Allergic rhinitis is an allergic reaction that happens when your immune system overreacts to substances that you have inhaled, such as pollen. The two types of allergic rhinitis are seasonal allergic rhinitis (hay fever) and perennial allergic rhinitis, which occurs year-round. Hay fever is caused by outdoor allergens. Perennial allergic rhinitis is caused by indoor allergens such as dust mites, pet dander, and mold.
Symptoms of allergic rhinitis resemble a cold, but they are not caused by a virus the way a cold is. When you breathe in an allergen, your immune system springs into action. It releases substances known as IgEs into your nasal passages, along with inflammatory chemicals such as histamines. Your nose, sinuses, or eyes may become itchy and congested. Scientists aren't sure what causes your immune system to overreact to an allergen.
Allergic rhinitis is common, affecting about 1 in 5 Americans. Symptoms can be mild or severe. Many people who have allergic rhinitis also have asthma.
Signs and Symptoms
Allergic rhinitis can cause many symptoms, including the following:
The immune system is designed to fight harmful substances like bacteria and viruses. But when you have allergic rhinitis, your immune system overreacts to harmless substances -- like pollen, mold, and pet dander -- and launches an assault. This attack is called an allergic reaction.
Seasonal allergic rhinitis is triggered by pollen and mold spores. Sources include:
Year-round allergic rhinitis may be triggered by:
Your doctor will ask about your family and personal history of allergy. You may be asked some of the following questions:
Your doctor will do a physical exam and may also recommend a skin test to find out what you are allergic to. In a scratch test, for example, small amounts of suspected allergens are applied to the skin with a needle prick or scratch. If there is an allergy, the area will become swollen and red. Sometimes a blood test may be used to find out which allergens you react to.
With young children, it can help to watch what they do. For example, a child with allergic rhinitis may wiggle his nose and push it upward with the palm of the hand.
The best way to control your symptoms is to avoid being exposed to the allergens that trigger your symptoms. These steps may help.
If you have hay fever, during days or seasons when airborne allergens are high:
If you have year-round allergies:
The best way to reduce symptoms is to prevent exposure to allergens.
Drugs such as antihistamines, decongestants, and nasal corticosteroid sprays may help control allergy symptoms. Some complementary and alternative therapies may also be used to treat the symptoms of allergic rhinitis.
Your doctor may recommend immunotherapy, or "allergy shots. With this treatment, you receive regular injections of an allergen, with each dose being slightly larger than the previous dose. Your immune system should gradually get used to the allergen so that it no longer reacts to it.
In addition, certain lifestyle and dietary changes may help prevent or improve symptoms of allergic rhinitis.
Although you can't stay indoors during all pollen and ragweed seasons, avoiding peak exposure times can help. Use your air conditioner in your home and car, and wear a dust mask when working in the yard.
For year-round allergies, you can take the following measures.
To reduce mold:
Depending on the type of allergic rhinitis you have, your doctor may recommend medications. If you have perennial allergic rhinitis, you may need to take medication daily. If you have seasonal allergic rhinitis -- hay fever -- you may start medications a few weeks before the pollen season begins.
Antihistamines are available in both oral and nasal spray forms, and as prescription drugs and over-the-counter remedies. Over-the-counter antihistamines are short-acting and can relieve mild-to-moderate symptoms. All work by blocking the release of histamine in your body.
Many over-the-counter and prescription decongestants are available in pill or nasal spray form. They are often used with antihistamines.
These prescription sprays reduce inflammation of the nose and help relieve sneezing, itching, and runny nose. It may take a few days to a week to see improvement in symptoms.
These prescription drugs block the production of leukotrienes, which are inflammatory chemicals produced by the body. They are taken once a day and do not cause sleepiness, and are also used to treat allergic asthma. Leukotriene modifiers include montelukast (Singulair) and zafirlukast (Accolate).
Cromolyn sodium (NasalCrom)
This over-the-counter nasal spray prevents the release of histamine and helps relieve swelling and runny nose. It works best when taken before symptoms start and may needed to be used several times a day.
Ipratropium bromide (Atrovent) is a prescription nasal spray that can help relieve a very runny nose. People with glaucoma or an enlarged prostate should not use Atrovent.
Eye drops may cause stinging or even headache.
Allergy shots, or immunotherapy, are often recommended to anyone 7 years and older who has severe allergy symptoms or who also has asthma. Immunotherapy helps your immune system get used to allergens through regular injections of small doses of an allergen over a long period of time.
Nasal irrigation or nasal lavage can help reduce symptoms of allergic rhinitis, studies show. One study found that doing nasal irrigation three times a day reduced allergy symptoms after about 3 - 6 weeks. To do nasal irrigation, you can use a neti pot, bulb syringe, or squeeze bottle to flush out nasal passages with salt water.
Nutrition and Dietary Supplements
Some people with allergic rhinitis also have food allergies. If you have any food allergies, eliminate those items from your diet.
The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, you should take herbs only under the supervision of a health care practitioner.
Some evidence suggests that acupuncture may help treat people with allergic rhinitis, although not all studies were positive. In one study that included 45 people with hay fever, acupuncture worked as well as antihistamines in improving symptoms, and the effects seemed to last longer. However, a controlled trial that compared acupuncture to placebo (sham acupuncture) found no real benefit. One study suggested that combining acupuncture with traditional Chinese herbs did help relieve symptoms.
Although few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of allergic rhinitis symptoms based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.
Traditional Chinese Medicine
Biminne -- Biminne is a Chinese herbal formula used to treat allergic rhinitis. In a study of 58 people with year-round allergic rhinitis, biminne relieved at least some symptoms in most of the participants. People in the study took the formula five times a day for 12 weeks, and they still showed the benefit of biminne even after one year. It is not known how biminne works, or if it is safe to use for extended periods. Ask your doctor before taking it. Biminne includes these herbs:
Using some nasal decongestant sprays for long periods of time can make your allergic rhinitis worse. Call your health care provider if you develop severe symptoms, if treatment that helped before is no longer working, or if symptoms do not get better with treatment.
If you are pregnant or breastfeeding, avoid the following:
Warnings and Precautions
Do not take stinging nettle without talking to your doctor first if you take blood pressure medication, anticoagulants (blood thinners), diuretics (water pills), or have diabetes.
Do not take tinospora cordifolia is you have diabetes or an autoimmune disease such as rheumatoid arthritis or Crohns disease.
Do not take astragalus if you have an autoimmune disease such as rheumatoid arthritis or Crohns disease should not take astragalus. People who take lithium should not take astragalus.
Butterbur may interact with some medications that are processed by the liver. If you take any prescription medications, ask your doctor before taking butterbur.
Skullcap can make you sleepy, and should be used with caution or not at all with antihistamines that also make you drowsy.
Prognosis and Complications
You can treat symptoms of allergic rhinitis, but they will appear each time you are exposed to an allergen.
Although perennial allergic rhinitis is not a serious condition, it can interfere with your life. Depending on how severe your symptoms are, allergic rhinitis can cause you to miss school or work. Medication may cause drowsiness and other side effects. Your allergies could also trigger other conditions, such as eczema, asthma, sinusitis, and ear infection (called otitis media). Seasonal allergies may get better as you get older.
Immunotherapy or allergy shots may cause uncomfortable side effects, such as hives and rash. Rarely, it may have dangerous side effects such as anaphylaxis. It usually works in about two-thirds of cases, and may require years of treatment.
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Review Date: 7/1/2011
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
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