Rhinitis (HaY fever) Overview
There are two types of rhinitis: allergic and non-allergic.
If you have allergic rhinitis, your immune system mistakenly identifies a typically harmless substance as an intruder. This substance is called an allergen. The immune system responds to the allergen by releasing histamine and chemical mediators that typically cause symptoms in the nose, throat, eyes, ears, skin and roof of the mouth.
Seasonal allergic rhinitis (hay fever) is most often caused by pollen carried in the air during different times of the year in different parts of the country.
Allergic rhinitis can also be triggered by common indoor allergens such as the dried skin flakes, urine and saliva found on pet dander, mold, droppings from dust mites and cockroach particles. This is called perennial allergic rhinitis, as symptoms typically occur year-round.
In addition to allergen triggers, symptoms may also occur from irritants such as smoke and strong odors, or to changes in the temperature and humidity of the air. This happens because allergic rhinitis causes inflammation in the nasal lining, which increases sensitivity to inhalants.
Many people with allergic rhinitis are prone to allergic conjunctivitis (eye allergy). In addition, allergic rhinitis can make symptoms of asthma worse for people who suffer from both conditions.
At least one out of three people with rhinitis symptoms do not have allergies. Nonallergic rhinitis usually afflicts adults and causes year-round symptoms, especially runny nose and nasal congestion. This condition differs from allergic rhinitis because the immune system is not involved.
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Rhinitis (Hay FEver) Symptoms & Diagnosis
Allergic rhinitis symptoms include:
• Itching in the nose, roof of the mouth, throat, eyes
• Stuffy nose (congestion)
• Runny nose
• Tearing eyes
• Dark circles under the eyes
Hay fever symptoms tend to flare up in the spring and fall. Perennial allergic rhinitis symptoms are year-long.
An allergist / immunologist has specialized training and experience to diagnose specific allergens that trigger your illness, or to determine if your symptoms are non-allergic. Your allergist will take a thorough health history followed by allergy testing. Skin tests or blood tests are the most common methods for determining your allergic rhinitis triggers.
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Rhinitis (Hay Fever) Treatment & Management
Once specific allergens are diagnosed, your allergist / immunologist will work with you to develop a plan to avoid allergens that trigger your symptoms. For example, if you are allergic to dust mites or indoor mold, you will want to take steps to reduce these allergens in your house as much as possible.
For outdoor allergies such as pollen, avoidance measures include limiting outdoor activities during times of high pollen counts. The National Allergy BureauTM (NAB) provides the most accurate and reliable pollen and mold levels from approximately 80 counting stations throughout the United States.
Immunotherapy (allergy shots) is a proven treatment approach providing long-term relief for many people suffering from allergic rhinitis.
Another form of allergy immunotherapy was recently approved in the United States called sublingual immunotherapy (SLIT) allergy tablets. Rather than shots, allergy tablets involve administering the allergens under the tongue generally on a daily basis.
Your allergist might prescribe medication to decrease allergic rhinitis symptoms. These medications may include nasal corticosteroid sprays, antihistamine pills, nasal antihistamine sprays or decongestant pills. A complete list of medications used to treat allergies can be found in the AAAAI Drug Guide.
The treatment options for non-allergic rhinitis include nasal corticosteroids, nasal antihistamines and nasal saline formulations.. If there is a lot of runny nose, ipratropium nasal spray can provide relief. If nasal congestion is a major problem, decongestant pills or sprays can be used, but the nasal decongestant sprays should not be used for more than four days.
The majority of allergy medications for seasonal allergic rhinitis (hay fever) work best if started before tree pollen is in the air each spring and allergy symptoms develop. If you start taking allergy medications before you first come into contact with spring allergens, the medication can prevent the release of histamine and other chemicals. As a result, allergy symptoms are prevented from developing or are much less severe.
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