Allergic Rhinitis (Hay Fever)- Details with proven treatment, symptoms, causes

Medically reviewed by Dr Itender Pal Singh

Allergic rhinitis, often referred to as hay fever, is a prevalent condition that affects a significant portion of the population. Characterized by inflammation of the nasal passages, this condition is triggered by allergens such as pollen, cats, ragweed or dust mites. When the immune system overreacts to these otherwise harmless substances, it results in a variety of uncomfortable symptoms, including sneezing, a runny or stuffy nose, itchy eyes, and a scratchy throat.

Types of Allergic Rhinitis: Differences

Allergic rhinitis manifests in two primary forms, each with distinct triggers and patterns.

1. Seasonal Allergic Rhinitis

Also known as hay fever, seasonal allergic rhinitis is typically triggered by pollen from trees, grasses, and weeds. Grass and weed pollen may cause allergic reaction during summer and ragweed during autumn. Individuals with this type of allergic rhinitis experience symptoms during specific seasons when pollen counts are elevated—most commonly in the spring and fall.

2. Perennial Allergic Rhinitis

Unlike its seasonal counterpart, perennial allergic rhinitis occurs year-round and is usually triggered by indoor allergens such as dust mites, feathers, pet dander ( the tiny skin flakes of animals like cats and dogs shed along with fur) which can be found in pillows, bedding and carpets and mold spores. This type can persist throughout the year, leading to more consistent symptoms.

Symptoms of Allergic Rhinitis

The symptoms of hay fever can vary in severity and often mimic those of a common cold. Typical symptoms include:

Sneezing: Frequent and sudden bursts of sneezing.
Runny or stuffy nose: Excessive nasal mucus or nasal congestion.
Itchy eyes, nose, or throat: Persistent itching in these areas.
Red, watery eyes: Often a result of irritation from allergens.
Coughing: Due to postnasal drip or throat irritation.
Fatigue: General tiredness resulting from disrupted sleep.
Dark circles under the eyes: Commonly referred to as “allergic shiners.”

If left untreated, hay fever can lead to complications such as sinus infections, ear infections, and disrupted sleep, significantly impacting daily life.

Causes of Allergic Rhinitis

Allergic rhinitis is primarily caused by an overactive immune response to allergens like pollen, pet dander, dust mites, and mold. When a person with hay fever inhales these allergens, their immune system mistakenly identifies them as harmful substances. In response, the body releases chemicals such as histamine, which leads to inflammation and the production of mucus, resulting in the symptoms associated with the condition.

Risk Factors: Who is More Likely to Develop Allergic Rhinitis?

Several factors can increase the likelihood of developing hay fever. These include:

Family history: A genetic predisposition plays a significant role, with individuals who have a parent or sibling with allergies being at higher risk.
Eczema: People with eczema, a skin condition marked by itching and inflammation, are more prone to developing allergic rhinitis.
Early life exposures: Exposure to indoor allergens, air pollution, and cigarette smoke during early childhood can heighten the risk.
Lifestyle factors: Smoking and poor sleep quality are also associated with a higher risk of allergic rhinitis.

Diagnosis

Diagnosing allergic rhinitis typically involves a thorough review of the patient’s medical history, a physical examination, and allergy testing. Common diagnostic tests include:

Skin prick test: In this test, a small amount of a suspected allergen is introduced to the skin to see if it triggers a reaction.
Allergy blood test: This test measures the level of IgE antibodies in the blood, which are elevated in individuals with allergic disorders.

Treatment Options: Managing Allergic Rhinitis

Effectively managing hay fever involves a combination of medications, allergen immunotherapy, and lifestyle modifications.

1. Medications

Several medications are commonly prescribed to manage symptoms:

Nasal corticosteroids: These are highly effective in reducing inflammation and controlling symptoms. These includes budesonide, fluticasone, mometasone etc.
Antihistamines: These help block the action of histamine, thereby reducing symptoms such as itching, sneezing, and runny nose. These include cetrizine, fexofenadine, loratidine etc.
Decongestants: These relieve nasal congestion by shrinking swollen blood vessels in the nasal passages.
Cromolyn sodium. Use this OTC nasal spray several times a day to stop the release of histamines. It works best when you start before symptoms show up.
Leukotriene modifier. This medicine hinders leukotrienes, chemicals in your immune system that cause your body to make extra mucus. A leukotriene modifier like montelukast can help when allergy symptoms come with mild asthma.
Nasal ipratropium. This prescription nose spray helps stop an extra-runny nose but doesn’t do much for symptoms like congestion or sneezing. Don’t take it if you’ve been diagnosed with glaucoma or an enlarged prostate gland.

2. Allergen Immunotherapy

This long-term treatment involves gradually introducing small amounts of allergens to build tolerance. It is available in the form of allergy shots or sublingual tablets. You have to go to doctor many times for this treatment, weekly preferably for 2-5 years.

3. Self-Care Measures

In addition to medical treatments, several self-care measures can help manage symptoms:

Regular nasal washes: Using saline solutions can help clear mucus and reduce nasal symptoms.
Avoiding known allergens: Staying indoors during high pollen seasons or using allergen-proof bedding can be crucial in minimizing exposure to allergens.

Prevention and Living with Allergic Rhinitis

While it is impossible to completely prevent hay fever, taking steps to minimize exposure to allergens can significantly reduce symptoms. Effective strategies include:

Monitoring local allergy forecasts: Staying informed about pollen counts can help you avoid outdoor activities during peak allergy seasons.
Using air purifiers: These can reduce indoor allergens by filtering the air in your home.
Adopting good hygiene practices: Regularly washing your hands and showering after being outdoors can help remove allergens from your skin and hair.

Managing Allergic Rhinitis for a Better Quality of Life

Allergic rhinitis can significantly impact your quality of life by disrupting sleep and reducing your ability to focus on daily tasks. However, with proper management, most people can control their symptoms and lead an active and fulfilling life. If you suspect you have allergic rhinitis, it is essential to consult a healthcare provider to explore the treatment options that can help you manage this condition effectively.

Taking proactive steps to understand and manage hay fever can make a considerable difference in your overall well-being. By staying informed and working with your healthcare provider, you can minimize the impact of this condition on your daily life.

Sources–

Harrison manual of internal medicine

MedlinePlus Medical Encyclopedia: “Hay Fever.”

MedlinePlus Medical Encyclopedia: “Allergy.”

American College of Allergy, Asthma and Immunology: “Allergies: Seasonal Allergies,” “Types of Allergies: Allergic Rhinitis.” “Hay Fever.”

National Health Service Choices: “Hay fever.”

American Academy of Allergy, Asthma & Immunology: “Rhinitis (Hay Fever),” “Hay Fever and Allergy Medications.”

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