If the symptoms of allergic rhinitis are mild, you should be able to treat the condition yourself by:
- taking over-the-counter medications such as antihistamines and decongestants to relieve congestion and a runny nose (see below)
- avoiding the particular allergen that triggers the condition (see Allergic rhinitis - prevention for more advice)
- nasal douching (rinsing your nasal passages regularly with salt water to keep your nose free of irritants)
If your symptoms are more severe, affecting your quality of life, and self-help measures are not effective, see your GP. The treatment options are described below.
Medication
Medication will not cure your allergy, but it can be used to treat the common symptoms of an allergy, such as a runny nose, itchy mouth and sneezing.
If your symptoms are caused by seasonal allergens, such as pollen, you should be able to stop taking your medication after the risk of being exposed to the allergen has passed. However, if your allergic rhinitis is caused by non-seasonal allergies, such as dust mites, you may require ongoing treatment.
Treatment for allergic rhinitis is generally the same for adults and children. If you are pregnant, you can take some antihistamines and corticosteroids. It is usually recommended that you use a nasal spray rather than taking tablets to minimise any risk to your unborn baby.
See your GP if your symptoms do not respond to medication after two weeks.
Antihistamines
Antihistamines relieve symptoms of allergic rhinitis by blocking the action of the chemical histamine, which the body releases when it thinks it is under attack from an allergen. Antihistamine tablets are available over-the-counter (OTC) without prescription from your pharmacist, but antihistamine nasal sprays are only available with a prescription.
Antihistamines can occasionally cause drowsiness, so if you are taking them for the first time, see how you react to the medication before driving or operating heavy machinery. Antihistamines can cause drowsiness if you drink alcohol while taking them.
Corticosteroids
If your symptoms are frequent or persistent and you have a nasal blockage or nasal polyps, your GP may recommend that you use a nasal spray or drops containing corticosteroids.
Corticosteroids help reduce inflammation (swelling). They take longer to work than antihistamines, but their effects last longer.
Side effects from inhaled corticosteroids are rare, but can include nasal dryness and irritation, and nosebleeds.
If you have a particularly severe bout of symptoms and need rapid relief, your doctor may prescribe a short course of corticosteroid tablets for 5 to 10 days.
Nasal decongestants
Decongestants are usually available over the counter and can help relieve a blocked nose. They can be taken as tablets, capsules, nasal sprays or liquids.
Nasal decongestants should not be used to treat allergic rhinitis for more than five to seven days. Using them for longer can make your congestion worse.
If you are taking a type of antidepressant known as a monoamine oxidase inhibitor (MAOI), do not use nasal decongestants.
Add-on treatments
If your allergic rhinitis does not respond to the above medications, there are several medicines that your GP can 'add on' to your original treatment. Your GP may suggest you try any of the following:
- increasing the dose of your corticosteroid nasal spray
- using a short-term course of a decongestant nasal spray to take with your other medication
- combining the use of antihistamine tablets with corticosteroid nasal sprays and possibly decongestants
- using an inhaler containing a medicine called ipratropium, which will help reduce excessive nasal discharge
If you do not respond to the add-on treatments, you will be referred to a specialist for further assessment and treatment.
Hyposensitisation (immunotherapy)
Another form of treatment for some allergies is hyposensitisation, also known as immunotherapy. It is only suitable for people with certain types of allergies, such as hay fever, and is only usually considered if your allergy is severe.
Hyposensitisation gradually introduces more and more of the allergen into your body to make it less sensitive to the allergen.
The allergen is usually injected under the skin of your upper arm. In the initial stages of treatment, you will be given injections at intervals of a week or less, while the allergen doses are gradually increased.
When you reach the ‘maintenance dose’ (a dose that is effective in reducing your normal allergic reaction), you will need to continue to have injections of this dose every few weeks for at least two years.
This type of treatment must only be carried out under the close supervision of a doctor, because there is a risk it may cause a serious allergic reaction.
