Allergic Rhinitis

Allergic rhinitis is inflammation of the lining of the nose caused by an allergic reaction. When you breathe in something you are sensitised to, the immune system releases histamine and other chemicals, and the nose responds with sneezing, congestion and a runny or itchy feeling. The eyes are often involved too.

Common signs and symptoms

• Repeated sneezing, often in bursts
• A blocked or runny nose, usually with clear mucus
• An itchy nose, throat or roof of the mouth
• Itchy, watery or red eyes
• Reduced sense of smell, mouth-breathing, and poor sleep when congestion is bad

Symptoms may be seasonal (worse at certain times of year) or year-round, depending on the trigger.

Typical triggers

Common causes include house dust mite, pollen from grasses, trees and weeds, mould spores, and animal dander. In Kerala, damp conditions and the monsoon can increase mould and mite exposure indoors.

How it is diagnosed

History and examination

The timing and pattern of symptoms often point to the likely trigger. The nose is examined to look for swelling and to rule out other causes of blockage.

Allergy testing

Skin-prick testing or specific IgE blood testing identifies which allergens you react to. Knowing the specific trigger allows focused avoidance advice and, where appropriate, immunotherapy aimed at the right allergen.

Managing allergic rhinitis

Reducing exposure

• Use mite-proof covers on pillows and mattresses; wash bedding hot and dry it well
• Keep windows shut when pollen counts are high and ventilate at low-pollen times of day
• Manage indoor damp and clean areas where mould forms
• Keep pets out of the bedroom if animal dander is a trigger

Medication

Options your clinician may consider include non-drowsy antihistamines, steroid nasal sprays used regularly during symptom periods, and saline rinses. Steroid nasal sprays are more effective when started before the season and used every day rather than occasionally.

Allergen immunotherapy

For people with a clear single or dominant trigger and symptoms that are not well controlled by avoidance and medication, immunotherapy — as sublingual drops or tablets, or as injections — can be discussed. It is a structured course that aims to reduce sensitivity over time.

When to book an appointment

See us if symptoms disturb sleep, affect concentration or work, are not settling with over-the-counter treatment, or if you are unsure whether the problem is allergy or something else such as sinus infection.

This page is general information and not a substitute for a consultation. Symptoms overlap between conditions, so a clinician's assessment is the reliable way to know what is going on and what will help in your case.