Allergic rhinitis, commonly known as hay fever, refers to inflammation of the nasal passages that causes cold-like symptoms. The immune system becomes sensitized and overreacts to environmental substances that an individual’s body cannot tolerate.
Unlike a cold, hay fever isn’t caused by a virus, but by an allergic response to outdoor, indoor, or occupational allergens, and affects about 20% of the population in the USA.
Types of Rhinitis
Seasonal rhinitis recurs in pollen season – spring, early summer, or fall.
Perennial Rhinitis occurs year-round, with symptoms becoming chronic.
Some people may experience both types of rhinitis, with perennial symptoms getting worse during pollen seasons.
Occupational or work-related rhinitis – is triggered and aggravated by allergens in the workplace – cleaning products, chemical fumes, certain types of dust and gases.
Nonallergic rhinitis is a response to environmental irritants like weather, medications, foods, stress and hormonal fluctuations. Smoke, perfumes, sprays, cosmetics, and dust may also be responsible. There are many things that can irritate us and cause nonallergic rhinitis, including some laundry detergents, cleaning solutions, car exhaust, and other air pollutants.
Rhinitis Symptoms
Allergic rhinitis manifests in nasal symptoms:
- Stuffy, congested, or runny nose
- Itching nose, mouth, eyes, throat, or skin
- Puffy, swollen eyelids
- Watering eyes
- Sneezing and Coughing
- Fatigue
Other symptoms of Rhinitis:
- Decreased concentration, decision-making
- Limited physical abilities
- Impaired hand-eye coordination
- Memory issues
- Irritability
- Missed work or school
- Accident and injury prone
Management of Rhinitis
The most important step is to avoid the trigger factors:
Outdoors
- Stay indoors during peak pollen season.
- Wear sunglasses when outdoors.
- Wear a pollen mask while gardening.
- Take appropriate medication.
- Dry laundry in the dryer, not outside.
Indoors
- Keep windows shut.
- Keep a/c units clean; use a/c in car and home, and a high-efficiency particulate air (HEPA) filter in bedroom.
- Use “mite-proof” covers for bed linens; wash frequently in hot water.
- Keep humidity low (between 30 and 50 percent). Use a dehumidifier, especially in damp, humid areas. Empty and clean often.
- Clean bathrooms, kitchen, and basement regularly.
- Clean visible mold with mild detergent and bleach solution.
- Damp-mop floors.
Pets
- Wash hands and clothes immediately after contact.
- Keep pets outdoors when possible; and out of the bedroom.
- Close bedroom air ducts of forced-air or central heating or cooling.
- Have hardwood, tile or linoleum floors.
Treating Rhinitis
The most effective treatment for allergic rhinitis can only by administered by an allergist. They will study you and your family’s detailed medical history, lifestyle, work and home environments, pets, and the frequency and severity of your symptoms.
Allergic rhinitis may be complicated by medical conditions, such as a deviated septum, or nasal polyps.
Your allergist may conduct skin tests in which small amounts of suspected allergens are fed into your skin. This is the most sensitive and least expensive way of identifying allergens:
Prick or scratch test: A tiny drop of a possible allergen is pricked or scratched into the skin. This percutaneous test is the most common type, showing results within 10-20 minutes.
Intradermal test: is more sensitive. The suspected allergen is injected under the skin. A reaction takes about 20 minutes.
Your personalized treatment plan may include:
- Lifestyle changes
- Nasal medications
- Antihistamines
- Decongestants
- Other medications
- Immunotherapy
- Allergy Shots
Medical Options for Rhinitis
Both OTC and prescription options are available in many forms. But even OTC options should be taken under advisement form your physician.
Intranasal corticosteroids: these sprays avoid the usual side effects from oral or injected steroids.
Antihistamines: counter the effects of histamine, (primary chemical responsible for rhinitis), the inflammatory chemical released when an allergic reaction occurs. Antihistamines are available as eye drops, nasal sprays, oral tablets, and syrup.
Decongestants: relieve the congestion and pressure caused by swollen nasal tissue. Nonprescription and prescription decongestants are found in many forms.
Nonprescription saline nasal sprays: counteract dry nasal passages or thick nasal mucus. Several OTC options include neti pots and saline rinse bottles.
Nasal cromolyn: prevents the release of allergy-causing substances in the body.
Nasal ipratropium bromide spray: reduces nasal drainage from allergic and nonallergic rhinitis.
Leukatriene pathway inhibitors: block the action of leukotriene that can cause symptoms of hay fever.
Immunotherapy: recommended for patients who don’t respond to medications or experience side effects. They may face unavoidable allergen exposure, or want a more permanent solution. Immunotherapy is available as allergy shots and sublingual (under-the-tongue) tablets. Immunotherapy doesn’t help the symptoms produced by nonallergic rhinitis.
Eye allergy preparations: for redness, watery eyes and itching. OTC and prescription eye drops and oral medications are used for short-term relief. They may not relieve all symptoms, and prolonged use is not advised.
If you experience persistent symptoms of rhinitis, our board-certified allergy/immunology specialists can help. Call the Allergy, Asthma, & Immunology Associates of Tampa Bay at (813) 971-9743 or make an appointment online.
