Do you also get a runny nose when you wake up in the morning? Does your nose feel stuffy and itchy? Do your eyes, mouth, and throat itch all the time? If so, you may have what we're talking about : Allergic Rhinitis , or as some call it , Hay Fever . Despite the "fever" in the name, most people don't get a fever. Let's talk about this in detail, very simply.
What is Allergic Rhinitis?
Simply put, allergic rhinitis is an allergic reaction of our body to things around us that are too small to see (called allergens) . When these allergens enter our body through our nose or mouth, our body thinks that something dangerous has entered. Then, the body releases a chemical called histamine . This is what causes the symptoms like sneezing, runny nose, and itchy eyes.
It is not contagious like the common cold. Also, not all nasal congestion is allergic rhinitis. Some people may also have a condition called non-allergic rhinitis , which has similar symptoms, but is not caused by allergens.
What are the main triggers for this?
There are several factors that can contribute to the development of allergic rhinitis. These can be both indoor and outdoor. Here are some of the main ones:
- Pollen from trees, grasses, and weeds: These float in the wind, especially during the flowering season.
- Mold spores: These grow in damp places, such as bathrooms, kitchens, and even among piles of leaf litter.
- Pet dander: These are common in homes with animals like cats and dogs.
- Dust mites: These tiny creatures, invisible to the naked eye, live in our mattresses, pillows, bed sheets, sofas, and curtains.
- Cockroach saliva and feces: Some people can also be allergic to these.
Imagine, when you go out to the garden in the morning, you start to sneeze continuously, or when you put away old books, your nose gets blocked. Maybe something like this is the reason.
What seasons are most affected by this allergy?
Allergic rhinitis can occur at any time of the year. However, some people are more affected by it during specific seasons.
- Seasonal allergies: These are usually most common during the spring, summer, and early fall seasons. This is because trees and flowers are in bloom during these times, and pollen levels are higher in the environment. However, these pollen seasons can vary depending on where you live.
- Perennial allergies: These can be present all year round. They are often caused by things that are inside the home. For example, dust mites, pet dander, etc. These can be exacerbated by closed windows in the winter.
How common is this condition really?
Yes, this is a much more common condition than you might think. Millions of people around the world suffer from allergic rhinitis. According to some studies, about 20% of the population has this condition. That means that it is very likely that someone in your family or friend has it.
What are the symptoms of allergic rhinitis?
These symptoms can vary from person to person, and sometimes the intensity of the symptoms can also vary. See if you have at least a few of these:
- Nasal congestion, sneezing, and runny nose.
- Itchy nose, throat, and eyes.
- Redness or watering of the eyes.
- Headache , sinus pressure, and dark circles around the eyes.
- Excessive mucus accumulation in the nose and throat.
- Feeling tired.
- Sore throat due to mucus getting into the throat (postnasal drip).
- Some people may also experience symptoms such as difficulty breathing, coughing, and wheezing .
Even if you have one or two of these symptoms, if they persist, it's a good idea to see a doctor.
Is this an allergy? Is it a cold? How do you know for sure?
This is a problem that many people have. Because the symptoms of allergic rhinitis are very similar to those of the common cold. However, there are some slight differences.
Itchy, red, watery eyes are common with allergies . However, these symptoms are not as severe with a cold. With a cold, you are more likely to experience body aches and fever.
Another thing is that allergic rhinitis is usually triggered by a specific cause (trigger) . For example, when the weather changes, such as bringing a new pet into the house. An allergy can come at about the same time every year (e.g., spring) and can start very quickly.
But, a cold is caused by a virus. It spreads from one person to another. So, if you've been around someone who has a cold, you could get a cold. A cold usually goes away in about a week. But, if it's an allergy, it can last until the allergen is removed from the environment.
Why do we get allergic rhinitis? What happens inside the body?
Allergic rhinitis, as mentioned earlier, is caused by a hypersensitivity reaction of our immune system to things (allergens) in our environment that are too small to be seen by the naked eye.
These allergens are actually harmless to most people. However, if you have allergic rhinitis, your immune system thinks that the allergen is an invader entering your body. So, to protect your body, the immune system releases chemicals like histamine into your bloodstream. This histamine causes the mucous membranes in your nose, eyes, and throat to swell and itch. This is how your body tries to get rid of the allergen.
We have already discussed the main types of allergens:
- Dust mites live in carpets, curtains, bedding, and furniture.
- Pollen from trees, grasses, and weeds.
- Pet dander.
- Mold spores.
- Cockroach saliva and waste.
Some food allergies can also cause inflammation of the nose and throat. However, food allergies can sometimes be life-threatening. Therefore, if you suspect that you are experiencing persistent allergy symptoms due to a certain food, it is very important to seek medical advice immediately.
Who is most at risk of developing this?
Allergies can be inherited . This means that if your parents or a close family member has allergies, you are more likely to develop allergic rhinitis.
Also, people with asthma or eczema (a skin disease like eczema) are more likely to develop this condition.
How does a doctor diagnose this?
When you go to see a doctor, they will first examine you and ask about your symptoms. They will also check for other conditions, such as colds and asthma. They may also do allergy tests .
- Blood allergy test: This measures the amount of antibodies in a sample of your blood that have been produced against a specific allergen. This is also called an Immunoglobulin E (IgE) test . It can detect many types of allergies, even food allergies.
- Skin prick test and/or intradermal test: These tests help to find out exactly what allergen you are allergic to. In a skin prick test , a doctor places a small amount of different allergens on the surface of your skin (usually the back of your arm or hand) and pricks it with a small needle. If you are allergic to an allergen, the area will turn red, itch, and swell within 15-30 minutes. An intradermal test is similar, but the allergen is injected just under the skin.
Once you find out what allergen is bothering you through these tests, it's easier to avoid it and get proper treatment.
How is allergic rhinitis treated?
Fortunately, there are several types of medications that can help control the symptoms of allergic rhinitis. These come in the form of pills, liquids, eye drops, nasal sprays, and injections. The most important thing is to talk to your doctor before using any medication. This is especially important if you are pregnant or have other health problems.
Here are some of the main treatment methods:
Antihistamines
These can be purchased over-the-counter (OTC) with or without a doctor's prescription. These medications work by blocking a chemical called histamine that is released by the body during an allergic reaction. They come in the form of pills, liquids, eye drops, nasal sprays, and inhalers. Examples:
- Loratadine (e.g. Claritin®)
- Cetirizine (e.g. Zyrtec®)
- Fexofenadine (e.g. Allegra®)
- Levocetirizine (e.g. Xyzal®)
Some antihistamines can cause drowsiness. Therefore, avoid drinking alcohol while taking these medications, especially if you are driving.
Medicines that reduce nasal congestion (Decongestants)
These medications reduce congestion in the nose and sinuses. They can be taken by mouth as pills, liquids, or nasal sprays. Examples:
- Afrin® nasal spray
- Phenylephrine nasal spray (e.g. Neo-Synephrine®)
- Pseudoephedrine (e.g. Sudafed®)
These can cause things like high blood pressure, headaches, insomnia, and restlessness. Using nasal decongestant sprays for more than five days can also lead to addiction.
Corticosteroid nasal sprays
These sprays and inhalers reduce inflammation in the nose and relieve symptoms of hay fever. Commonly used nasal sprays include Flonase®, Nasacort®, and Rhinocort®. These can cause side effects such as headaches, inflammation inside the nose, nosebleeds, and coughing.
Leukotriene inhibitors
During an allergic reaction, our body releases chemicals called histamine and leukotrienes. These also cause swelling and hay fever symptoms. These medications come in pill form and can only be taken with a doctor's prescription. They work by blocking these leukotrienes. The most commonly used is Montelukast (e.g. Singulair®). Some people may experience mood swings, strange dreams, involuntary muscle movements, and skin rashes when taking these medications.
Immunotherapy
This treatment teaches your body to tolerate the allergens. Your doctor gives you a series of injections (called subcutaneous immunotherapy, or allergy shots) of very small amounts of the allergen. With each injection, your doctor gradually increases the amount of allergen. Over time, your immune system becomes accustomed to the allergen and stops reacting to it.
In some special cases, your doctor may also recommend oral immunotherapy, which comes as a pill that you put under your tongue. This treatment is currently only available for allergies to trees, grasses, and dust mites (in the United States).
How long does this allergy usually last?
It varies from person to person. Most people get relief within a few days of taking medication. However, you will need to continue taking the medication until the allergen is gone. Some people may have these symptoms for weeks or even months, especially if they don't take medication or if they can't get medication to help reduce their symptoms.
What can you expect when living with this condition?
Allergic rhinitis can be a bit uncomfortable. However, it usually doesn't cause serious health problems. Many people manage these symptoms with lifestyle changes and over-the-counter medications.
However, people with allergies to these airborne substances are at higher risk of ear infections and sinus infections . Also, if this causes you to not sleep well at night, you may feel tired during the day. If you have asthma, hay fever can make your asthma symptoms worse.
What can we do to prevent allergic rhinitis?
There is no way to completely prevent this from happening. However, with a few lifestyle changes, it is easier to live with this allergy. The most important thing is to stay away from allergens as much as possible. Try these things to reduce symptoms:
- Minimize touching your face, eyes, and nose as much as possible.
- Keep your home and car windows closed during periods of high pollen levels (spring, summer, and early fall).
- Put covers on pillows, mattresses, and bed sheets to protect against dust mites.
- Stop pets from getting on sofas and beds. Keep doors closed in rooms you don't want them in.
- Use filters on your vacuum cleaner and air conditioner to reduce the amount of allergens in the air.
- Wash your hands often, especially after playing with animals.
- Wear a hat and sunglasses to protect your eyes from pollen when you go outside. Change your clothes as soon as you get home.
Do you need to see a doctor?
Although allergic rhinitis usually doesn't cause major health problems, it's a good idea to see a doctor to make sure it's not another condition, such as asthma or a sinus infection. In particular, you should see a doctor if:
- If allergy symptoms are interfering with your daily activities.
- If you have trouble sleeping properly at night.
- If the symptoms do not subside despite taking allergy medication.
A doctor can help you find out what allergen you are allergic to and recommend treatments that can provide you with relief.
In summary (Take-Home Message)
So, this condition called Allergic Rhinitis can be a bit annoying. But, there is nothing to worry about. If managed properly, it is not a problem to live a normal, happy life with it. Millions of people manage this condition with medication and lifestyle changes. If you have any of these symptoms, talk to a doctor and get the treatment and advice that suits you best. Then you too can breathe easy and be well!
` Allergic rhinitis, hay fever, allergies, sneezing, nasal congestion, pollen, dust mites
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