause symptoms year-round.

What is the cause?

Your immune system is your body's natural defense against bacteria, viruses, and other foreign substances. Before you can have a reaction to a particular substance, your immune system must first be sensitive to it. Usually this means your body has to have been exposed to the substance at least once before. Once it is sensitive to it, your body will react every time you have contact with the substance.

The substances that most often cause allergic rhinitis are:

• Pollen in the air from grasses, weeds, and trees
• Molds
• Mites (tiny bugs) in house dust
• Animal dander (dried skin flakes)

What are the symptoms?

Symptoms of allergic rhinitis may occur year-round or just during certain times of year, depending on what you are allergic to. Common symptoms are:

• Sneezing
• Stuffy or runny nose
• Itchy nose, throat, or ears
• Ear pressure or fullness
• Red, itchy, watery eyes
• Headache
• Coughing, wheezing, or shortness of breath

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

• Blood tests
• A skin prick test or scratch test, which uses a drop of allergen extract (liquid) put under your skin using a needle

How is it treated?

Some symptoms are so mild that they don’t need treatment. A mix of lifestyle and environment changes and several kinds of medicines may be used to treat your symptoms:

• Decongestants reduce swelling in your nose and sinuses. They may also lessen the amount of mucus made by your nose. If you use decongestants more often than directed, your stuffy nose may get worse. Do not give decongestants to children under the age of 4. If your child is between the ages of 4 and 6, ask your healthcare provider before giving decongestants.
• Antihistamines block the effect of histamine. Histamine is a chemical your body makes when you have an allergic reaction. Do not give antihistamines to children under the age of 4. If your child is between the ages of 4 and 6, ask your healthcare provider before giving antihistamines.
• Nasal steroid sprays help reduce the irritation and swelling in your nose and sinuses. By lessening the swelling, you will have fewer symptoms and be able to breathe better.
• Cromolyn nasal spray can help prevent the body’s reaction to inhaled allergens. It may take 2 to 4 weeks for it to start working. Also, it is more helpful if you use it before you are around allergens. It is available without a prescription.
• Your healthcare provider may recommend eye drops for itchy, watery eyes.
• Immunotherapy is a type of treatment that includes shots or pills containing small amounts of the substances you are allergic to. It may take several months or years of treatment for your symptoms to decrease.

If you have symptoms that come and go, you may be able to take a nonprescription decongestant or antihistamine. Ask your healthcare provider or pharmacist which medicine is best for you and how to use it. Nonprescription medicine may have side effects. Read the label and take as directed.

Your healthcare provider may also recommend eye drops to relieve your symptoms.

How can I take care of myself?

Follow the full course of treatment prescribed by your healthcare provider. In addition:

• Try to avoid the things you are allergic to:
  • Put plastic covers on pillows and mattresses for protection against dust and mold.
  • Wear a mask over your nose and mouth if you have symptoms when you do yard work or housecleaning. (You can buy masks at the drug store.)
  • Vacuum your carpets, curtains, and furniture often, and use a HEPA filter if possible. Remove carpets, fluffy stuffed animals, and extra pillows from the bedroom. Clean your uncarpeted floors with a damp mop or cloth.
  • Try to keep pets off the bed and other furniture and out of the bedroom. Wash your hands after petting or grooming a pet.
  • Remove any mold you find in your home. Use paint rather than wallpaper on your walls. Don't put carpet in damp areas.
  • Stay away from trees and grass as much as you can during pollen season. Do not exercise outside when pollen levels are high.
  • Keep doors and windows shut during pollen season. Use an air conditioner, if you have one, in your house and car. Do not use a window or attic fan.
  • Shower or bathe each evening to remove pollens or other allergens from your hair and skin.
• Wash your pillowcases, sheets, and bedcovers every week with hot water.
• Use artificial-tears eye drops to help wash out your eyes. Antihistamine eye drops may help, too. You can get these eye drops at the store without a prescription.
• You may find that nasal saline rinses help. Nasal saline rinses can remove dirt, dust, and pollen, as well as help to loosen thick mucus. This can help relieve symptoms of allergic rhinitis. You can buy a nasal saline rinse kit at the store, or you can make your own:
  • Mix 8 ounces of water (1 cup) with 1/2 teaspoon of non-iodized table salt and a pinch of baking soda. Use lukewarm distilled or previously boiled water. Having the right mix helps prevent irritation. Do not use plain tap water.
• If you smoke, try to quit. Cigarette smoke can make hay fever symptoms worse. Also try to stay away from others who are smoking.

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent allergic rhinitis?

There is no sure way to prevent allergies, but treatment can help you manage your symptoms.