Allergic rhinitis and hay fever

What is allergic rhinitis

Allergic rhinitis is inflammation inside the nose caused by an allergy. Hay fever is the seasonal form caused by pollen; dust mites, animal dander and mould can cause symptoms at other times of year.

What causes it

Allergic rhinitis occurs when your immune system overreacts to allergens in the air. Common triggers include:

• Pollen (from trees, grasses, and weeds).
• House dust mites.
• Animal fur or dander.
• Mould spores.

Symptoms

• Sneezing.
• Runny or blocked nose.
• Itchy nose, eyes, throat or ears.
• Watery or red eyes.
• Postnasal drip (mucus in the throat).
• Tiredness due to poor sleep.
• Reduced sense of smell.

Types of allergic rhinitis

• Seasonal: linked to pollen, with timing depending on the pollen you react to.
• Perennial: caused by year-round allergens like dust mites or pet dander.

Treatment options

Avoiding triggers

• Keep windows closed during high pollen seasons.
• Shower and change clothes after being outdoors.
• Reduce exposure to your identified allergens where practical. Ask for advice on measures likely to help your particular allergy.

Medications

• Antihistamines (e.g. cetirizine, loratadine) help relieve sneezing and itching.
• Steroid nasal sprays, such as fluticasone or mometasone, reduce inflammation when used regularly. They may take several days or longer to work fully. Aim the spray away from the middle wall of the nose.
• Decongestant nasal sprays or drops may help briefly. Do not use for more than 5 days; longer use can worsen blockage. Ask a pharmacist about suitability, especially if you take other medicines or are pregnant.
• Eye drops for itchy or watery eyes.

Allergen immunotherapy

• In some cases, a course of allergy shots or tablets (under specialist care) can help desensitise your immune system.

Self-care tips

• Monitor pollen forecasts and plan ahead.
• Use barrier balms (like Vaseline) around the nostrils.
• Wear sunglasses outdoors to protect your eyes.
• Saline rinses may help remove allergens. Use sterile or distilled water, or water that has been boiled and allowed to cool, for nasal rinses. Follow the product instructions and clean the rinse device after use.

When to see a doctor

• Symptoms are severe or long-lasting.
• Over-the-counter treatments don’t help.
• You have asthma or frequent sinus infections.
• You’re considering immunotherapy.