Rhinitis simply means ‘inflammation of the nose’ and usually causes symptoms such as nasal congestion (a blocked nose), a runny nose, itching, sneezing and a postnasal drip. There are many different causes of rhinitis so identifying the cause is the key to managing the symptoms. For many people, rhinitis can be a short-term (acute) condition that clears up after a few days or it can be a longer-term (chronic) condition that lasts several months or even all year round. Rhinitis is common and often becomes more common with increasing age.
If rhinitis is caused by allergens (or irritants), this is known as allergic rhinitis. When exposed to an allergen we release chemicals called histamines which causes an allergic response.
A good example of allergic rhinitis is seasonal allergic rhinitis, more usually known as hay fever with the common allergen being tree or grass pollen. It typically occurs at the time of year with high pollen counts in late spring or early summer.
Another example is perennial allergic rhinitis which occurs all year long and the most common causes of this are house dust mite, animal dander and mould.
Non-allergic rhinitis is caused by chemicals or particles that can cause similar symptoms to other types of rhinitis - such as pollution or cigarette smoke. Additionally, infections like the common cold and viral (flu) or bacterial respiratory infections can also affect the nose and upper airway system, leading to rhinitis symptoms, and rhinitis can also occur as a side effect of medications, such as using nasal sprays too often.
A common medication used to treat rhinitis is known as antihistamines (also known as hay fever tablets). These can be taken as tablets, liquids or nasal sprays and they work by counteracting the histamine release that causes the response. Decongestant nasal sprays and drops are often used too to help relieve blockage and obstruction in the nasal passage. As we mentioned earlier, decongestants should not be used long term as they can eventually lead to worsening of rhinitis symptoms or rebound worsening when you first stop.
If over the counter treatment is not working, your doctor may suggest using a steroid nasal spray to help reduce inflammation and the allergic response in certain scenarios. If these are not effective, there are other medications that your doctor can try, such as a combination of steroid and antihistamine nasal sprays or a leukotriene receptor antagonist.
If these still don't work your doctor may refer you to an ear nose and throat doctor who will investigate your symptoms further and suggest alternative tests and treatment for you to try.
Immunotherapy may be a long term solution suggested for allergic rhinitis which involves a healthcare professional injecting the allergen under the skin repeatedly over a period of time to make your body less sensitive to it over time. However, this is not readily available on the NHS at present.
It is important to identify causative factors and if possible avoid coming into contact with that irritant as much as possible.
To reduce allergens, wash your bed linens and pillowcases in hot water regularly and try to keep pets out of the bedroom. Hay fever can be very problematic and accessories like sunglasses and wide hats can be used to avoid pollen entering the eyes. Wash your hands regularly with soap and water and avoid rubbing your nose to reduce adding irritants to your nasal passages.
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