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Overview

What Is Allergic Rhinitis?

Allergic rhinitis is an immune reaction to usually harmless airborne substances, such as pollen, dust mites, mold, or animal dander. It can occur during particular seasons, such as spring or fall, or continue throughout the year. The immune response causes swelling and irritation in the nose, leading to symptoms such as sneezing and congestion. Unlike a common cold, allergic rhinitis is not caused by an infection and usually does not cause a fever.

Symptoms

Allergic Rhinitis Symptoms

  • Sneezing may occur repeatedly, especially after exposure to a trigger.
  • A runny nose (rhinorrhea) can produce clear, watery mucus.
  • A stuffy nose (nasal congestion) can make it harder to breathe through the nose.
  • Postnasal drip may cause mucus to drain down the back of the throat.
  • The nose or throat may feel itchy.
  • The eyes may become watery or itchy.
  • A reduced sense of smell may occur when the nasal passages are swollen.
  • Fatigue can develop when symptoms disturb sleep or continue during the day.

Allergic rhinitis and fever

When symptoms may mean something else

Fever is not a typical symptom of allergic rhinitis. A high fever, severe facial pain, or illness that is worsening may point to an infection or another cause and should be assessed by a clinician.

Causes

Causes and Triggers of Allergic Rhinitis

In allergic rhinitis, the immune system mistakenly identifies a harmless substance as harmful. After exposure, immune cells release chemicals such as histamine, which inflame the lining of the nose and produce rhinitis symptoms. Some people become sensitized to one or more allergens, so even small amounts can trigger a reaction.

SEASONAL TRIGGERS

Tree, grass, and weed pollen commonly cause symptoms during specific times of the year. Pollen levels and local weather can affect when symptoms flare.

YEAR-ROUND TRIGGERS

Dust mites, indoor mold, cockroach particles, and animal dander can cause symptoms throughout the year, particularly in homes or workplaces where exposure continues.

Risk Factors

Risk Factors for Allergic Rhinitis

  • A family history of allergies can increase the likelihood of developing rhinitis.
  • Asthma or eczema is associated with a higher chance of allergic conditions, including rhinitis.
  • Frequent exposure to indoor or outdoor allergens can increase the risk of symptoms.
  • Living or working in an environment with substantial air pollution may increase nasal irritation and susceptibility.
  • Younger age or repeated exposure to a particular allergen may contribute to developing symptoms.

Complications

Complications of Allergic Rhinitis

  • Nasal symptoms can disturb sleep and make it harder to get restful rest.
  • Poor sleep and ongoing inflammation may contribute to daytime fatigue.
  • Persistent congestion can contribute to sinusitis or sinus pressure.
  • Fluid buildup or infection in the middle ear can occur, particularly in children.
  • Allergic rhinitis may worsen asthma symptoms in people who have asthma.
  • Ongoing rhinitis symptoms can reduce concentration and affect quality of life.

When symptoms persist

Ask about better symptom control

Arrange a clinical review if congestion continues, breathing problems develop, or symptoms interfere with sleep, work, school, or daily activities. Better control of rhinitis may also help manage related sinus or asthma problems.

Diagnosis

How Allergic Rhinitis Is Diagnosed

Diagnosis usually begins with questions about the timing, pattern, possible triggers, and duration of symptoms. A clinician may examine the nose, eyes, ears, throat, and lungs to look for signs of allergy or another condition. Testing is not always needed, but it can help when the trigger is unclear or symptoms are difficult to control.

  • A medical history helps identify symptom patterns, exposures, family history, and related conditions such as asthma or eczema.
  • A physical examination checks the nose, eyes, ears, throat, and lungs for findings that support allergic rhinitis.
  • Skin-prick testing can identify reactions to selected airborne allergens.
  • Blood testing for allergen-specific IgE may be used when skin testing is unsuitable, the trigger is unclear, or symptoms remain difficult to control.

Treatment & Management

Allergic Rhinitis Treatment and Management

REDUCE TRIGGERS

Reduce exposure to known allergens where practical, such as by limiting pollen exposure, controlling dust mites, and addressing indoor dampness or mold. Saline nasal rinses may also help clear irritants and mucus when used safely.

USE MEDICINES

Nasal corticosteroid sprays are often effective for nasal inflammation. Antihistamines may reduce sneezing, itching, and runny nose; decongestants may help congestion when used carefully and with clinician or pharmacist guidance.

Medication safety

Use treatments as directed

Follow product directions and avoid prolonged use of topical nasal decongestant sprays unless a clinician advises it, because overuse can worsen congestion. Ask a clinician or pharmacist about treatment during pregnancy, for children, or if you have other medical conditions or take other medicines. Allergy immunotherapy may be considered for selected people whose symptoms remain troublesome despite standard treatment.

Prevention

Preventing Allergic Rhinitis Flare-Ups

  • Keep windows closed during periods when outdoor pollen levels are high.
  • Shower and change clothes after spending time outdoors during a known pollen season.
  • Use high-efficiency filtration where appropriate and maintain heating or cooling system filters as directed.
  • Reduce dust mites by washing bedding regularly and using allergen-resistant covers when appropriate.
  • Control indoor dampness and mold by improving ventilation and repairing water leaks.
  • Avoid tobacco smoke and other irritating fumes that can worsen nasal symptoms.

Outlook and Prognosis

Outlook and Prognosis for Allergic Rhinitis

Allergic rhinitis is usually manageable rather than an emergency, but symptoms can recur seasonally or persist year-round depending on triggers and individual sensitivity. Some people have symptoms only during a particular pollen season, while others experience chronic rhinitis from ongoing indoor exposures. Treatment and trigger reduction can help maintain daily comfort and function.

When Should You See a Doctor

When Should You See a Doctor for Allergic Rhinitis?

  • Arrange medical care when allergic rhinitis symptoms persist or regularly disrupt sleep.
  • Seek advice when symptoms do not improve with appropriate over-the-counter treatment.
  • Recurrent sinus problems or ear infections warrant an assessment for contributing factors.
  • Wheezing, shortness of breath, or worsening asthma symptoms should be discussed promptly with a clinician.
  • Ask for an evaluation if you are uncertain whether symptoms are caused by allergic rhinitis or another condition.

Seek medical advice

Symptoms that need prompt assessment

Seek prompt evaluation for a high fever, severe facial pain, swelling around the eyes, severe headache, breathing difficulty, or rapidly worsening symptoms. These signs may indicate an infection or another urgent problem rather than uncomplicated allergic rhinitis.

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