Allergic Rhinitis (Hay fever)

There are two types of rhinitis: allergic and non-allergic.


When your immune system mistakenly identifies a normally harmless substance (called an allergen) as an intruder, you have allergic rhinitis. The immune system’s response to an allergen is to release histamine and chemical mediators that can cause symptoms in the nose, eyes, ears, throat, roof of the mouth and on the skin.

Seasonal allergic rhinitis, commonly called hay fever, is caused by elevated levels of pollen in the air during certain seasons.

Common indoor allergens such as droppings from dust mites, cockroaches, mold, and pet dander can trigger allergic rhinitis. This is called perennial allergic rhinitis because of symptoms that occur year round.

Symptoms may also occur from irritants such as strong odors, changes in air temperature or humidity, or smoke. Allergic rhinitis causes inflammation in the lining of the nasal cavity, causing an increased sensitivity to inhalants.

Some patients with allergic rhinitis may also suffer with eye allergy or allergic conjunctivitis. Allergic rhinitis can also make asthma symptoms worse for patients who suffer from both conditions.


About one third of patients with rhinitis symptoms do not actually have allergies; nonallergic rhinitis usually affects adults and triggers year-round symptoms, especially nasal congestion and runny nose. In this case, the immune system is not involved.


  • Symptoms of allergic rhinitis include:
  • Stuffy nose (congestion)
  • Sneezing
  • Runny nose
  • Tearing eyes
  • Dark circles under the eyes
  • An itching sensation in the roof of the mouth, throat, nose or eyes

Hay fever symptoms tend to worsen in the spring or fall when pollen counts are elevated. Perennail allergic rhinitis symptoms occur year-round.


Our physicians will take a thorough health history followed by allergy testing to determine if your symptoms are allergic or non-allergic. Blood tests or skin tests are the most common methods to determine allergic rhinitis triggers.


Once we determine which specific allergens are your triggers, we’ll work with you to develop a plan to avoid those specific allergens. For example, if you are allergic to indoor mold or dust mites, we’ll help you take the necessary steps to reduce those allergens in your house as much as possible.

Avoidance measures for outdoor allergies (such as pollen) include limiting outdoor activities during high pollen counts. To obtain the most accurate and reliable pollen and mold levels from around 80 counting stations in the USA, visit our website or see the National Allergy Bureau™(NAB) website for current levels.

A proven treatment approach to allergic rhinitis is immunotherapy or allergy shots. This treatment has provided long-term relief for many patients.

Sublingual immunotherapy (SLIT) allergy tablets is another form of treatment for allergic rhinitis that was recently approved in the USA. Allergy tablets involve taking the allergens under the tongue on a daily basis, rather than take frequent injections.

Medications to treat allergic rhinitis symptoms may include nasal corticosteroid sprays, nasal antihistamine sprays, decongestant pills, or nasal antihistamine sprays.

Treatment options for non-allergic rhinitis may include nasal antihistamines, nasal saline formulations, or nasal corticosteroids. Ipratropium nasal spray can provide welcome relief from a runny nose. Decongestant pills or sprays can help with nasal congestion, but we recommend sprays not be used for more than four days unless that are used in conjunction with a nasal corticosteroid spray.

Most medications used to treat allergic rhinitis (hay fever) perform best when started before tree pollen is airborne in the spring, prior to allergy symptoms developing. By taking allergy medications before you come into contact with spring outdoor allergens, the medication can prevent the release of histamine and other chemicals by the body, resulting in reduced allergy symptoms.

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