What is allergic rhinitis?
Allergic rhinitis (hay fever) is swelling of the inside of your nose. The swelling is a reaction to allergens in the air. An allergen can be anything that causes an allergic reaction. Allergies to weeds, grass, trees, or mold often cause seasonal allergic rhinitis. This only happens during certain seasons of the year. Some people have allergic rhinitis almost all year. This is usually caused by allergies to indoor dust mites (tiny bugs that live in house dust) or cockroaches. It may be caused by pet dander (tiny dead skin flakes) or mold.
What are the signs and symptoms of allergic rhinitis?
- Sneezing and runny, itchy, or stuffy nose
- Itchy eyes, ears, and throat
- Red, watery eyes, or dark circles under your eyes
- Coughing, wheezing, or loud breathing
- Low energy and tiredness
- Facial pain and headaches
- Decreased sense of taste or smell, or a feeling that your ears are plugged
How is allergic rhinitis diagnosed?
Your healthcare provider will ask about your signs and symptoms and when they began. He will ask if you have symptoms all year or only during certain seasons. He may ask if you know what makes your symptoms worse. He will look at your eyes and inside your nose and ears. Tell him if you have pets. Tell him if you have any other medical conditions or diseases. Tell him if anyone in your family has allergic rhinitis, atopic dermatitis, asthma, or food allergies. You may need the following tests:
- Blood tests: Your blood may be tested to check for antibodies that are caused by exposure to allergens. The blood may be taken from your hand, arm, or the bend in your elbow.
- Skin prick tests: Your healthcare provider will lightly prick or scratch your skin with tiny amounts of a possible allergen. He watches to see how your skin reacts. If a bump appears within a few minutes, you are likely allergic to the allergen.
- Nasal swab: Fluid from your nose may be tested for infection.
- Rhinoscopy: Your healthcare provider will use a thin tube to look inside your nose. This may be done to check for another cause of your symptoms, such as a mass or object.
How is allergic rhinitis treated?
The goals of treatment are to relieve your symptoms and help you feel better. Mild or seasonal symptoms may be treated differently than severe or year-round symptoms. You may need one or more of the following:
- Antihistamines: These medicines help reduce itching, sneezing, and a runny nose. Some antihistamines can make you sleepy. Ask your healthcare provider which one is best for you.
- Decongestants: These medicines help clear your stuffy nose. Do not use them for more than 3 days in a row, because they can make your symptoms worse.
- Nasal steroids: This is a mist you spray in your nose. It is used to decrease swelling.
- Mast cell stabilizers: These are medicines you spray in your nose to help decrease swelling in your nose.
- Leukotriene antagonists: These medicines help decrease swelling and the amount of mucus in your nose. They are taken as pills and require a prescription.
- Immunotherapy: This treatment may be given if your symptoms are very bad or other medicines do not work. Immunotherapy is given as a series of injections (shots), as a pill you swallow, or as medicine that goes under your tongue. At first, the therapy contains tiny amounts of the allergen. Your healthcare provider will slowly increase the amount of allergen. This may help your body learn to accept the allergen and stop reacting to it. You may need immunotherapy for weeks or longer.
What are the risks of allergic rhinitis?
Allergic rhinitis can cause ear infections and sinusitis. It may increase your risk for asthma. Medicines used to treat allergies may keep you awake or make you nervous. They may also make it hard to think clearly or make you sleepy. If you are very sleepy, do not drive. Medicines may cause bloody noses, headaches, or dry mouth. If you receive immunotherapy, you could have a rash or hives. Your chest could feel tight, and you could cough or wheeze. There is a small chance you could have a life-threatening allergic reaction. Without treatment, you may not be able to sleep well because of your symptoms. You may be tired and lack energy. This can affect work and other daily activities. Your child may be so tired that he does poorly in school.
How can I manage allergic rhinitis?
Use a sinus rinse device to rinse your nasal passages with saline (salt water) solution. This will help thin the mucus in your nose and rinse away pollen and dirt. It will also help reduce swelling so you can breathe normally. Ask your healthcare provider how often to rinse your sinuses. Do the following to help reduce the amount of allergens around you:
- Reduce dust mites: Wash sheets and towels in hot water every week. If your child has allergic rhinitis, try to limit the number of stuffed animals and soft toys your child has. Wash your child's toys in hot water regularly. Cover your pillows and mattresses with allergen-free covers. Use a vacuum cleaner with an air filter. If possible, get rid of carpet and curtains. These collect dust and dust mites. Call an exterminator if you think you have cockroaches in your home.
- Reduce pollen: Keep windows and doors closed in your house and car. Stay inside when the pollen count is high. Run your air conditioner on recycle, and change air filters often. Shower and wash your hair before bed every night to rinse away pollen. Avoid raking leaves or mowing your lawn.
- Reduce pet dander: If possible, do not keep cats, dogs, birds, or other pets. If you do keep pets in your home, keep them out of bedrooms and carpeted rooms, and bathe them often.
- Reduce mold: Do not spend time in basements. Choose artificial plants instead of live plants. Keep your home's humidity at 35% to 40%. Do not have ponds or standing water in your home or yard.
- Avoid anything that worsens your symptoms: Many other things may trigger allergic rhinitis or make it worse. These include paint, tobacco smoke, perfume, and hairspray. Keep a diary of your symptoms to help you learn what makes them worse.
When should I contact my healthcare provider?
Contact your healthcare provider if:
- You have a fever.
- You have a headache that is severe or will not go away.
- Your symptoms get worse, even after treatment.
- You have yellow, green, brown, or bloody mucus coming from your nose.
- Your nose is bleeding or you have pain inside your nose.
- You have questions or concerns about your treatment or condition.
When should I seek immediate care?
Seek care immediately or call 911 if:
- You cough up blood.
- You have chest pain or shortness of breath.
You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
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