Allergic rhinitis control in adults

Overview

Allergic rhinitis is a condition where the inside of your nose becomes inflamed, sore, and swollen because you breathe in something you are allergic to, such as pollen or dust. It is often called hay fever, but it can happen all year round.

Yes, allergic rhinitis is very common. Around 10 to 30 out of every 100 adults in the UK experience it at some point in their lives.

It can affect anyone, but it often starts in childhood or early adulthood. People with a family history of allergies, asthma, or eczema are more likely to develop it.

Symptoms

Common symptoms

• Sneezing, especially after waking up or being around triggers.
• Runny or blocked nose.
• Itchy nose, roof of the mouth, or throat.
• Itchy, red, or watery eyes.
• Coughing, especially at night or early morning.

Symptoms in children

• Children may rub their nose upward a lot (called the allergic salute).
• They might have dark circles under their eyes (allergic shiners).
• They can have trouble sleeping or feel tired during the day.

Symptoms in older adults

• Symptoms may be less obvious but can still cause a blocked nose and reduced sense of smell.
• Older adults may be more likely to have other health conditions that make managing symptoms harder.

Causes

Main causes

• The immune system mistakenly treats harmless substances (allergens) as dangerous and releases chemicals like histamine, which cause inflammation.
• Common allergens include pollen from grass, trees, or weeds; dust mites; animal dander (tiny flakes of skin from pets); and mould spores.

Risk factors

• Having other allergic conditions such as asthma, eczema, or food allergies.
• Family history of allergies.
• Living in areas with high pollen or pollution levels.
• Exposure to tobacco smoke or strong chemical irritants.

When to see a doctor

See a doctor urgently if:

• If you have chest tightness, shortness of breath, or your symptoms are interfering with your daily life despite using over‑the‑counter treatments.

Book a routine appointment if:

• If your symptoms last for more than a few weeks and are affecting your sleep, work, or quality of life.
• If you need help identifying your triggers or finding the right treatment.

Diagnosis

A doctor will ask about your symptoms, when they happen, and your personal and family history of allergies. They may also examine your nose and eyes.

Tests that may be done

• Allergy skin prick tests – small drops of allergen solutions are placed on your skin to see if a reaction occurs.
• Blood tests – measure the level of allergy‑related antibodies in your blood.
• Sometimes a doctor will suggest a trial of medicine to see how you respond.

What to expect at your appointment

Diagnosis is usually straightforward. Your doctor will discuss your results and recommend a treatment plan. You may be referred to a specialist if the cause is unclear or your symptoms are severe.

Treatment

Treatment aims to reduce symptoms and help you feel better. It usually involves a combination of avoiding triggers, using medicines, and sometimes allergy shots (immunotherapy) for long‑term control.

Self-care at home

• Avoid known triggers – for example, stay indoors when pollen counts are high, keep windows closed, and use a high‑efficiency air filter.
• Wash bedding in hot water (at least 60°C) weekly to kill dust mites.
• Use a saline (salt water) nasal spray to rinse your nose and clear allergens.
• Keep pets out of the bedroom if you are allergic to animal dander.

Medical treatments

Doctors often recommend medicines such as antihistamines (which block histamine), nasal corticosteroid sprays (which reduce inflammation), or decongestants (for short‑term relief). These are available as tablets, sprays, or eye drops. Always use them as directed. Your doctor can help you choose the safest option for your situation.

When is surgery considered?

Surgery is rarely needed but may help if you have large nasal polyps (growths inside the nose) or a severely blocked nose that does not improve with other treatments.

Living with this condition

Living with allergic rhinitis means being aware of your triggers and taking steps to avoid them. With good control, you can still do most normal activities. Many people learn to plan around pollen seasons or keep a symptom diary to spot patterns.

Lifestyle tips

• Monitor pollen forecasts and limit time outdoors when counts are high.
• Wear sunglasses and a hat to keep pollen away from your eyes and hair.
• Shower and change clothes after being outside to wash off pollen.
• Use a dehumidifier if damp conditions are a trigger.

Diet and exercise

There is no special diet for allergic rhinitis, but eating a balanced diet rich in fruits and vegetables may help your immune system. Exercise is safe and beneficial – just try to exercise indoors on high‑pollen days.

Mental health and emotional wellbeing

Living with constant sneezing, a blocked nose, and tiredness can affect your mood and sleep. It is normal to feel frustrated or down at times. If you feel overwhelmed, speak to your healthcare provider – they can offer support or refer you to counselling if needed.

Prevention

Allergic rhinitis cannot be prevented entirely, but you can reduce the chance of it developing by avoiding known allergens early in life. For example, keeping your home clean and dust‑free may help.

Complications

If left untreated

• Poor sleep and daytime tiredness.
• Increased risk of asthma attacks if you have asthma.
• Sinus infections (sinusitis) because blocked sinuses can trap bacteria.
• Ear infections, especially in children.

Long-term outlook

With the right management, most people with allergic rhinitis can live a normal, active life. Symptoms may improve over time or change with age. There are many effective treatments available, and you can work with your healthcare team to find what works best for you.

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