What Is Allergic Rhinitis?
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Medically reviewed by Corinne Savides Happel, MD
Allergic rhinitis is the inflammation of nasal passageways that occurs when your immune system overreacts to allergens such as pollen, pet dander, or dust mites that are in the air. When it's pollen causing the nasal inflammation, allergic rhinitis is referred to as hay fever or seasonal allergies.
In people with allergic rhinitis, exposure to allergens can trigger uncomfortable symptoms like sneezing; runny or stuffy nose; red or watery eyes; and itchiness around the mouth, nose, and eyes.
More than 400 million people worldwide experience allergic rhinitis. Treatments, including over-the-counter (OTC) and prescription medications and allergen immunotherapy, can help control symptoms and reduce their impact on your daily life.
Types of Allergic Rhinitis
There are two main types of allergic rhinitis: seasonal and perennial. The type of allergic rhinitis you have depends on how frequently you experience symptoms and how long the symptoms last.
Seasonal Allergic Rhinitis
Also known as hay fever—though it is not specific to hay and does not cause a fever—seasonal allergic rhinitis occurs at specific times of the year when pollen counts are high. People with allergies to pollen from grasses, weeds, and trees can experience seasonal allergic rhinitis, usually in the spring and fall. In addition to hay fever, seasonal allergic rhinitis may be referred to as seasonal allergies.
Perennial Allergic Rhinitis
The word "perennial" means year-round. As such, perennial allergic rhinitis refers to allergy-related nasal inflammation that can last year-round. People allergic to dust mites, pet dander, cockroach debris, and mold spores can have perennial allergic rhinitis.
Allergic Rhinitis Symptoms
Symptoms of allergic rhinitis develop shortly after exposure to a substance to which you are allergic and can include:
Runny nose with clear-colored mucus
Sneezing
Red, watery eyes
Itchy eyes, nose, or mouth
Untreated or prolonged allergic rhinitis can lead to additional symptoms, such as:
Nasal congestion (stuffiness)
Postnasal drip (mucus drainage down the back of the throat)
Cough
Headache
Reduced sense of smell
Clogged ears or ear-popping sensations
Sinus pressure (pressure around the cheeks and nose)
Facial puffiness
Difficulty sleeping
Causes
Allergic rhinitis develops when the immune system overreacts to an allergen, which are normally harmless substances like pollen or dust mites that trigger an immune response in people with allergies.
When people with allergies breathe in an allergen, the immune system mistakenly identifies it as a threat, triggering the release of histamine and other chemicals. Histamine causes inflammation in the lining of the nose and increases mucus production, leading to symptoms of allergic rhinitis.
Common allergens that trigger allergic rhinitis include:
Pollen from grasses, weeds, and trees
Pet dander from furry pets like dogs and cats
Dust mites
Mold spores
Cockroach debris
Risk Factors
Several factors can increase your risk of developing allergic rhinitis, including:
Family history: If you have a family member with allergies, you're more likely to experience allergic rhinitis.
Eczema: People with eczema, a chronic inflammatory skin condition, are more prone to allergies and allergic rhinitis.
Early life exposures: Exposure to air pollution, indoor allergens like dust mites, secondhand smoke, and antibiotic use in early childhood can increase the risk of allergic rhinitis.
Lifestyle habits: Smoking and having poor sleep quality are associated with an increased risk of allergic rhinitis.
Diagnosis
When you visit a healthcare provider for symptoms of allergic rhinitis, they will likely begin by reviewing your medical history and asking about your symptoms. They may ask about the following:
What triggers your symptoms
How frequent and severe your symptoms are
Whether anyone else in your family has a history of allergies
What your work and home environments are like, such as whether you have a pet at home or your workplace involves exposure to chemicals
Your healthcare provider will probably perform a physical examination and may recommend allergy testing to identify what is triggering your allergic rhinitis symptoms.
The most common type of allergy test is a skin prick or scratch test. This involves scratching or pricking (poking) small amounts of possible allergens into your skin and observing whether an allergic reaction occurs in response. If you are allergic to one of the tested allergens, you will likely develop a raised itchy bump where your skin was scratched with that allergen.
Your healthcare provider may also have you do an allergy blood test, such as an ImmunoCAP test. Allergy blood tests measure the amount of immunoglobulin E (IgE) in your blood. IgE are antibodies your body makes against specific allergens. Higher IgE levels can mean you have an allergic disorder like allergic rhinitis.
Treatments for Allergic Rhinitis
The goal of allergic rhinitis treatment is to manage symptoms so you can reduce discomfort and improve your quality of life. Your healthcare provider will develop a treatment plan based on the type of allergic rhinitis you have (seasonal vs. perennial) and the severity of your symptoms.
Medications
Several over-the-counter (OTC) and prescription medications effectively reduce allergic rhinitis symptoms. These include:
Nasal steroid sprays: Intranasal corticosteroid sprays are the most effective medication for allergic rhinitis. These sprays help reduce inflammation and swelling in the nose, making it less stuffy. They also relieve symptoms like a runny nose, sneezing, and itchiness. Daily use of nasal steroid sprays typically yields the best results, and it may take up to two weeks to notice improvements in your symptoms.
Antihistamines: These medicines block the action of histamine to help reduce symptoms like sneezing, itchiness, watery eyes, and runny nose. They come in many forms, including eye drops, oral tablets, syrups, and nasal sprays. Antihistamines are most effective when taken before exposure to an allergen and on a short-term basis; many people find they become less effective over time or as pollen counts increase in the air.
Decongestants: These medicines, available in nasal spray or pill form, temporarily relieve nasal congestion to help make breathing easier. Decongestants work quickly and can relieve stuffiness for hours, but you should only use them three days at a time. Overusing nasal spray decongestants can cause rebound swelling and worsen nasal congestion after you stop using them.
Leukotriene pathway inhibitors: Prescription medications such as Singular (montelukast) block leukotrienes, which are inflammatory chemicals the body releases during an allergic reaction to help reduce symptoms such as runny nose and congestion.
Related: 8 Best OTC Allergy Medications to Help You Breathe Easy
Allergen Immunotherapy
Allergen immunotherapy offers a long-term solution for managing allergic rhinitis when other treatments are ineffective. It involves gradually increasing doses of identified allergens to help your body build a tolerance to the allergens and reduce the severity and frequency of allergy symptoms.
Depending on your allergies, your healthcare provider may recommend immunotherapy in the form of allergy shots or sublingual (under the tongue) tablets.
Allergy shots are injections containing diluted allergen extracts. A healthcare provider administers the shots on a regular basis to help your body build a tolerance to the allergen. The injection schedule varies, depending on your allergies and symptom severity. You may notice your symptoms improve within several months of injections, and you will likely require fewer injections over time as your body's reaction to allergens improves.
Sublingual tablets can be effective if you are allergic to grass or ragweed pollen or dust mites. This treatment involves dissolving a tablet containing allergen extracts under your tongue daily to reduce allergy symptoms. Usually, you will begin taking sublingual tablets several months before allergy season begins. Treatment can continue for up to three years.
Self-Care Measures
Self-care measures may help relieve allergic rhinitis symptoms.
This might include nasal washes, which involves rinsing your nasal passages with saline or a saltwater solution from a neti pot or nasal spray bottle. Doing this can help clear mucus from your nose. You can purchase nasal saline in a store or make a saline solution following the instructions on a pre-mixed packet for nasal saline rinses. Be sure to use distilled or boiled-and-cooled water to avoid the risk of life-threatening infections that can occur using unboiled tap water.
You can also try your best to avoid triggers, if possible. You may need to keep a symptom journal for a while to help you identify what specific allergens are causing your symptoms. Once you know your allergens, avoiding these triggers may include keeping windows closed during high-pollen days, washing your hands after petting animals, or using allergen-proof bedding.
How To Prevent Allergic Rhinitis
There is no known way to prevent allergic rhinitis entirely, but along with doing your best to avoid known allergens, there are ways to prevent symptoms. You can try to prevent allergic rhinitis symptoms by doing the following:
Monitor allergy index forecasts: Weather and plant growth stages can increase the release and spread of pollen in the air. Following your area's allergy index forecast can help you keep track of high pollen count days so you can adjust your activities accordingly.
Minimize allergen exposure: Steps to minimize exposure to allergens may include keeping windows closed during high pollen seasons such as the spring, summer, and early fall or keeping pets out of your bedroom.
Wash hands regularly: Wash your hands with soap and water frequently, and avoid touching or rubbing your nose and eyes.
Use eye protection: Wear sunglasses and a wide-brimmed hat outdoors to prevent pollen from reaching your eyes.
Use air filters: To help remove allergens from your home environment, use air purifiers with high-efficiency particulate air (HEPA) filters.
Related Conditions
People with allergic rhinitis are more likely to develop certain other conditions. Many of these conditions have similar inflammatory processes and shared risk factors with allergic rhinitis. These conditions include:
Asthma: About 38% of people with allergic rhinitis also have asthma, which causes breathing difficulties in response to allergens and other factors.
Eczema: Many people with eczema also have allergies and allergic rhinitis. Exposure to certain allergens can trigger eczema and allergic rhinitis symptoms.
Obstructive sleep apnea (OSA): Allergic rhinitis symptoms, such as nasal congestion, can disrupt sleep and contribute to the development of OSA. OSA is a sleep disorder that occurs when the airways are partially or completely blocked, obstructing the flow of oxygen while you sleep and leading to frequent awakenings and broken sleep.
Allergic conjunctivitis: Allergic rhinitis and allergic conjunctivitis frequently occur together. Allergic conjunctivitis is when allergens cause the conjunctiva (the transparent, thin membrane covering your eyeball) to get inflamed and swollen, causing redness, itching, watering, and pain.
Living With Allergic Rhinitis
Allergic rhinitis can significantly impact your quality of life. Many people with allergic rhinitis report that symptoms disrupt their sleep and cause daytime fatigue and headaches that impact their emotional well-being and ability to engage in work, school, and social activities.
The good news is that treatments and lifestyle modifications can effectively control symptoms. Talk to a healthcare provider if you have allergic rhinitis symptoms or your treatments are no longer working. They can discuss treatment options that effectively reduce symptoms so you can enjoy and participate in your daily activities.
Frequently Asked Questions
Can you get rid of allergic rhinitis permanently?
While allergic rhinitis has no cure, some children outgrow allergies over time. Adults with severe allergic rhinitis may majorly benefit from allergen immunotherapy, a treatment that builds tolerance to allergens over time, reducing the frequency and severity of symptoms.
What allergens should you avoid if you have allergic rhinitis?
Common allergens that trigger allergic rhinitis symptoms include pollen, pet dander, and dust mites. However, specific triggers vary from person to person. Keeping a symptom journal and undergoing allergy testing can help pinpoint allergens that trigger your symptoms so you can avoid them.
Which vitamins are good for rhinitis?
Research regarding how supplements affect allergic rhinitis symptoms is inconclusive. However, some research suggests that vitamins C, D, and E as well as probiotics may help control allergic rhinitis symptoms. Talk to your healthcare provider if you are interested in taking supplements for allergic rhinitis.
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