Allergic Rhinitis
Sources consulted
This article is original patient-education content.
- WHO—Health topics A–Z(2024)
- NHS—Health A to Z(2024)
- CDC—Health topics(2024)
Based on international clinical guidelines
Overview
Allergic rhinitis is an inflammation of the inside of the nose caused by an allergic reaction to substances like pollen, dust mites, mould, or pet dander. It is often called hay fever, but it can occur all year round.
Key facts
- Allergic rhinitis is very common and affects people of all ages, though it often starts in childhood.
- It is not contagious and cannot be spread from person to person.
- With proper management, most people can control their symptoms and lead a normal life.
Yes, allergic rhinitis affects millions of people worldwide. In the UK, it is estimated that 1 in 5 people experience symptoms.
It can affect anyone, but it is more common in people with a family history of allergies, asthma, or eczema. Symptoms often begin in childhood or early adulthood.
Symptoms
- Severe difficulty breathing or wheezing that does not improve with your usual medication
- Swelling of the face, lips, tongue, or throat
- Signs of anaphylaxis (e.g., sudden hives, dizziness, fainting, rapid heartbeat)
- ⚠Symptoms that are severe and interfere with daily activities or sleep
- ⚠High fever or thick yellow-green nasal discharge, which could mean a sinus infection
- ⚠Symptoms that do not improve with over-the-counter treatments or worsen over time
Common symptoms
- Sneezing, especially after waking up or outdoors
- Runny or blocked nose
- Itchy nose, roof of mouth, throat, or eyes
- Watery, red, or swollen eyes (allergic conjunctivitis)
- Coughing, especially at night
Symptoms in children
- Snoring or difficulty sleeping due to a blocked nose
- Mouth breathing or frequent nose rubbing
- Poor concentration or fatigue during the day
- Ear infections or hearing problems
Symptoms in older adults
- Symptoms may be milder or mistaken for a cold or sinus infection
- Dry nose or crusting instead of runny nose
- Worsening of asthma or breathing problems
- Fatigue and reduced quality of life
Causes
Main causes
- Inhaled allergens such as pollen from trees, grasses, or weeds (seasonal allergic rhinitis)
- House dust mites (often cause year-round symptoms)
- Mould spores from damp indoor or outdoor areas
- Pet dander from cats, dogs, or other animals
- Cockroach droppings (more common in urban environments)
Risk factors
- Family history of allergies, asthma, or eczema
- Having asthma or atopic dermatitis (eczema)
- Exposure to cigarette smoke or air pollution
- Working in environments with high allergen exposure (e.g., farming, woodworking)
When to see a doctor
See a doctor urgently if:
- If you have severe symptoms that affect your breathing, sleep, or ability to work or go to school
- If you develop a high fever, facial pain, or thick nasal discharge that lasts more than a week
- If over-the-counter treatments are not helping or you need to use them every day
Book a routine appointment if:
- If your symptoms are mild but bothersome and last for several weeks
- If you want to confirm the diagnosis or identify your triggers through testing
Diagnosis
Your doctor will usually diagnose allergic rhinitis based on your symptoms and a discussion of your triggers and family history. They may refer you to an allergy specialist if the cause is unclear or symptoms are severe.
Tests that may be done
- Skin prick test: placing a tiny amount of common allergens on your skin to see if you have a reaction
- Blood test (specific IgE test): measures the level of allergy-related antibodies in your blood
What to expect at your appointment
During your appointment, your doctor will ask about your symptoms, when they occur, and what makes them better or worse. They may look inside your nose with a small lighted tool (nasal endoscopy). If tests are needed, they are quick and usually done in clinic. You may be asked to keep a symptom diary.
Treatment
Treatment for allergic rhinitis focuses on managing symptoms and reducing exposure to allergens. Options include lifestyle changes, medications, and in some cases, immunotherapy (allergy shots).
Self-care at home
- Avoid allergens as much as possible, such as staying indoors on high-pollen days and using dust-mite-proof covers on bedding
- Use saline (salt water) nasal sprays or rinses to wash allergens out of your nose
- Keep windows closed and use an air purifier with a HEPA filter
- Wash clothes and bedding regularly in hot water
- Take a shower and change clothes after being outdoors to remove pollen
Medical treatments
Medications for allergic rhinitis include antihistamines (available as tablets, syrups, or nasal sprays), corticosteroid nasal sprays to reduce inflammation, and decongestants for short-term relief of a blocked nose. These are available over the counter or on prescription. For more severe cases, your doctor may recommend immunotherapy, where you are given gradually increasing doses of the allergen to build tolerance. Treatment plans are tailored to your specific symptoms and triggers.
When is surgery considered?
Surgery is rarely needed. It may be considered if you have nasal polyps (benign growths) or structural problems in the nose that make symptoms worse, such as a deviated septum. Surgery is only recommended after trying other treatments.
Living with this condition
Living with allergic rhinitis means planning ahead for allergy seasons. Check pollen forecasts and adjust your activities. Keep your home allergen-free by cleaning regularly and reducing clutter where dust can collect. Always carry your medication, especially during high-pollen times.
Lifestyle tips
- Monitor pollen counts and stay indoors when they are high
- Use an air purifier and keep windows closed in spring and summer
- Dry laundry indoors to avoid pollen sticking to clothes
- Wipe down surfaces with a damp cloth instead of dusting
- Consider using allergy-proof covers on pillows and mattresses
Diet and exercise
No specific diet is proven to prevent or treat allergic rhinitis, but eating a balanced diet rich in fruits and vegetables supports overall health. Exercise is fine, but try to do it indoors when pollen counts are high. Wearing sunglasses outdoors can also protect your eyes from pollen.
Mental health and emotional wellbeing
Chronic symptoms like a blocked nose, sneezing, and fatigue can affect sleep, concentration, and mood. It is common to feel frustrated or low. If these feelings persist, talk to your doctor. They can offer support, and you can also reach out to a counsellor or mental health helpline. You are not alone.
Prevention
Allergic rhinitis cannot always be prevented, but you can reduce the chance of developing it and manage triggers effectively. Early treatment may help prevent it from becoming more severe.
Vaccines
There is no vaccine to prevent allergic rhinitis. However, immunotherapy (allergy shots or tablets) can reduce sensitivity to specific allergens over time and may be considered a form of treatment that modifies the allergy.
Screening programmes
Routine screening for allergic rhinitis is not recommended. Testing is done when symptoms are present and the cause is unclear.
Complications
If left untreated
- Chronic sinus infections and sinusitis (inflammation of the sinuses)
- Sleep problems, fatigue, and reduced concentration at work or school
- Worsening of asthma symptoms or new onset of asthma
- Ear infections, especially in children
- Nasal polyps (soft growths inside the nose)
Long-term outlook
With proper management, most people with allergic rhinitis can control their symptoms and live normally. Many people find that symptoms improve over time, especially as they learn to avoid triggers. Treatment options are effective and safe, and ongoing research continues to improve care. You can expect to have good days and bad days, but you don't have to let it take over your life.
Find support
International organisations
Local organisations
- Allergy UK ↗ · United Kingdom
- NHS (National Health Service) ↗ · United Kingdom
Helplines
External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.
Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.