Allergic Rhinitis: Sneezing, Runny Nose and Dust Allergy Care

6 min read · Conditions · By the Asthra Health Care team

What is allergic rhinitis?

Allergic rhinitis, often called nasal allergy or dust allergy, happens when the immune system overreacts to harmless particles in the air. When you breathe them in, the body releases chemicals such as histamine, which cause sneezing, a runny or blocked nose and itching. It is not an infection and does not spread from person to person.

It is very common in India and often starts in childhood. It may be seasonal, flaring when certain pollen is in the air, or perennial, lasting all year because of indoor allergens like dust mites. It often occurs along with asthma, eczema and eye allergies, and tends to run in families.

Common triggers

Knowing what sets off your symptoms is the first step to control. Many people react to more than one trigger. Irritants such as smoke, pollution, perfumes and incense are not true allergens but can make symptoms worse. Common allergens include:

• House dust mites in bedding, mattresses, pillows, curtains and carpets
• Pollen from grasses, weeds and trees, including parthenium in many parts of India
• Mould, especially in damp homes during the monsoon
• Pet dander from cats and dogs
• Cockroach droppings

Symptoms of allergic rhinitis

Symptoms include repeated sneezing, especially in the morning, a watery runny nose, a blocked nose, itching in the nose, throat or roof of the mouth, and red, itchy, watery eyes. Mucus may drip down the back of the throat, causing throat clearing or cough. Some people lose their sense of smell for a while.

Long-term blockage can cause mouth breathing, snoring, poor sleep, headaches and tiredness during the day. Children may rub their nose upwards often, have dark circles under the eyes and find it hard to concentrate at school. Unlike a cold, there is usually no fever, and symptoms can last for weeks.

Diagnosis and tests

A doctor usually diagnoses allergic rhinitis from your symptoms, the pattern of triggers and a look inside the nose. Tests are not always needed. If symptoms are severe, do not improve with treatment, or a specific trigger needs to be confirmed, your doctor may order allergy tests, such as skin prick testing or blood tests for specific IgE.

A blood count may show raised eosinophils, a type of white blood cell linked to allergy. If there is a one-sided blockage, bleeding or facial pain, your doctor may examine the nose more closely or arrange a scan to rule out polyps, a bent septum or sinus infection.

How allergic rhinitis is treated

Saline nasal sprays or rinses wash allergens and mucus from the nose and are safe for regular use, including in pregnancy and children. Non-drowsy antihistamine tablets help sneezing, itching and runny nose, and many are available over the counter; follow the label or your pharmacist's advice. Older antihistamines can cause drowsiness, so avoid driving after taking them.

Steroid nasal sprays are the most effective treatment for persistent symptoms, especially blockage. They work slowly and need regular use, and should be used only on a doctor's prescription. Avoid using decongestant nasal drops for more than a few days, as overuse causes rebound blockage.

Reducing your exposure

Wash bedsheets and pillow covers weekly in hot water and dry them in the sun. Use dust-mite-proof covers for mattresses and pillows if possible. Dust with a damp cloth, avoid heavy carpets and soft toys in the bedroom, and keep the house dry and well ventilated to prevent mould.

During high pollen seasons, keep windows closed in the early morning and evening, and wear sunglasses outdoors. Wash your face and change clothes after coming in. Keep pets out of the bedroom. Avoid tobacco smoke, mosquito coils and incense indoors. Use a mask while sweeping or dusting.

Special groups and long-term care

In pregnancy and breastfeeding, some antihistamines and nasal sprays are safer than others, so check with your doctor before using any. Children need doses based on age and weight, as advised by a doctor. Older adults should avoid drowsy antihistamines, which can cause confusion and falls.

For severe allergy not controlled by medicines, a specialist may suggest allergen immunotherapy, which gradually trains the immune system over years. Treating nasal allergy also helps asthma control. Avoid steroid injections for allergy unless a specialist advises them. For advice on the right medicine for you, speak to your doctor or pharmacist.

This article is general health information, not medical advice. Do not start, stop or combine medicines on your own — always follow your doctor's prescription and ask your pharmacist if unsure.