Nasal Allergy, Rhinitis and Allergic Rhinitis

Rhinitis translates to “inflammation of the nose.” It’s caused by the body’s reaction to airborne allergens, irritants or viruses.

Here’s how it happens: The nose produces mucus to trap dust, viruses or allergens and keep them from getting into the lungs. The particles drain down your throat instead of going into your lungs. This happens every day. Normally the mucus is thin and there isn’t much of it, so you don’t even realize it’s happening. When you catch a cold, your nose produces thick mucus, so you need to blow your nose. This can irritate your nasal passages and throat, and cause coughing. When you have allergies, your body creates a histamine response to your triggers. This can cause allergy symptoms, as your nose produces an excess of thin, watery mucus.

Illnesses and allergies can both cause rhinitis, but the time frame differs. Rhinitis from a cold is temporary, clearing up in a few days or a week. People with allergies may have chronic rhinitis lasting weeks or months at a time. Chronic rhinitis can even be present year-round if your allergy triggers are not seasonal.

A person sneezing into a tissue, eyes closed, wearing a white shirt, against a gray background.

There are 3 types of rhinitis we will examine:

Illustration showing a comparison of healthy nasal mucosa and inflamed mucosa due to rhinitis. The healthy side shows normal texture, while the inflamed side is red and swollen, indicating irritation.

What are the symptoms of rhinitis?

Rhinitis symptoms are typical of a cold or any other allergies, including:

  • itching in the nose and eyes
  • sneezing
  • stuffy nose
  • congestion
  • runny nose
  • phlegm in the throat
  • postnasal drip

How is rhinitis diagnosed?

Your doctor will first:

  • review your medical history, including the frequency and severity of symptoms
  • perform a physical examination.

Your doctor will then search for clues to identify your allergies. Are you spending a lot of time outdoors? You may be allergic to pollen or mold. Are you living with a pet? It could be animal dander. Do you wake up at night or in the morning with an itchy nose and eyes? Likely dust mites.

To confirm the diagnosis, your doctor may recommend an allergy skin prick or blood test. A positive test reveals sensitivity to a particular allergen. Diagnosis occurs when the history of symptoms matches the allergy test result.

How to treat rhinitis?

There is no cure for rhinitis. Managing symptoms and avoiding triggers is the best way to keep rhinitis under control. Figuring out what triggers your rhinitis and avoiding them is the first step. They may include:

  • smoke from tobacco or wood fires
  • perfumes, hair spray, or other strong scents (you may need to talk to family, friends, and coworkers if they use products that trigger rhinitis)
  • scented cleaning agents

If avoidance isn’t enough and symptoms arise, you can manage them with:

  • over-the-counter (OTC) and prescription medication
  • nasal irrigation
  • nasal sprays, either OTC or prescription
  • correction of nasal polyps or deviated septum to improve breathing

Lifestyle management strategies include:

  • keep windows and doors closed to keep pollen out
  • limit outdoor activities when pollen levels are high — usually in the morning through late afternoon; if you must go outside, consider wearing a face mask
  • clean or replace the filters in your home once a month, especially during your allergy season
  • change clothes and remove shoes immediately after being outside to prevent pollen from spreading indoors
  • bathe before going to bed to remove pollen from your body; be sure to wash your hair

What is allergic rhinitis?

Allergic rhinitis is caused by allergies to pollen. Irritants like smoke, perfume and cleaners can trigger symptoms as well. You may be more sensitive to inhaled irritants when your nasal passages are inflamed from rhinitis. If you also have asthma, allergic rhinitis may worsen respiratory symptoms.

Allergic rhinitis doesn’t apply just to seasonal allergies, though. Allergies to indoor mold, pet dander, dust or dust mites can trigger symptoms.

Are hay fever and allergic rhinitis the same thing?

Allergic rhinitis is often called “hay fever,” but there’s no connection to hay, and there’s no fever. Hay fever is more of a blanket term for seasonal allergies that stem from pollen in the air. These are also called nasal allergies.

What are the symptoms of allergic rhinitis?

Symptoms that may occur soon after exposure to an allergen:

  • runny nose with clear or pale-colored mucus
  • sneezing
  • red, watery eyes
  • itching around the nose, mouth or eyes

Untreated allergic rhinitis symptoms can lead to:

  • nasal congestion (swelling of nasal passages)
  • postnasal drip
  • coughing
  • lower respiratory problems
  • sore throat
  • headache
  • decreased sense of smell
  • ear or sinus infection
  • puffiness or dark circles under the eyes
  • fatigue

Fever is not a symptom of allergic (or any) rhinitis. See your doctor to check the cause of a fever.

How to treat allergic rhinitis?

Medications are usually prescribed to treat allergic rhinitis. Antihistamines help stop your body from making histamine, reducing symptoms. Decongestants reduce congestion, but it’s not recommended to use them longer than three days. Corticosteroid nasal sprays help control inflammation. Eye drops and saline nasal sprays can help relieve eye allergies.

Always check with your doctor about allergy medications. Find out if any allergy medications will not interfere with any other medicine you may take.

Speak to your doctor if your symptoms:

  • are severe and don’t respond to any method of home treatment
  • prevent you from enjoying daily life

You may want to consider allergen immunotherapy. Immunotherapy will decrease your response to allergens over time. There are two forms of immunotherapy:

  • allergy shots
  • under-the-tongue allergy tablets

Alternative remedies may be helpful. These include acupuncture, herbal remedies and probiotics. Always talk to a healthcare professional before using alternative therapies. These remedies are not FDA-approved for allergic rhinitis or evaluated for efficacy.

A woman with blonde hair holds a tissue and medicine bottle, suggesting she might be battling allergies. Standing in front of a brick wall, she wears a knitted scarf and light sweater, peering at the bottle with a concerned expression.

What are complications from allergic rhinitis?

Complications and secondary infections might affect people with allergic rhinitis. These can include:

  • chronic ear infections
  • sinusitis
  • growth of nasal polyps
  • sleep apnea
  • loss of smell
  • worsening asthma symptoms

In addition, any form of rhinitis, allergic or non-allergic, can affect your quality of life. Symptoms can decrease your productivity at work or school. Some allergy medications can cause drowsiness as well.

What is seasonal rhinitis?

Seasonal rhinitis is the specific term for allergic rhinitis caused by pollen from allergens. These include:
– trees
– grasses
– weeds
– mold spores

With seasonal rhinitis, symptoms occur mainly during spring and fall, when outdoor allergens are more common. Seasonal rhinitis varies according to where you live and the specific plants that trigger your allergies.

Trees, grasses and weeds release pollen at various times of the year. Tree pollens bloom in early spring, grass pollens arrives in late spring and ragweed pollen arrives in late summer and early fall.

What is perennial rhinitis?

Perennial rhinitis is a chronic allergic condition. Symptoms are present most days of the year. Perennial rhinitis is often caused by indoor allergens that are present year-round. such as:
– dust mites
– pet dander
– cockroaches
– rodents
– mold

It is also caused or made worse by strong odors, pollution or industrial dust. Pollen can also cause symptoms year-round, depending on your local climate.

A young girl with braided hair is wearing a white shirt. She is holding a tissue or handkerchief over her nose and mouth, suggesting she might be sneezing or covering her face. The background is a soft, pale color.

What is nonallergic rhinitis?

Some people get rhinitis symptoms without any allergies at all. This is called nonallergic rhinitis. It’s sometimes referred to as vasomotor rhinitis. Nonallergic rhinitis affects adults year-round. Symptoms include:
– congestion
– postnasal drip
– sneezing
– runny nose

The immune system is not involved with nonallergic rhinitis. Instead, symptoms are caused by irritants such as:
– smoke
– air pollution
– strong odors from perfume, cosmetics, or laundry detergents

These are not allergens but they may cause allergy-like symptoms that contribute to an allergic rhinitis flare.

Diagnosis comes after ruling out every other cause of symptoms. Many factors can trigger nonallergic rhinitis, including:

Environmental factors:

  • car exhaust
  • smog
  • smoke from a fire or tobacco
  • wood dust
  • paint
  • chemical solvents

Personal and home products:

  • perfume
  • cosmetics
  • hair spray
  • latex
  • glues
  • cleaning products
  • laundry detergents
A person with long dark hair pinching the bridge of their nose, eyes closed, as if experiencing discomfort or a headache, against a plain white background.

Food

Food can cause symptoms, especially spicy cuisines. Alcohol, especially wine and beer, can also trigger symptoms. When this occurs, it’s called gustatory rhinitis.

Medications

Medications that may cause symptoms include:
nonsteroidal anti-inflammatory drugs (NSAIDs)

  • oral contraceptives
  • antidepressants
  • tranquilizers
  • erectile dysfunction medication
  • blood pressure medication
  • decongestant nasal sprays and drops

Hormones

Hormone changes can trigger symptoms. Hormones are often imbalanced during:

  • pregnancy
  • menstruation
  • hypothyroidism

Weather

Weather changes can trigger nonallergic rhinitis, especially when it’s abrupt. Cold air can cause sneezing or a runny nose. Humidity changes can cause swelling in the nasal passages.

Stress

Whether emotional or physical, stress and anxiety can trigger nonallergic rhinitis symptoms.

Health problems

Medical conditions such as gastroesophageal reflux disease (GERD), chronic fatigue, or underactive thyroid may cause or worsen nonallergic rhinitis.

Pregnant woman sitting in bed, wearing a blue shirt, blowing her nose with a tissue, and touching her stomach. She looks unwell, with a tissue box nearby. The bed has white sheets and a light, airy atmosphere.

What is pregnancy rhinitis?

Pregnancy brings many changes to a woman’s body – some of them wonderful and some not as welcome. Pregnancy rhinitis is common. It happens when a pregnant woman has congestion or a runny nose without having an illness or allergies. Researchers believe hormones play a role and affect nasal passages.

Pregnancy hormones that can cause increased blood flow and mucus production include:

  • estrogen
  • progesterone
  • placental growth hormone

More blood and mucus leads to pregnancy rhinitis by:

  • swelling nasal passages
  • irritating the nose and ears
  • causing congestion

When does pregnancy rhinitis start?

Pregnancy rhinitis can start at any point during pregnancy but it seems to happen most often during the second trimester. Some women experience it for a few days, while some seem to have it throughout pregnancy.

Pregnancy rhinitis doesn’t pose a risk to you or your baby, though it can disrupt sleep and make you feel lousy. It sometimes causes ear infections or sinusitis.

If you’re pregnant and you have asthma, it’s important to monitor your asthma symptoms as they can worsen. Discuss any changes in your symptoms with your doctor. Make sure you follow all instructions about medications.

There are a few ways to ease symptoms if pregnancy rhinitis affects your quality of life. You can ease symptoms by:

  • using humidifiers in the home
  • drinking plenty of liquids
  • avoiding irritants, like smoke, perfume, or pollution
  • exercising will decrease congestion and improve sleep
  • elevating your head to drain mucus
  • using saline sprays or nasal irrigation — but always check with your doctor first

How long does pregnancy rhinitis last?

As with all pregnancy symptoms, pregnancy rhinitis is unique to each person. You may have symptoms for a few days or several weeks. You may have symptoms once or several times. Chronic symptoms usually resolve a week or two after giving birth.

Important notes:

  • Pregnancy rhinitis isn’t dangerous, but you should always mention symptoms at your prenatal visits.
  • Pregnancy rhinitis symptoms can mirror those of respiratory infections, allergies and asthma flares. After diagnosis, your doctor should discuss with you the best treatment for your health and your baby’s health.

Is It Nasal Allergy? Find Out For Sure

Download the Rhinitis Control Assessment Test (RCAT) below and discuss the results with your healthcare provider.

Image of a nasal allergy questionnaire form titled "Is it Nasal Allergy? Find Out For Sure." The form includes sections for personal information and questions about nasal allergy symptoms and their frequency, with rating options ranging from "Never" to "Always.