Allergic Rhinitis: Causes, Symptoms, and Diagnosis

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Allergic Rhinitis
Written by Kristeen Moore
Medically Reviewed by Steven Kim, MD on October 14, 2015

What is allergic rhinitis?

An allergen is a normally harmless substance that causes an allergic reaction.
Allergic rhinitis, or hay fever, is an allergic response to speci c allergens. Pollen is
the most common allergen.
Nearly 8 percent of adults in the United States experience allergic rhinitis of some kind, according to the
American Academy of Allergy, Asthma & Immunology (AAAAI). Between 10 to 30 percent of the worldwide
population may also have allergic rhinitis. Learn more about this condition.

Symptoms of allergic rhinitis

Common symptoms of allergic rhinitis include:
sneezing
a runny nose
a stu y nose
an itchy nose
coughing
a sore or scratchy throat
itchy eyes
watery eyes
dark circles under the eyes
frequent headaches
eczema-type symptoms, such as having extremely dry, itchy skin that often blisters
hives
excessive fatigue
Youll usually feel one or more of these symptoms immediately after coming into contact with an allergen.
Some symptoms, such as recurrent headaches and fatigue, may only happen after long-term exposure to
allergens. Fever isnt a symptom of hay fever.
Some people experience symptoms only rarely. This is highly likely when youre exposed to allergens in large
quantities. Other people experience symptoms all year long. Talk to your doctor about possible allergies if
your symptoms last for more than a few weeks and dont seem to be improving.

What causes allergic rhinitis?

When your body comes into contact with an allergen, it releases histamine, which is a natural chemical that
defends your body from the allergen. This chemical causes allergic rhinitis and its symptoms, including a
runny nose, sneezing, and itchy eyes.

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In addition to pollen, other common causes include:

grass
dust
animal dander, which is old skin
cat saliva
mold
During certain times of the year, pollen can be especially problematic. Tree and ower pollens are more
common in the spring. Grasses and weeds produce more pollen in the summer and fall.

What are the types of allergic rhinitis

The two types of allergic rhinitis are seasonal and perennial, which lasts all year. Pollen-based allergies are
usually seasonal. Perennial allergies usually occur due to sensitivity to dust mites, cockroaches, or animal
dander. Its possible to be in constant contact with all of these allergens on a daily basis. This is especially true
if you have a dog or pests in your home.

Risk factors for allergic rhinitis

Allergies can a ect anyone, but youre more likely to develop allergic rhinitis if your family has a history of
allergies.
Some external factors can trigger or worsen this condition, including:
cigarette smoke
chemicals
cold temperatures
humidity
wind
air pollution
hairspray
perfumes
colognes
wood smoke
fumes

How is allergic rhinitis diagnosed?

If you have minor allergies, youll probably only need a physical exam. However, your doctor may perform
certain tests to gure out the best treatment and prevention plan for you.
A skin prick test is one of the most common. Your doctor places several substances onto your skin to see how
your body reacts to each one. Usually, a small red bump appears if youre allergic to a substance.
A blood test, or radioallergosorbent test (RAST), is also common. The RAST measures the amount of
immunoglobulin E antibodies to particular allergens in your blood.

Treatments for allergic rhinitis

You can treat your allergic rhinitis in several ways.

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Antihistamines
You can take antihistamines to treat allergies. They work by stopping your body from making histamine.
Some popular over-the-counter (OTC) antihistamines include:
Allegra (fexofenadine)
Clarinex (desloratadine)
Claritin (loratadine)
Xyzal (levocetirizine)
Zyrtec (cetirizine)
Talk to your doctor before starting a new medication. Make sure that a new allergy medication wont interfere
with other medications or medical conditions.

Decongestants
You can use decongestants over a short period to relieve a stu y nose and sinus pressure. Popular OTC
decongestants include:
Afrin nasal spray (oxymetazoline)
Sudafed (pseudoephedrine)
Sudafed PE (phenylephrine)
Zyrtec-D (cetirizine with pseudoephedrine)
If you have high blood pressure or a genitourinary disease, speak with your doctor before using a
decongestant.

Eye drops and nasal sprays

Eye drops and nasal sprays can help relieve itchiness and other allergy-related symptoms for a short time.
However, you should avoid long-term use of these products.
Overusing eye drops can cause a rebound e ect. This means that, when you stop using them after a long
period, your symptoms will be worse than before you started using eye drops.
Overusing nasal spray can cause a yeast infection to occur in the back of your nose. It can also create a hole
in your nasal septum.
Corticosteroids can also help with in ammation or immune responses. These steroids are usually available as
injections, creams, or eye drops.
Read more: Nasal and oral corticosteroids for allergies

Immunotherapy
Your doctor may recommend immunotherapy, or allergy shots, if you have severe allergies. You can use this
treatment plan in conjunction with medications to control your symptoms. These shots decrease your
immune response to particular allergens over time.
An allergy shot regimen begins with a buildup phase. During this phase, youll go to your allergist for a shot
one to three times per week for about three to six months to let your body get used to the allergen in the
shot.

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During the maintenance phase, you should see your allergist for shots about once per month over the course
of three to ve years. You may not notice a change until over a year after the maintenance phase begins.
Once you reach this point, its possible that your allergy symptoms will fade or disappear altogether.
Some people experience severe allergic reactions to an allergen in their shot. Many allergists ask you to wait
in the o ce for 30 to 45 minutes after a shot to ensure that you dont have an intense or life-threatening
response to it.

Sublingual immunotherapy (SLIT)

SLIT involves placing a tablet containing a mixture of several allergens under your tongue. It works similarly to
allergy shots. You can take SLIT treatments, such as Oralair, at home after an initial consultation with your
doctor.
Possible side e ects include itching in the mouth or ear and throat irritation. In rare cases, SLIT treatments
can cause anaphylaxis. Talk to your doctor about SLIT to see if your allergies will respond to this treatment.

Home remedies
Home remedies will depend on your allergens. If you have seasonal or pollen allergies, you can try using an
air conditioner instead of opening your windows. If possible, add a lter designed for allergies.
Using a dehumidi er or a high-e ciency particulate air (HEPA) lter can help you control your allergies while
indoors. If youre allergic to dust mites, wash your sheets and blankets in hot water thats above 130F
(54.4C). Adding a HEPA lter to your vacuum and vacuuming weekly may also help.

Allergic rhinitis in children

Children can develop allergic rhinitis, and it typically appears before the age of 10. If you notice that your
child develops cold-like symptoms at the same time each year, they probably have allergic rhinitis.
The symptoms in children are similar to those in adults. Children usually develop watery, bloodshot eyes,
which is called allergic conjunctivitis. If you notice wheezing or shortness of breath in addition to other
symptoms, your child may have also developed asthma.
Limit your childs exposure to allergens by keeping them inside and washing their clothes and sheets
frequently during allergy season. Many antihistamines, decongestants, and corticosteroids are available to
help your childs allergies. However, some antihistamines can cause drowsiness or hyperactivity in your child,
even in small doses.

Outlook
The outcome of treatment depends on your condition. Seasonal allergic rhinitis usually isnt severe, and you
can manage it well with medications. However, severe forms of this condition will likely require long-term
treatment.

Preventing allergies
The best way to prevent allergy symptoms is to manage your allergies before your body has a chance to
respond to substances adversely. The AAAAI recommends starting medications before seasonal allergy
attacks. For example, if youre sensitive to tree pollen in the spring, you may want to start taking

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antihistamines before an allergic reaction has the chance to occur.

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