An allergen is a normally harmless substance that causes an allergic reaction. Allergic rhinitis, or hay fever, is an allergic response to specific allergens. Pollen is the most common allergen.
Nearly 8 percent of adults in the United States experience allergic rhinitis of some kind, according to the American Academy of Allergy, Asthma & Immunology (AAAAI). Between 10 to 30 percent of the worldwide population may also have allergic rhinitis. Learn more about this condition.
Common symptoms of allergic rhinitis include:
- a runny nose
- a stuffy nose
- an itchy nose
- a sore or scratchy throat
- itchy eyes
- watery eyes
- dark circles under the eyes
- frequent headaches
- eczema-type symptoms, such as having extremely dry, itchy skin that often blisters
- excessive fatigue
You’ll usually feel one or more of these symptoms immediately after coming into contact with an allergen. Some symptoms, such as recurrent headaches and fatigue, may only happen after long-term exposure to allergens. Fever isn’t a symptom of hay fever.
Some people experience symptoms only rarely. This is highly likely when you’re exposed to allergens in large quantities. Other people experience symptoms all year long. Talk to your doctor about possible allergies if your symptoms last for more than a few weeks and don’t seem to be improving.
When your body comes into contact with an allergen, it releases histamine, which is a natural chemical that defends your body from the allergen. This chemical causes allergic rhinitis and its symptoms, including a runny nose, sneezing, and itchy eyes.
In addition to pollen, other common causes include:
- animal dander, which is old skin
- cat saliva
During certain times of the year, pollen can be especially problematic. Tree and flower pollens are more common in the spring. Grasses and weeds produce more pollen in the summer and fall.
The two types of allergic rhinitis are seasonal and perennial, which lasts all year. Pollen-based allergies are usually seasonal. Perennial allergies usually occur due to sensitivity to dust mites, cockroaches, or animal dander. It’s possible to be in constant contact with all of these allergens on a daily basis. This is especially true if you have a dog or pests in your home.
Allergies can affect anyone, but you’re more likely to develop allergic rhinitis if your family has a history of allergies.
Some external factors can trigger or worsen this condition, including:
- cigarette smoke
- cold temperatures
- air pollution
- wood smoke
If you have minor allergies, you’ll probably only need a physical exam. However, your doctor may perform certain tests to figure out the best treatment and prevention plan for you.
A skin prick test is one of the most common. Your doctor places several substances onto your skin to see how your body reacts to each one. Usually, a small red bump appears if you’re allergic to a substance.
A blood test, or radioallergosorbent test (RAST), is also common. The RAST measures the amount of immunoglobulin E antibodies to particular allergens in your blood.
You can treat your allergic rhinitis in several ways.
You can take antihistamines to treat allergies. They work by stopping your body from making histamine.
Some popular over-the-counter (OTC) antihistamines include:
- Allegra (fexofenadine)
- Clarinex (desloratadine)
- Claritin (loratadine)
- Xyzal (levocetirizine)
- Zyrtec (cetirizine)
Talk to your doctor before starting a new medication. Make sure that a new allergy medication won’t interfere with other medications or medical conditions.
You can use decongestants over a short period to relieve a stuffy nose and sinus pressure. Popular OTC decongestants include:
- Afrin nasal spray (oxymetazoline)
- Sudafed (pseudoephedrine)
- Sudafed PE (phenylephrine)
- Zyrtec-D (cetirizine with pseudoephedrine)
If you have high blood pressure or a genitourinary disease, speak with your doctor before using a decongestant.
Eye drops and nasal sprays
Eye drops and nasal sprays can help relieve itchiness and other allergy-related symptoms for a short time. However, you should avoid long-term use of these products.
Overusing eye drops can cause a rebound effect. This means that, when you stop using them after a long period, your symptoms will be worse than before you started using eye drops.
Overusing nasal spray can cause a yeast infection to occur in the back of your nose. It can also create a hole in your nasal septum.
Corticosteroids can also help with inflammation or immune responses. These steroids are usually available as injections, creams, or eye drops.
Your doctor may recommend immunotherapy, or allergy shots, if you have severe allergies. You can use this treatment plan in conjunction with medications to control your symptoms. These shots decrease your immune response to particular allergens over time.
An allergy shot regimen begins with a buildup phase. During this phase, you’ll go to your allergist for a shot one to three times per week for about three to six months to let your body get used to the allergen in the shot.
During the maintenance phase, you should see your allergist for shots about once per month over the course of three to five years. You may not notice a change until over a year after the maintenance phase begins. Once you reach this point, it’s possible that your allergy symptoms will fade or disappear altogether.
Some people experience severe allergic reactions to an allergen in their shot. Many allergists ask you to wait in the office for 30 to 45 minutes after a shot to ensure that you don’t have an intense or life-threatening response to it.
Sublingual immunotherapy (SLIT)
SLIT involves placing a tablet containing a mixture of several allergens under your tongue. It works similarly to allergy shots. You can take SLIT treatments, such as Oralair, at home after an initial consultation with your doctor.
Possible side effects include itching in the mouth or ear and throat irritation. In rare cases, SLIT treatments can cause anaphylaxis. Talk to your doctor about SLIT to see if your allergies will respond to this treatment.
Home remedies will depend on your allergens. If you have seasonal or pollen allergies, you can try using an air conditioner instead of opening your windows. If possible, add a filter designed for allergies.
Using a dehumidifier or a high-efficiency particulate air (HEPA) filter can help you control your allergies while indoors. If you’re allergic to dust mites, wash your sheets and blankets in hot water that’s above 130°F (54.4°C). Adding a HEPA filter to your vacuum and vacuuming weekly may also help.
Children can develop allergic rhinitis, and it typically appears before the age of 10. If you notice that your child develops cold-like symptoms at the same time each year, they probably have allergic rhinitis.
The symptoms in children are similar to those in adults. Children usually develop watery, bloodshot eyes, which is called allergic conjunctivitis. If you notice wheezing or shortness of breath in addition to other symptoms, your child may have also developed asthma.
Limit your child’s exposure to allergens by keeping them inside and washing their clothes and sheets frequently during allergy season. Many antihistamines, decongestants, and corticosteroids are available to help your child’s allergies. However, some antihistamines can cause drowsiness or hyperactivity in your child, even in small doses.
The outcome of treatment depends on your condition. Seasonal allergic rhinitis usually isn’t severe, and you can manage it well with medications. However, severe forms of this condition will likely require long-term treatment.
The best way to prevent allergy symptoms is to manage your allergies before your body has a chance to respond to substances adversely. The AAAAI recommends starting medications before seasonal allergy attacks. For example, if you’re sensitive to tree pollen in the spring, you may want to start taking antihistamines before an allergic reaction has the chance to occur.