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Allergic Rhinitis
(Hay Fever)

Definition:
Allergic rhinitis is the set of symptoms that occur when you breathe in substances to which you are allergic. These substances are called allergens.

Seasonal Allergic Rhinitis—sometimes called hay fever or rose fever. It occurs during specific times of the year when allergens (usually pollens) to which you are allergic are in the air. Seasonal allergies are usually at their peak during spring and fall.

Perennial Allergic Rhinitis—caused by allergens such as chemicals, dust, dust mites, cockroaches, animal dander, mild spores, or, occassionally, certain foods. It may occur at any time during the year when you encounter these allergens.

Causes:
The symptoms of allergic rhinitis occur when your body's immune system responds excessively to an allergen. Common allergens include dust mites, pollen, animal dander, and molds. When you breathe in an allergen, cells in your nasal passages make a chemical called histamine. Histamine causes your nose to feel itchy. Histamine also causes swelling and mucus production in the nasal passages.

Risk Factors:
A risk factor is something that increases your chance of getting a disease or condition. Some risk factors include:
  • Family members with allergic rhinitis, eczema, or asthma
  • Eczema
  • Asthma
  • Food allergies
Symptoms:
Allergic rhinitis can cause the following Symptoms:
  • Sneezing
  • Itching in the nose, eyes, throat, ears
  • Red, watery eyes
  • Runny nose, nasal congestion
  • Sinus pressure
  • Postnasal drip and cough
  • Headache
  • Dark circles under your eyes
Diagnosis:
If you have the symptoms of allergic rhinitis, your doctor can try to find out which allergens you are allergic to. Your doctor may refer you to an allergist, if necessary.

Tests may include:

Skin Prick Test
A tiny bit of an allergen is placed under the skin with a needle. Then the doctor watches to see if the skin in that area becomes raised or irritated. This can be done for multiple allergens at the same time.

RAST Testing
A small sample of blood is taken and tested for a few or dozens of different allergens.

Provocation Testing
You breathe in air containing an allergen, and the doctor watches to see if you have an allergic reaction, such as wheezing or trouble breathing.

Treatment:
The most effective way to treat allergic rhinitis is to avoid the offending allergen. Since this can sometimes be difficult or impossible, other treatments are available.

Treatments may include:

Medications

Antihistamines—stop or reduce the production of histamine. They are usually taken as pills.

Decongestants—decrease congestion by constricting blood vessels. They can be taken as pills or as a nasal spray.

Mast Cell Inhibitors—nasal sprays that interfere with the chemical reactions leading to histamine release.

Topical Corticosteroids—nasal sprays that decrease swelling in the nasal passages.

Immunotherapy (also called allergy shots)

Injections of very small amounts of selected allergens are gradually increased over weeks, months, or even years. The goal is to make your body's immune system less sensitive to those particular allergens.

Instead of allergy shots, it may be possible to perform immunotherapy by placing allergens under the tongue (sublingual). In a recent study, adults patients allergic to a certain grass pollen modestly reduced their rhinitis symptoms by taking grass allergen tablets sublingually every day for 18 weeks.

Prevention:
The following strategies may help prevent allergic rhinitis:
  • Stay inside during the morning hours, when pollen counts are highest.
  • Avoid outside activities during the time of year when the trees, flowers, or molds to which you are allergic are blooming.
  • Keep the windows of your house and car closed to keep pollen out.
  • Use an air conditioner to reduce indoor humidity during the warmer months. This will prevent mold and mildew growth.
  • Clean your air conditioner's filters regularly.
  • Consider running an air purifier in your home, especially in your bedroom.
  • Use vacuum cleaners and air conditioners with HEPA filters to trap allergens.
  • Decrease or avoid outdoor activities on hot summer days, when ozone levels may exacerbate allergies.
  • Cover pillows and mattresses with vinyl covers to reduce your exposure to dust mites.
  • Wash bedding weekly in very hot water.
  • Use fewer dust-collecting items such as curtains, bed skirts, carpeting, and stuffed animals, especially in your bedroom or in rooms where you spend most of your time.
  • If you can't avoid having a furry pet, vacuum frequently. Try to keep your pet out of bedrooms and other rooms with carpets.
 
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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