What Are Nasal Allergies?
Nasal allergies are your body’s reaction to substances in your environment, such as pollen, mold, dust mites, and pet dander. Your body sees the thing you’re allergic to as an invader. It sends out chemicals such as histamines to fight off the foreign substance.
Histamine is what sets off your symptoms. You get congested, and your nose and eyes may itch and water. You probably sneeze a lot.
You can be allergic to more than one substance. You can also have seasonal and year-round allergies.
Nasal allergies can cause you to miss work or school, but there are many things you can do to ease your symptoms and feel better.
Sinuses and Allergies
Sinuses are hollow pockets filled with air. You have sinuses throughout your body, but the ones that nasal allergies affect are the paranasal sinuses behind your nose and in your cheeks, forehead, and in between your eyes.
Your sinuses are lined with mucous membranes. When allergies trigger swelling in the mucous membranes, the inflamed tissue can block off your sinuses. Your sinuses can’t drain, trapping mucus and air inside. That leads to congestion, pain, pressure, and other allergy symptoms.
Nasal Allergy Symptoms
Chemicals called histamines that your body releases to fight off the substance you're allergic to are the main cause of your nasal allergy symptoms. The most common symptoms are:
- Runny or stuffy nose
- Sinus pressure
- Sneezing
- Itchy eyes
- Watery eyes
- Headache
- Tiredness
- Coughing, trouble breathing, and wheezing
Postnasal drip is also a common symptom. Normally, you swallow mucus without even knowing it. But if your mucus becomes thick, or if you have more mucus than normal, it results in postnasal drip. That’s when you can feel mucus dripping from the back of your nose into your throat. Postnasal drip can also feel like a lump in your throat and can lead to pain or irritation there.
Allergic Rhinitis Diagnosis
Usually, your doctor can diagnose allergies based on your symptoms and triggers. If your reactions are more severe, an allergist (a doctor who specializes in treating allergies) may do a skin test to find out what your triggers are.
They'll prick or scratch your skin with tiny bits of things that might cause an allergic reaction. If any of the substances cause redness and itchiness, it means you have an allergy to that specific trigger.
It’s not all that common, but your doctor may also do a blood test to help diagnose you. This is usually because you are taking medications that can affect the results of a skin test. However, blood tests are not as accurate as skin tests for diagnosing nasal allergies.
Who Gets Outdoor Allergies?
As much as 30% of adults and 40% of children in the U.S. have allergies that affect the nasal passages. No one knows why some people get them and others don't.
If your parents have allergies, there's a higher chance you will, too. If you have asthma or eczema, you're more likely to get hay fever or year-round allergies.
Allergic Rhinitis Treatment
If you have mild symptoms that only happen for a short period during the year, over-the-counter (OTC) medicines may be enough. For OTC medicines, you don’t need a prescription from your doctor. However, it's always a good idea to get your doctor's advice before taking any medication. If you have a health condition, it may not be safe for you to take these medications, even though they don't require a prescription.
OTC treatments for allergic rhinitis include:
Antihistamines. These drugs work by blocking histamine, a chemical that causes many allergy symptoms. They help relieve itching, sneezing, stuffiness, and other symptoms. Examples include cetirizine (Zyrtec), fexofenadine (Allegra), and loratadine(Claritin). The antihistamines chlorpheniramine and diphenhydramine are known to cause drowsiness. If your main problem is sneezing and itching, your doctor may recommend one of these, possibly with other treatments, too.
Decongestants. As their name says, these medications help with congestion. They reduce swelling in the nasal passages, opening them up. The most common decongestant is pseudoephedrine. It's sold on its own as Sudafed, and it's also combined with antihistamines such as Zyrtec, Allegra, and Claritin. When these medications have pseudoephedrine, the name will be followed by “-D” -- Zyrtec-D, Allegra-D, Claritin-D.
Some decongestants come as nasal sprays, such as Afrin. Don't use nasal spray decongestants for more than 3 days at a time. If you use them for too long, they can make your symptoms worse.
Oral decongestants you take by mouth aren’t OK for everyone. These medicines raise blood pressure, so you shouldn’t take them if you already have high blood pressure or certain heart-related conditions. Men who have trouble peeing because of an enlarged prostate may find that this problem gets worse if they take decongestants.
Steroid nasal sprays. These drugs work by reducing the swelling in the nasal passages. Although some of these are only available by prescription, many are OTC, such as budesonide (Rhinocort), fluticasone propionate (Flonase), and triamcinolone acetonide (Nasacort). Nasal steroids have benefits as well as risks. They are generally safe and effective, and they focus the medication on the affected area -- in your nose -- instead of circulating it throughout your body. They have some side effects, too, such as nosebleeds and eye problems if you use them the wrong way. Only use these medicines if your doctor tells you that it's OK.
Other drugs. A few other OTC drugs may help, too. Many others are available by prescription, as mentioned below. Cromolyn is a nasal spray that can ease a runny or itchy nose, stuffy nose, and sneezing due to allergies. Allergy eye drops containing naphazoline (Naphcon-A, AK-Con-A) can relieve red eyes. Other eye drops with ketotifen (Zaditor, Alaway), which is an antihistamine, help relieve itchy eyes.
Prescription treatments for allergic rhinitis
If OTC medicines aren’t giving you relief, you might need prescription drugs. Prescription treatments for allergic rhinitis include:
Prescription antihistamines and decongestants. Your doctor may also recommend a prescription antihistamine pill such as desloratadine (Clarinex) or levocetirizine (Xyzal). Some prescription antihistamines also contain a decongestant. Azelastine (Astelin) is a nasal spray antihistamine, which is often used alongside steroid sprays. Antihistamines also come as prescription eye drops.
Other medications. Montelukast (Singulair), a medication called a “leukotriene modifier,” helps relieve symptoms of allergic rhinitis. But it shouldn’t be the main form of treatment. Depending on your symptoms, prescription sprays and eye drops are also options. For severe flare-ups, oral steroids can help -- prednisone is the standard.
Immunotherapy. If you’re wary of long-term drug use, allergy shots might be an option. Your doctor puts a little bit of the allergy trigger into your body. The goal is that over time you get used to the substance and don’t react to it anymore. This doesn't work for everyone. If it does work for you, you’ll need to get the shots for at least 3-5 years to make the benefits last.
Also, the FDA has approved some tablets that you can take at home by dissolving them under your tongue. The prescription tablets treat hay fever and work the same way as shots -- the goal is to boost your tolerance of allergy triggers.
Allergic Rhinitis Self-Care
Medications are often the key to handling nasal allergies and sinus problems. But there’s also a lot that you can do on your own. Here are some suggestions.
Nasal irrigation. By washing out your nasal passages and sinuses with salt water, you clear out the allergens that are triggering your symptoms -- along with bacteria and excess mucus.
If you are irrigating, flushing, or rinsing your sinuses, use distilled, sterile, or previously boiled water to make up the irrigation solution. It’s also important to rinse the irrigation device after each use and leave it open to air dry.
Environmental control. If you can reduce your exposure to an allergen, you’ll help reduce your symptoms. So, take some sensible precautions at home. If you’re allergic to dust mites, buy a mattress cover to keep them out. If it’s pollen, keep the windows shut and use air conditioners to filter the air. If it's possible, you could purchase a HEPA (high-efficiency particulate air) filter.
Moist air. If the air is dry and you’re having sinus problems, such as pain and pressure, keep your nasal passages moist. Use a humidifier or vaporizer (and keep it clean). Additionally, you can take warm showers, apply warm compresses over your nose and mouth, and breathe in steam from a pot on the stove.
Protection. If you know you’re going to be exposed to an allergen, take some precautions. If you need to rake outside during pollen season, for example, wear a mask and goggles, or get someone else to do it.
Supplements. If you want to find a natural treatment for your allergies, there is some evidence that these nutrients and herbs can help:
- Vitamin C
- Spirulina
- Butterbur
- Stinging nettle
- Astragalus
More research needs to be done to confirm that they can help. Also, you should check with your doctor before taking any supplements, as they might not mix well with your other medications. They might also not be safe if you have certain health conditions.
