Allergic rhinitis is an allergic reaction that happens when your immune system overreacts to substances that you inhale, such as pollen.
The two types of allergic rhinitis are:
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 are similar to cold symptoms. 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 eyes may itch or your nose and sinuses may become itchy and congested. Scientists are not sure what causes your immune system to overreact to allergens.
Allergic rhinitis is common, affecting about 1 in 5 Americans. Seasonal allergic rhinitis is more common in children and adolescents. Most people with allergic rhinitis have symptoms before age 20. Symptoms stay constant through early adulthood, but begin to improve during middle age and beyond. Symptoms can be mild or severe. Many people who have allergic rhinitis also have asthma.
Allergic rhinitis can cause many symptoms, including:
The immune system is designed to fight harmful substances like bacteria and viruses. When you have allergic rhinitis, your immune system overreacts to harmless substances, like pollen, mold, and pet dander. This reaction 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 questions about your family and personal history of allergies.
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 them.
If you have hay fever, during days or seasons when airborne allergens are high:
If you have year-round allergies:
There is evidence to suggest that exposure to infections, farm animals, and even domestic pets (like cats and dogs) during infancy and early childhood may reduce the risk of developing allergic rhinitis later in life. One study even suggest that premature babies have a lower risk of allergic rhinitis because of earlier exposure to pathogens.
The best way to reduce symptoms of allergic rhinitis 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.
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 cannot 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.
If you have year-round allergies:
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 need to start taking your medications a few weeks before the pollen season begins.
Antihistamines work by blocking the release of histamine in your body. They 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.
Many over-the-counter and prescription decongestants are available in pill or nasal spray form. They are often used with antihistamines.
Oral and nasal decongestants include Sudafed, Actifed, Afrin, and Neo-Synephrine. Some decongestants may contain pseudoephedrine, which can raise blood pressure. People with high blood pressure or an enlarged prostate should not take drugs containing pseudoephedrine. Using nasal decongestant sprays for more than 3 days can cause "rebound congestion," which makes congestion worse. Avoid using nasal decongestant sprays for more than 3 days in a row unless your doctor tells you to. DO NOT use them if you have emphysema or chronic bronchitis.
Nasal corticosteroids are prescription sprays that reduce inflammation and help relieve sneezing, itching, and runny nose. They include:
It may take a few days to a week of using these sprays 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. They 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. One study found that doing nasal irrigation three times a day reduced allergy symptoms after about 3 to 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.
Some people with allergic rhinitis also have food allergies. If you have any food allergies, eliminate those food items from your diet.
The use of herbs is a time-honored approach to strengthening the body and treating disease. However, herbs can trigger side effects and 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 agree. In one study of 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, includes your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.
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 5 times a day for 12 weeks, and they still showed the benefit of biminne even after 1 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 allergic rhinitis worse. Call your doctor if you develop severe symptoms, if treatment that helped before is no longer working, or if symptoms do not get better with treatment.
Poorly controlled allergic rhinitis may lead to sleep problems, learning problems, and lost productivity at work.
If you are pregnant or breastfeeding, avoid:
DO NOT take stinging nettle without talking to your doctor first if you have diabetes or if you take blood pressure medication, anticoagulants (blood thinners), or diuretics (water pills).
DO NOT take tinospora cordifolia is you have diabetes or an autoimmune disease such as rheumatoid arthritis or Crohn disease.
DO NOT take astragalus if you have an autoimmune disease such as rheumatoid arthritis or Crohn disease. 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. DO NOT use skullcap with antihistamines that can make you drowsy.
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 (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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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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