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Allergic Rhinitis

(Hay Fever)

Definition

Allergic rhinitis is the set of symptoms that occur when you breathe in substances to which you are allergic. These substances are called allergens.

Seasonal Allergic Rhinitis – sometimes called hay fever or rose fever. It occurs during specific times of the year when allergens (usually pollens) to which you are allergic are in the air. Seasonal allergies are usually at their peak during spring and fall.

Perennial Allergic Rhinitis – caused by allergens such as chemicals, dust, animal dander, etc. It may occur at any time during the year when you encounter these allergens.

Causes

The symptoms of allergic rhinitis occur when your body's immune system over-responds to an allergen. Common allergens include dust mites, pollen, animal dander, and molds. When you breathe in an allergen, cells in your nasal passages produce a chemical called histamine. Histamine causes your nose to feel itchy. Histamine also causes swelling and mucus production in the nasal passages.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

Family members with allergic rhinitis
Eczema
Food allergies

Symptoms

Allergic rhinitis can cause the following symptoms:

Sneezing
Itching in the nose, eyes, throat, ears
Red, watery eyes
Runny nose, nasal congestion
Sinus pressure
Postnasal drip and cough
Headache
Dark circles under your eyes

Diagnosis

If you have the symptoms of allergic rhinitis, a doctor who specializes in allergies (called an allergist) can try to find out which allergens you are allergic to.

Tests may include:

Skin Prick Test

A tiny bit of an allergen is placed under the skin with a needle. Then the doctor watches to see if the skin in that area becomes raised or irritated.

RAST Testing

A small sample of blood is taken and tested for dozens of different allergens.

Provocation Testing

You breathe in air containing an allergen, and the doctor watches to see if you have an allergic reaction.

Treatment

The most effective way to treat allergic rhinitis is to avoid the offending allergen. Since this can be difficult or impossible, other treatments are available.

Treatments may include:

Medications

Antihistamines - stop or reduce the production of histamine. They are usually taken as pills.

Decongestants - decrease congestion by constricting blood vessels. They can be taken as pills or as a nasal spray.

Mast Cell Inhibitors - nasal sprays that interfere with the chemical reactions leading to histamine release.

Topical Corticosteroids - nasal sprays that decrease swelling in the nasal passages.

Immunotherapy (also called allergy shots)

Injections of very small amounts of allergens are gradually increased over weeks, months, or even years. The goal is to make your body's immune system less sensitive to those allergens.

Prevention

The following strategies may help prevent allergic rhinitis:

Stay inside during the morning hours, when pollen counts are highest.
Avoid outside activities during the time of year when the trees, flowers or molds to which you are allergic are blooming.
Keep the windows of your house and car closed to keep pollen out.
Use an air conditioner to reduce indoor humidity during the warmer months. This will prevent mold and mildew growth.
Clean your air conditioner's filters regularly.
Consider running an air purifier in your home, especially in your bedroom.
Use vacuum cleaners and air conditioners with HEPA filters to trap allergens.
Decrease or avoid physical activity on hot summer days, when ozone levels may exacerbate allergies.
Cover pillows and mattresses with vinyl covers to reduce your exposure to dust mites.
Wash bedding weekly in very hot water.
Use fewer dust-collecting items such as curtains, bed skirts, carpeting, and stuffed animals.
If you can't avoid having a furry pet, vacuum frequently. Try to keep your pet out of bedrooms and other rooms with carpets.