Rhinitis refers to an inflammation of the nose. Symptoms include nasal congestion, runny nose, itching, sneezing and a postnasal drip. There are many different causes of rhinitis. Identifying the cause of rhinitis is really 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 can be caused by allergens (or irritants), leading to so-called allergic rhinitis. When exposed to an allergen we release chemicals called histamines which causes an allergic response. An example of allergic rhinitis is seasonal allergic rhinitis, also known as hay fever. The common allergen is 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. The common cause is typically dust mite, animal dander and mould. Non-allergic rhinitis is caused by chemicals or particles that can cause similar symptoms, such as pollution or cigarette smoke. Additionally, infections like the common cold, viral or bacterial respiratory infections can affect the nose and upper airway system leading to rhinitis symptoms. 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 called antihistamines (also known as hay fever tablets). Antihistamines can be taken as tablets, liquids or nasal sprays and they work by counteracting the histamine release that causes the response. Nasal sprays and drops are often used too – decongestants 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 steroid nasal sprays which help reduce inflammation and reduce 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.
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.