What is allergic rhinitis?

Allergic rhinitis is commonly called hay fever, and refers to inflammation of the lining of the nose (rhinitis), due to an allergy. Symptoms of allergic rhinitis can include sneezing, runny nose, and watery, itchy eyes and are caused by an allergic reaction to substances in the air called allergens (eg, tree and grass pollens).

Seasonal or perennial

Allergic rhinitis can be categorised into two groups - seasonal allergic rhinitis, where symptoms occur at particular times of the year (eg, spring), and perennial allergic rhinitis, where symptoms occur at any time of the year. When people say they have hay fever, they generally mean they have seasonal allergic rhinitis.

Types of allergens

Substances that cause allergic rhinitis are present in the air and are breathed into the nose. They include grass, weed and tree pollens, house dust mite faeces ('dust mite allergen'), mould spores, animal dander (hair and skin flakes) especially from cats, and less commonly cockroach droppings ('cockroach allergen').

Wind-borne pollens are the cause of seasonal allergic rhinitis, which usually occurs in spring and summer. The length of the pollen season depends on where you live and the plant species involved. Dust mite allergen is the most common cause of perennial allergic rhinitis.

Symptoms

Symptoms of allergic rhinitis:

• sneezing bouts
• itchy nose, eyes, palate and ears
• runny nose: lots of watery fluid streaming from the nose
• watery, red, puffy eyes - often itchy
• blocked nose, and sometimes blocked ears as well
• sore throat, tickly cough and husky voice
• bad breath.

If your allergic rhinitis is severe and untreated, you might sleep poorly at night, and become sleepy during the day. You may be more prone to sinus infections and eye infections. If you have asthma, allergic rhinitis can make your asthma symptoms more difficult to control.

Finding out if you have allergic rhinitis

The symptoms of allergic rhinitis can be similar to other conditions that might affect your nose, such as colds or nasal polyps. See your doctor to confirm whether your symptoms are due to allergic rhinitis or some other condition.

It may be obvious from your history which substance (allergen) is causing your rhinitis, or your doctor may need to order blood tests or skin-prick tests to find out what you are allergic to. This is an important step in treating allergic rhinitis, because once you know which allergen is triggering your symptoms, you can aim to avoid it.

Treatment for allergic rhinitis

Allergen avoidance. An allergen such as pollen can be difficult to avoid, but you might consider doing mainly indoor pursuits during the pollen season, and staying indoors on windy days or just after a thunderstorm. Avoid mowing the lawn, and shower after any activities that have exposed you to a lot of pollen. If you are allergic to pet dander, keep your pet outdoors.

Minimise house dust mites by keeping your house well ventilated, avoiding a build up of moist air inside the house, selecting furnishings and floor coverings that don't encourage dust, covering mattresses and pillows with dust mite covers, using a vacuum cleaner with an appropriate air filter, and using damp dusting techniques when house cleaning. Soft toys are a common resting place for house dust mites, so wash them regularly in hot water, and avoid keeping toys on the bed.

Medications. Medications to treat and help prevent allergic rhinitis are available from your doctor or over-the-counter at your pharmacy. These can be very effective in reducing your symptoms. Always continue to avoid your allergen whenever possible, even when taking medications.

These medications are taken as a tablet or as a nasal spray, and include antihistamines (including a non-sedating type); corticosteroid nasal sprays; decongestants (for short-term use); and combination products that combine these medications (eg, an antihistamine and a decongestant). Other medicines are available on prescription. Some medications are started before the pollen season, and taken every day to help prevent your symptoms occurring. Others can be used 'as needed' for quick relief when symptoms occur. Your doctor can advise you on which option is best for you.

More information on over-the-counter treatments for hay fever (allergic rhinitis)

Immunotherapy. If allergic rhinitis symptoms are still troublesome despite the use of allergen avoidance and appropriate medications, immunotherapy may have a place in addition to these measures. This is prescribed by an allergy specialist and means you receive a very small amount of the allergen by repeated injections, with the amount increasing gradually over several years. The aim is to desensitise you to the allergen, and reduce or even eliminate your symptoms.

Pollen and Mould Season - Dos and Don'ts

DO…

• keep windows closed at night; use air-conditioning, which cleans, cools and dries the air
• minimise early morning activity when most pollen is usually emitted (between 5 and 10am)
• keep your windows closed when you travel by car
• use your car air-conditioning on ‘recirculated air’ rather than bringing in air from outside
• stay indoors when the pollen count or humidity is high and on windy days
• take a holiday somewhere more pollen-free (eg, the beach) during the height of the pollen season
• avoid high pollen areas such as farms and orchards
• wear glasses outdoors to protect your eyes
• have lawns mowed frequently to avoid flowering
• wear a mask if it is absolutely necessary for you to do the mowing
• select garden plants that are low pollen producers (usually native species)
• have fallen leaves and garden debris removed
• ensure your home is well ventilated and in good repair, to avoid mould
• take care to allow enough ventilation to minimise humidity and dampness if building a new home
• take the medications prescribed by your doctor.

DON'T...

• mow lawns or be around freshly cut grass; mowing stirs up pollens and moulds
• rake leaves (this also stirs up moulds)
• hang sheets or clothing outside to dry, as pollens and moulds may collect in these items
• grow too many indoor plants; wet soil causes moulds to grow
• have an open compost heap.

Original material provided by myDr, 2010. Edited by everybody, February 2012.