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Allergic rhinitis

• Overview
• Symptoms
• Treatment
• Prevention

Alternative Names:

Hay fever; Nasal allergies

Treatment:

The goal of treatment is to reduce allergy symptoms caused by the inflammation of affected tissues.

The best "treatment" is to avoid what causes your allergic symptoms in the first place. It may be impossible to completely avoid all allergens to which you are sensitive, but you can often take steps to reduce exposure.

Medication options include the following:

• Short-acting antihistamines can relieve mild to moderate symptoms, but can cause drowsiness. Many may be bought without a prescription. A pediatrician should be consulted before using these medicines in children, as they may affect learning. Loratadine (Claritin) is now available over the counter. It does not tend to cause drowsiness or affect learning in children.
• Longer-acting antihistamines are available by prescription. They cause less drowsiness and can work just as well. They usually do not interfere with learning. These medications include fexofenadine (Allegra), and cetirizine (Zyrtec).
• Nasal corticosteroid sprays work very well for people with symptoms not relieved by antihistamines alone. These prescription medications include fluticasone (Flonase), mometasone (Nasonex), and triamcinolone (Nasacort).
• Azelastine (Astelin) is a new, nasal antihistamine that is used to treat allergic rhinitis.
• Decongestants may also be helpful in reducing symptoms such as nasal congestion, but they should not be used for long periods.
• Cromolyn sodium is a nasal spray (Nasalcrom) for treating hay fever. Eye drop versions of cromolyn sodium and antihistamines are available for itchy, bloodshot eyes.
• The leukotriene inhibitor Singulair is a prescription medicine approved to help control asthma and to help relieve the symptoms of seasonal allergies.

The most appropriate medication depends on the type and severity of symptoms. Specific illnesses that are caused by allergies (such as asthma and eczema) may require other treatments.

Allergy shots (immunotherapy) are occasionally recommended if the allergen cannot be avoided and if symptoms are hard to control. This includes regular injections of the allergen, given in increasing doses (each dose is slightly larger than the previous dose) that may help the body adjust to the antigen .

Expectations (prognosis):

Most symptoms of allergic rhinitis can be readily treated.

In some cases (particularly children), people may outgrow an allergy as the immune system becomes less sensitive to the allergen. However, as a general rule, once a substance causes allergies for an individual, it can continue to affect the person over the long term.

More severe cases of allergic rhinitis require immunotherapy (allergy shots) or removal of tissue in the nose or sinuses.

Complications:

• Drowsiness and other side effects of antihistamines
• Side effects of other medications
• Sinusitis
• Nasal polyps
• Disruption of lifestyle (usually not severe)

Calling your health care provider:

Call for an appointment with your health care provider if severe symptoms of allergies or hay fever occur, if previously successful treatment has become ineffective, or if your symptoms do not respond to treatment.

• Review Date: 10/30/2006
• Reviewed By: Donald Accetta, MD, MPH, President, Allergy & Asthma Care, PC, Taunton, MA. Review provided by VeriMed Healthcare Network.

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