Perennial allergic rhinitis

Overview

Perennial allergic rhinitis is a condition where the inside of your nose becomes inflamed (swollen and irritated) because of an allergy to things that are around all year, like dust mites, pet dander, or mold. It causes symptoms like sneezing, a stuffy or runny nose, and itchy eyes that can last for weeks or months at a time.

Yes, perennial allergic rhinitis is very common. Many people around the world have it, and it often starts in childhood or young adulthood.

It can affect people of any age, but it often begins in childhood or young adulthood. People with other allergies (like asthma or eczema) are more likely to have it. It also tends to run in families.

Symptoms

Common symptoms

• Sneezing, especially when you wake up or after exposure to allergens
• Runny or stuffy nose
• Itchy nose, roof of mouth, or throat
• Itchy, watery, or red eyes (allergic conjunctivitis)
• Postnasal drip (mucus dripping down the back of your throat, causing a cough or sore throat)
• Frequent headaches or sinus pressure

Symptoms in children

• Frequent sneezing and a constantly runny or blocked nose
• Snoring or trouble sleeping at night
• Rubbing the nose upward (called an 'allergic salute')
• Dark circles under the eyes (called 'allergic shiners')
• Ear infections or poor hearing from fluid in the middle ear

Symptoms in older adults

• Symptoms may be milder but can still cause a stuffy nose and postnasal drip
• Reduced sense of smell or taste
• Difficulty sleeping due to nasal congestion
• Worsening of other health conditions like asthma or sinusitis

Causes

Main causes

• Dust mites – tiny bugs found in bedding, carpets, and soft furnishings
• Pet dander – tiny flakes of skin from dogs, cats, and other animals
• Mold spores – from damp areas like bathrooms, basements, or leaf piles
• Cockroach droppings or other pests

Risk factors

• Having a family history of allergies, asthma, or eczema
• Having other allergic conditions like asthma or eczema
• Living in a home with high humidity or poor ventilation
• Exposure to dust, pets, or mold from a young age

When to see a doctor

See a doctor urgently if:

• If you have trouble breathing or a feeling that your throat is closing
• If you develop a high fever with your symptoms (might indicate an infection)

Book a routine appointment if:

• If your symptoms are bothersome and affecting your quality of life (sleep, work, school)
• If over-the-counter remedies (like antihistamines or nasal sprays) are not helping
• If you have frequent sinus infections or ear infections

Diagnosis

Your doctor will ask about your symptoms and when they happen, and look inside your nose. They may also refer you to an allergy specialist for further testing.

Tests that may be done

• Skin prick test – small drops of allergen extracts are placed on your skin, and the area is gently pricked to see if you react
• Blood test (specific IgE) – checks the level of allergy antibodies in your blood to common allergens

What to expect at your appointment

The diagnosis is usually straightforward. Your doctor or an allergy specialist will explain the results and discuss what triggers your symptoms. They will also talk about how to avoid those triggers and possible treatments.

Treatment

Treatment for perennial allergic rhinitis focuses on avoiding triggers and using medicines to control symptoms. Your doctor will suggest a plan that works best for you. Usually, a combination of avoidance, self-care, and medical treatments works well.

Self-care at home

• Use a saline (salt water) nasal rinse to wash out allergens and mucus
• Keep your home clean and dust-free – vacuum with a HEPA filter, wash bedding in hot water weekly
• Reduce humidity – use a dehumidifier in damp areas to prevent mold
• Keep pets out of the bedroom and off soft furniture
• Shower and change clothes after being around pets or moldy places

Medical treatments

Your doctor may recommend antihistamine pills or nasal sprays to reduce symptoms. Corticosteroid nasal sprays help reduce inflammation when used regularly. Decongestant sprays can be used for short periods but not for more than a few days. Your doctor may also suggest allergy shots (immunotherapy) for long-term relief.

When is surgery considered?

Surgery is rarely needed for perennial allergic rhinitis. It may be considered if you have large nasal polyps (benign growths) or severe sinus problems that do not improve with other treatments.

Living with this condition

Living with perennial allergic rhinitis means being aware of your triggers and taking steps to avoid them. Many people find that with good habits and regular treatment, they can enjoy normal daily activities without much trouble.

Lifestyle tips

• Use allergy-proof covers on pillows and mattresses
• Wash your hands after touching pets
• Keep windows closed during high-pollen or high-humidity days (if pollen is also a trigger)
• Use an air purifier with a HEPA filter in your bedroom

Diet and exercise

There is no special diet for this condition, but eating a balanced diet helps your immune system stay healthy. Exercise can improve your overall well-being; if outdoor triggers bother you, try exercising indoors (like in a gym or at home). Some people find that certain foods (like spicy foods) can make a runny nose worse, but this varies.

Mental health and emotional wellbeing

Chronic symptoms like constant sneezing, a stuffy nose, and poor sleep can affect your mood, energy, and ability to focus. This can sometimes lead to frustration or low mood. It is important to talk to your doctor about how you are feeling so they can help you manage both your physical and emotional health.

Prevention

It is not always possible to prevent perennial allergic rhinitis, especially if you have a genetic tendency. However, you can reduce your risk of developing severe symptoms by avoiding known triggers as much as possible and treating allergies early.

Vaccines

There are no vaccines to prevent allergic rhinitis. However, allergy immunotherapy (allergy shots) can help reduce the sensitivity to triggers over time.

Screening programmes

There is no routine screening for this condition. If you have ongoing allergy-like symptoms, it is a good idea to see your doctor for an evaluation.

Complications

If left untreated

• Chronic sinusitis (long-term inflammation of the sinuses) and frequent sinus infections
• Ear infections or hearing problems, especially in children
• Nasal polyps (soft, non-cancerous growths inside the nose)
• Poor sleep, which can lead to fatigue and difficulty concentrating during the day
• Worsening of asthma symptoms if you have asthma

Long-term outlook

With proper management, most people with perennial allergic rhinitis can control their symptoms and live a normal, active life. There are many effective treatments available, and doctors can help you find what works best for you. It is a condition you can manage, not a disease you have to suffer from.

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