Cough/Cold/Allergy: Allergic Rhinitis
Overview
In the United States, allergic rhinitis, also commonly known as hay fever, is estimated to affect 20% of adults and 40% of pediatric patients. For many allergy sufferers, allergic rhinitis can negatively impact an individual’s quality of life, including daily activities, by impairing concentration and causing fatigue and sleep disturbances. Many people with allergic rhinitis may also have asthma. Unfortunately, the number of newly diagnosed cases continues to increase annually, and hay fever symptoms tend to flare up in the spring and fall. Perennial allergic rhinitis symptoms occur all year long.

Signs and Symptoms
Symptoms typically occur rapidly after someone is exposed to the allergen, and they vary in severity from person to person. Common symptoms include 1 or more of the following:
  • Nasal congestion
  • Runny nose
  • Repetitive sneezing
  • Watery, red, or itchy eyes
  • Decreased sense of smell
  • Coughing
  • Sinus pressure
  • Dark circles under eyes

Cause/Common Triggers
When a person with allergic rhinitis encounters an allergen, such as pollen, mold or pet dander, the body releases chemicals that cause the allergy symptoms. Common triggers include the following.

Seasonal Allergy Triggers
  • Pollen from trees, weeds, and grass in the spring and late summer
  • Ragweed pollen in late fall
  • Spores from mold and fungus

Year-Round (Perennial Allergies)
  • Pet dander
  • pores from indoor and outdoor fungi and molds
  • Dust mites
  • Mold

Tests and Diagnosis
Your doctor may order skin and blood tests to determine the cause of your allergies, perform a physical examination, and review your medical history and symptoms to assess your allergies.

Prevention/Management
The most effective way to prevent allergy symptoms is to adhere to allergy therapy and take steps to control allergy symptoms, including:
  • Adhere to your medication regimen
  • Take allergy medications before symptoms start
  • Wear a mask when dusting
  • Avoid triggers when possible
  • Close doors and windows during pollen season
  • Vacuum and clean carpeting and upholstery routinely
  • Use allergy-proof covers on mattress and pillows
  • Use an air purifier
  • Use HEPA filters for heating and air units
  • Wash bedding in hot water at least once a week
  • Check pollen levels in your area

Treatment and Care
Treatment depends on the cause of your allergies, your symptoms, the severity of your symptoms, and your medical and medication history. Treatments may include avoidance of triggers if feasible and the use of an antihistamine, a nasal or oral corticosteroid, a decongestant, cromolyn sodium, a leukotriene modifier, nasal ipratropium, or immunotherapy (allergy shots). Your doctor will determine the best treatment for your individual needs.

Homeopathic and Alternative Remedies
While clinical data are limited, a number of alternative remedies have been used to manage allergy symptoms, including:
  • Nasal irrigation with saline
  • Butterbur extract
  • Honey
  • Feverfew
  • Capsaicin-based nasal sprays

If you are considering using alternative therapies or supplements, you should talk to your doctor or pharmacist before using these products to discuss the best ways to manage your allergy symptoms and so that potential drug interactions and contraindications can be avoided.

Self-Care
Several OTC products can be used to treat allergic rhinitis symptoms, including oral and ocular antihistamines, oral and nasal decongestants, mast cell stabilizers, and a recently FDA-approved nasal spray that was once available by prescription only. To prevent potential drug interactions and contraindications, it is important to consult your doctor or pharmacist before using these products. A pharmacist can also provide advice or recommendations based on symptoms and patient preferences.

Resources for Patients
National Institutes of Health’s National Institute of Allergy and Infectious Diseases
Medline Plus

Resources for Pharmacists
American Academy of Allergy Asthma and Immunology
Asthma and Allergy Foundation of America
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