Allergic Rhinitis Your Nose Knows

Overview

Allergic rhinitis is a condition where the inside of your nose becomes inflamed (swollen and irritated) when you breathe in something you're allergic to, like pollen, dust mites, or animal dander. It causes symptoms such as sneezing, a runny or blocked nose, and itching.

Yes. Allergic rhinitis is one of the most common long-term conditions in the UK, affecting around 1 in 4 adults and a similar number of children.

It often starts in childhood, the teenage years, or early adulthood, but it can begin at any age. You're more likely to have it if you already have asthma, eczema, or other allergies, or if allergies run in your family.

Symptoms

Common symptoms

• Sneezing and an itchy nose
• A runny nose with a clear, watery discharge
• A blocked or stuffy nose
• Itchy, red or watery eyes
• Post-nasal drip (mucus running down the back of your throat)
• A sore or dry throat from breathing through your mouth
• A cough, especially at night

Symptoms in children

• A constant runny or blocked nose, often mistaken for a cold
• Mouth breathing or snoring at night
• Frequent nosebleeds
• Rubbing the nose upwards with the palm of the hand (sometimes called the 'allergic salute')
• Poor sleep, tiredness and trouble concentrating at school

Symptoms in older adults

• Symptoms are often less obvious, like a stuffy nose and a reduced sense of smell
• Less sneezing and watery eyes than in younger people
• Mucus may be thicker, which can feel more uncomfortable
• Age-related dryness of the nose can make symptoms harder to tell apart

Causes

Main causes

• Tree, grass, and weed pollen (the most common cause of seasonal symptoms)
• House dust mites
• Animal dander (tiny flakes of skin from cats, dogs, and other furry animals)
• Mould spores, especially in damp areas
• Cockroach droppings (in some environments)

Risk factors

• A family history of allergies, asthma, or eczema
• Having asthma, eczema, or another allergic condition
• Being exposed to tobacco smoke, especially in childhood
• Being exposed to dust, pollen, or animals in your work or home environment

When to see a doctor

See a doctor urgently if:

• You have severe difficulty breathing or swallowing, or any signs of anaphylaxis (call your local emergency number immediately)
• Your symptoms are unmanageable and you are in danger of missing important events or are unable to sleep for several nights

Book a routine appointment if:

• Your symptoms last for more than a few weeks and are not improving with basic self-care
• Allergic rhinitis is affecting your school, work, or social life
• You have asthma and your chest symptoms are getting harder to control
• You feel you need a clear plan for a pollen season or a set of triggers

Diagnosis

A doctor can usually diagnose allergic rhinitis by listening to your symptoms and asking about your triggers, family history and whether symptoms are worse at certain times of year. Sometimes they'll refer you for allergy tests.

Tests that may be done

• Skin prick test (tiny drops of allergen are placed on your skin and lightly scratched to see if a bump appears)
• Specific IgE blood test (checks for antibodies to common allergens)
• Rarely, a trial of one medicine may be used to see if symptoms improve

What to expect at your appointment

Your doctor may look inside your nose with a lighted instrument, ask you to keep a symptom diary for a week or two, and help you make a management plan. If allergy testing is needed, they'll explain how to prepare and what it feels like.

Treatment

The goal of treatment is to ease your symptoms and help you live your daily life without interruption. This usually involves avoiding triggers as much as possible, using medicines recommended by a doctor or pharmacist, and in some cases, immunotherapy (a treatment that slowly helps your immune system get used to an allergen).

Self-care at home

• Avoiding high-pollen times by staying indoors when pollen counts are high
• Using a salt-water (saline) nasal rinse to wash out irritants and keep your nasal passages moist
• Keeping windows closed during peak pollen season and using air conditioning or a pollen filter if available
• Washing your face, rinsing your hair, and changing your clothes after being outdoors
• Using dust-mite-proof covers on your mattress, pillows, and duvet
• Washing bedding regularly at a high temperature
• Keeping pets out of the bedroom and vacuuming regularly

Medical treatments

Medicines for allergic rhinitis are available from your pharmacist or on prescription. Common approaches include antihistamine tablets, nasal sprays containing corticosteroids, cromoglicate nasal sprays, and short-term decongestants. Some people benefit from immunotherapy, where you gradually receive a small amount of the allergen (under medical supervision) to reduce your reaction over time. Your doctor or pharmacist can help you find the right option for your age, symptoms, and pregnancy status. Always follow the instructions given, and don't use decongestants for more than a few days.

When is surgery considered?

Surgery is rarely needed for allergic rhinitis. It may be considered if you have complications such as nasal polyps or a severely deviated septum that blocks nasal breathing, but this is not a first-line treatment.

Living with this condition

With the right approach, you can lead a full and active life. Plan ahead for pollen season by checking the local pollen forecast, keeping medications with you, and adapting outdoor activities when pollen counts are high. For indoor allergies, make small changes over time, like using dust-mite covers and keeping your home dry and well aired.

Lifestyle tips

• Shower and change your clothes after being outside during high-pollen days
• Keep windows closed in the bedroom at night and use a pollen filter in the car
• Vacuum and mop floors regularly, and consider a vacuum with a HEPA filter
• Wear wrap-around sunglasses outdoors to protect your eyes
• Avoid smoking and smoky environments, which can irritate your nose

Diet and exercise

There is no special diet for allergic rhinitis, but eating a balanced diet and staying active supports your overall health. Exercise outdoors may be better in the evening when pollen counts are lower. If exercise triggers your nose symptoms, talk to a doctor or pharmacist about what might help beforehand.

Mental health and emotional wellbeing

Living with constant sneezing, a blocked nose, and poor sleep can be exhausting and frustrating. It's normal to feel irritable, low, or anxious about symptoms, especially if they're affecting your performance at work or school. These feelings matter, and seeking help for allergic rhinitis can also improve your mental wellbeing. If you're struggling with low mood, anxiety, or stress, speak to a GP or call a local mental health support line.

Prevention

You can't always prevent allergic rhinitis from developing, but once you know your triggers, you can do a lot to prevent symptoms. Avoiding exposure to the allergen is the most effective way to reduce symptoms, along with early treatment when symptoms first appear.

Vaccines

There's no vaccine that prevents allergic rhinitis. Immunotherapy (allergy shots or tablets under medical supervision) is a treatment that aims to reduce your sensitivity over time, not a vaccine.

Screening programmes

There is no routine screening test. If you or your child have regular nasal symptoms, check with a healthcare professional to see if allergy testing is appropriate.

Complications

If left untreated

• Chronic nasal congestion that affects sleep and daily activities
• Sinusitis (inflammation and infection of the sinuses)
• Otitis media with effusion (a build-up of fluid behind the eardrum)
• Nasal polyps (soft, painless growths inside the nasal passages)
• Worsening of asthma symptoms
• Loss of sense of smell (more common in longstanding symptoms)

Long-term outlook

With the right treatment and trigger management, most people with allergic rhinitis can keep symptoms well controlled and enjoy normal daily life. It often improves with age, but even if it doesn't, there are many effective options to explore.

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