Allergic rhinitis is irritation and inflammation in the nose after it comes in touch with allergens. An allergens is anything that causes an abnormal response of the immune system. In allergic rhinitis, the immune system may cause swelling of the inside of the nose, runny or itchy nose, watery eyes, stuffiness, and sneezing. It may be:
An allergic reaction happens when the immune system overreacts to an allergen. When the allergen makes contact with the inside of the nose, it starts a chain of events. Immune cells in the nose release a chemical called histamine. Histamine causes itchiness, swelling, and increases the amount of mucus in the nose.
Site of Histamine Production
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Factors that increase your chance of having allergic rhinitis include:
The reaction to the allergen can lead to:
You will be asked about your symptoms and medical history. Allergic rhinitis is most often diagnosed based on description of symptoms. A referral to an allergy specialist may also be made.
The following tests may also be done:
Avoiding the allergen as much as possible is the best way to treat allergies. Specific steps will depend on the type of allergen, for example:
Reducing dust mite allergens:
Reducing mold contact:
Reducing animal allergens:
Reducing pollen contact: Use news reports or online resources to track pollen levels in you area. If your allergen is high:
General steps that may reduce contact with allergen:
Though reducing allergens can help, it is not possible to completely eliminate all allergens. Other treatments may help reduce the body's reaction to the allergen:
Medications can help to decrease the reaction of the immune system. This will lead to fewer and less severe symptoms like swelling and mucous. These medications may be given alone or in combination. Options include:
These medications are most effective when taken before contact with the allergen. It will also need to be continued as long as the allergen is present.
Other medications that may be added include:
Decongestants may be recommended for severe congestion. Decongestants are not appropriate for everyone and only temporarily relieve some pressure. Overuse of nasal decongestant sprays can actually make symptoms worse.
Immunotherapy uses injections or pills to gradually introduce your body to an allergen. The goal is to make your body's immune system less sensitive to those allergens. For some it may stop allergic rhinitis for others it may help decrease symptoms. It is most often used for those who have a poor response to allergy medications.
The therapy is delivered in small amounts over weeks, months, or even years. Immunotherapy is only available for specific allergens but more may become available after appropriate testing.
American Academy of Allergy, Asthma, and Immunology
Asthma and Allergy Foundation of America
Allergy Asthma Information Association
Allergic rhinitis. American College of Allergy, Asthma & Immunology website. Available at: http://www.acaai.org/allergist/allergies/types/rhinitis/Pages/default.aspx. Accessed September 23, 2015.
Allergic rhinitis. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116217/Allergic-rhinitis. Updated September 29, 2016. Accessed September 30, 2016.
Managing Indoor Allergen Culprits. American Academy of Allergy Asthma and Immunology website. Available at: http://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Libraries/EL-indoor-allergies-managing-patient.pdf. Updated February 2011. Accessed September 23, 2015.
Rhinitis. American Academy of Allergy, Asthma & Immunology website. Available at: http://www.aaaai.org/conditions-and-treatments/allergies/rhinitis.aspx. Accessed September 23, 2015.
Wheatley L, Togias A. Allergic Rhinitis. N Engl J Med 2015; 372:456-463. Accessed at: http://www.nejm.org/doi/full/10.1056/NEJMcp1412282. Accessed September 23, 2015.
8/11/2006 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T116217/Allergic-rhinitis: Durham SR, Yang WH, Pedersen MR, et al. Sublingual immunotherapy with once-daily grass allergen tablets: a randomized controlled trial in seasonal allergic rhinoconjunctivitis. J Allergy Clin Immunol. 2006;117:802-809.
8/27/2013 DynaMed Plus Systematic Literature Surveillance http://www.dynamed.com/topics/dmp~AN~T116217/Allergic-rhinitis: Kim JM, Lin SY, Suarez-Cuervo C, et al. Allergen-specific immunotherapy for pediatric asthma and rhinoconjunctivitis: a systematic review. Pediatrics. 2013 Jun;131(6):1155-67.
Last reviewed September 2016 by Marcin Chwistek, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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