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Allergic rhinitis


Alternative Names:

Hay fever; Nasal allergies; Seasonal allergy; Seasonal allergic rhinitis

Signs and tests:

The health care provider will perform a physical exam and ask about your symptoms. You will be asked whether your symptoms vary by time of day or season, and exposure to pets or other allergens.

Allergy testing may reveal the pollen or other substances that trigger your symptoms. Skin testing is the most common method of allergy testing.

If your doctor determines you cannot have skin testing, special blood tests may help with the diagnosis. These tests, known as IgE RAST tests, can measure the levels of allergy-related substances.

A complete blood count (CBC) test called the eosinophil count may also help diagnose allergies.

Treatment:

LIFESTYLE AND AVOIDING ALLERGENS

The best treatment is to avoid the pollens that cause your symptoms. It may be impossible to avoid all pollen. But you can often take steps to reduce your exposure.

You may be prescribed medicine to treat allergic rhinitis. The medicine your doctor prescribes depends on your symptoms and  how severe they are. Your age and whether you have other medical conditions, such as asthma, will also be considered.

For mild allergic rhinitis, a nasal wash can help remove mucus from the nose. You can buy a saline solution at a drug store or make one at home using one cup of warm water, half a teaspoon of salt, and pinch of baking soda.

Treatments for allergic rhinitis include:

ANTIHISTAMINES

Antihistamines work well for treating allergy symptoms. They may be used when symptoms do not happen often or do not last long. Be aware of the following:

  • Many antihistamines taken by mouth can be bought without a prescription.
  • Some can cause sleepiness. You should not drive or operate machines after taking this medicine.
  • Others cause little or no sleepiness.
  • Antihistamine nasal sprays work well for treating allergic rhinitis.  Ask your doctor if you should try these medicines first.

CORTICOSTEROIDS

  • Nasal corticosteroid sprays are the most effective treatment for allergic rhinitis.
  • They work best when used nonstop, but they can also be helpful when used for shorter periods of time.
  • Many brands are available. You will need a prescription from your doctor.
  • Corticosteroid sprays are generally safe for children and adults.

DECONGESTANTS

  • Decongestants may also be helpful for reducing symptoms such as nasal stuffiness.
  • Do not use nasal spray decongestants for more than 3 days.

OTHER MEDICINES

  • Leukotriene inhibitors are prescription medicines that block leukotrienes. These are the chemicals that the body releases in response to an allergen that also trigger symptoms. 

ALLERGY SHOTS

Allergy shots (immunotherapy) are sometimes recommended if you cannot avoid the pollen and your symptoms are hard to control. This includes regular shots of the pollen you are allergic to. Each dose is slightly larger than the dose before it, until you reach the dose that helps control your symptoms. Allergy shots may help your body adjust to the pollen that is causing the reaction.

Expectations (prognosis):

Most symptoms of allergic rhinitis can be treated. More severe cases need allergy shots.

Some people, especially children, may outgrow an allergy as the immune system becomes less sensitive to the trigger. But once a substance, such as pollen, causes allergies, it often continues to have a long-term effect on the person.

Calling your health care provider:

Call for an appointment with your health care provider if:

  • You have severe hay fever symptoms
  • Treatment that once worked for you no longer works
  • Your symptoms do not respond to treatment
Prevention:

You can sometimes prevent symptoms by avoiding the pollen you are allergic to. During pollen season, you should stay indoors where it is air-conditioned, if possible.

References:

Frew AJ. Allergen immunotherapy. J Allergy Clin Immunol. 2010 Feb;125(2 Suppl 2):S306-13.

Greiner AN, Hellings PW, Rotiroti G, Scadding GK. Allergic rhinitis. Lancet. 2011;378(9809):2112-2122.

Orban NT, Saleh H, Durham SR. Allergic and non-allergic rhinitis. In: Adkinson NF Jr., Bochner BS, Busse WW, et al., eds. In: Middleton’s Allergy Principles and Practice. 7th ed.  Philadelphia, Pa.: Elsevier Mosby; 2008:chap 55.


Review Date: 5/27/2013
Reviewed By: Stuart I. Henochowicz, MD, FACP, Associate Clinical Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, Georgetown University Medical School. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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