Hay Fever (Allergic Rhinitis)

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What is allergic rhinitis?

Allergic rhinitis is an allergic reaction of the lining of the nose. Seasonal allergic rhinitis is also called hay fever.

How does it occur?

Allergic rhinitis occurs when the nose, ears, sinuses, and/or throat come into contact with allergy-causing substances. The allergy-causing substances are called allergens. The most common allergens are pollens, molds, dust, and animal dander. Some allergens like ragweed are present only during certain seasons. Other allergens like dust mite or mold are present year-round. When the lining tissues of the nose and sinuses come into contact with allergens, several chemicals are released from cells in these tissues. Histamine causes the nose lining to swell, itch, and produce mucus.

What are the symptoms?

Common symptoms of allergic rhinitis are:

itchy, runny nose


nasal and head congestion

fatigue and lethargy

itchy throat

postnasal drip

itchy watery eyes

How is it diagnosed?

Your medical history is usually the basis for the diagnosis of allergic rhinitis. Knowledge of a family history of allergic problems is also helpful. However, it may take some detective work to figure out exactly what you are allergic to. Tests for specific allergies may be performed. The best test is the skin scratch test with intradermals. In these tests, tiny amounts of suspected allergens are placed on or under your skin. These allergy tests can identify which of many possible allergens are causing your symptoms. In some cases blood tests may be done to look for antibodies to suspected allergens.

How is it treated?

The first principle of allergy treatment is to avoid the allergy-causing substance. Air conditioners and special filters can minimize the amount of pollen and mold that circulates indoors. Try not to use an attic fan if you are allergic to pollen. Putting plastic covers on mattresses may help you avoid dust and mold. Pillows may also be covered with covers. When environmental measures such as the ones described above are inadequate to control symptoms, medication is usually effective. If your symptoms are severe in spite of medications, we may consider allergy shots (immunotherapy). Hopefully, allergy injections will desensitize you to the substances that cause your allergies. Usually after 4 to 6 months of allergy injections, people begin to have relief from their allergies. However, you will probably need to continue the injections for several years. Proper treatment of allergy symptoms is the best way to prevent complications of allergic rhinitis, such as ear and sinus infections.

How long will the effects last?

If childhood allergies persist into adulthood, they will likely be present for a lifetime. New allergies can develop any time, even in previously non-allergic persons. Allergy symptoms are dependent not only on season and weather but also on location. Hence, your allergies may wax and wane, depending on where you are living.