Allergic Rhinitis - Treatment Overview
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Treatment for allergic rhinitis consists of avoiding the specific allergens that cause your symptoms, using medicines to control symptoms, and, in severe cases, getting allergy shots (immunotherapy). You are more likely to need daily treatment if you have symptoms throughout the year. But if you have allergies during a certain season, you may only need daily treatment at that time.
Because allergic rhinitis cannot be cured and may be frustrating to treat, people may try alternative treatment methods, such as homeopathy. But most of these treatments either have not been studied or have not been proved to work. Such treatments may be expensive, and some can be dangerous to your health.
Avoiding allergens
It is important to avoid allergens that are causing your symptoms. By doing this, you may be able to reduce your allergy symptoms, manage them without medicine or with fewer medicines, and reduce your risk of having complications such as sinusitis. For more information, see:
Self-treatment
Some people start using over-the-counter medicines for allergic rhinitis before they see their doctors. These medicines can work well. But people with other medical problems, older adults, children, women who are pregnant or breast-feeding, and people with more than occasional mild symptoms should see a doctor before starting self-treatment.
Pregnant women and children
Your symptoms may be worse if you are pregnant. Although you and the baby (fetus) are not in danger, allergic rhinitis may make asthma and sinusitis worse. If possible, do not use medicine for at least the first 3 months of your pregnancy. If you feel you need the medicine, talk to your doctor. If you become pregnant and are already taking allergy shots (immunotherapy), you may continue them. But don't start allergy shots if you are pregnant.
Treatment for children who have allergic rhinitis is much the same as for adults who have allergies. Treating children with medicine may be more difficult because of the possible side effects. Some medicines also may not be approved to treat children.
Initial and ongoing treatment
Treatment for allergic rhinitis usually starts with over-the-counter medicines. These include antihistamines, decongestants, and eyedrops to relieve symptoms. These medicines may not be safe for young children or for people who have certain health problems. Before you use them, check the label. If you do use these medicines, always follow the directions about how much to use based on age and in some cases weight.
If over-the-counter medicines don't work or they cause bothersome side effects, such as drowsiness or decreased coordination, your doctor may prescribe medicine. These include:
- Antihistamines that don't make you sleepy(non-sedating). They generally are very effective at relieving sneezing, runnynose, itching, and watery eyes. You can take them with an over-the-counterdecongestant to relieve a stuffy nose. Before you give decongestants to a child, check the label. They may not be safe for young children or for people who have certain health problems.
- Eyedrops, if you have redness, itching, and wateryeyes. Eyedrops can be prescription or over-the-counter and may contain anantihistamine or decongestant.
- Nasalcorticosteroid sprays, which you may use withantihistamines. These sprays may reduce all symptoms of allergic rhinitis andare thought to be the most effective treatment for most people. They startworking quickly, but it may be several weeks before you get the full effect.
Your doctor may suggest other medicines if these do not work or in special cases, such as if you are pregnant. These include:
- Leukotriene modifiers, which can relieve a stuffynose, itching and sneezing, and a runny nose.
- Cromolyn sodium, which may reduce sneezing, nasaldischarge, a stuffy nose, and eye irritation. Children and pregnant women oftenuse cromolyn because it is very safe.
- Ipratropium bromide, which can relieve a runnynose.
If you do not take your medicine, your symptoms may return or get worse. It can be helpful to explain to children why they are taking medicine and how it can help them, as well as what side effects may occur.
You may use medicine daily for quick relief of symptoms that occur suddenly or are getting worse. Or you may use it in advance if you know you may breathe an allergen. For example, if you have severe pollen allergies, your doctor may suggest that you start using a corticosteroid spray 1 to 2 weeks before the pollen season starts.
You can treat a stuffy nose by cleaning your nasal passages with a saline solution (salt water). You may be able to prevent or manage mild sinus infections at home using over-the-counter medicines or other methods.
Different medicines treat different allergy symptoms. It may take a combination of medicines to relieve all of your symptoms. Talk with your doctor about which symptoms are most important for you to treat and which medicines may work best for you.
Treatment if the condition gets worse
If avoiding allergens and using antihistamines or nasal corticosteroids do not help your symptoms of allergic rhinitis, your doctor may suggest you take pill or injected corticosteroids. They are used only for symptoms that are severe. And they are used only for 3 to 10 days. This is because these types of corticosteroids have severe side effects when you take them for a long time.
If medicines do not help your symptoms or if they cause bad side effects, your doctor may suggest allergy shots (immunotherapy). Allergy shots are small doses of allergens that your doctor injects under your skin. This helps your body "get used to" the allergen, so you may have fewer or less severe symptoms. For more information, see:
Although surgery does not cure allergic rhinitis, you may need it to fix something that makes treating your allergies difficult, such as a physical defect of the nose, or when allergies lead to blockage in the eustachian tube that causes chronic ear infections.
What to think about
If you have long-term (chronic) allergic rhinitis, complications such as sinusitis, plugged ears, or ear infections may occur. A severe complication is one of the few times that you may need to seek extra care from your doctor for allergic rhinitis.
Omalizumab (Xolair) is a medicine for allergic asthma. Studies have shown that it can reduce nasal symptoms of allergic rhinitis, such as sneezing and an itchy, runny, or stuffy nose.2 Some doctors may prescribe omalizumab for allergic rhinitis (unlabeled use). But it's not known if omalizumab works as well as nasal steroids. And it is very expensive.
| By: | Healthwise Staff | Last Revised: August 4, 2010 |
| Medical Review: | E. Gregory Thompson, MD - Internal Medicine Harold S. Nelson, MD - Allergy and Immunology | |
1995-2011 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.
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