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Treatment - Allergic rhinitis

Treatment for allergic rhinitis depends on how severe your symptoms are and how much they're affecting your everyday activities.

In most cases treatment aims to relieve symptoms, such as sneezing and a blocked or runny nose.

If you have mild allergic rhinitis, you can often treat the symptoms yourself. 

You should visit your GP if your symptoms are more severe and affecting your quality of life, or if self-help measures have not worked.

Self-help

It's possible to treat the symptoms of mild allergic rhinitis with medicines you by from a pharmacy or shop, such as long-acting non-sedating antihistamines.

If possible, try to reduce exposure to the allergen that triggers the condition.

Find out more about preventing allergic rhinitis

Cleaning your nasal passages

Regularly cleaning your nasal passages with a salt water solution, known as nasal douching or irrigation, can also help by keeping your nose free of irritants.

You can do this by using a solution made with sachets bought from a pharmacy.

Small syringes or pots that often look like small horns or teapots are also available to help flush the solution around the inside of your nose.

To rinse your nose:

  • stand over a sink, cup the palm of 1 hand and pour a small amount of the solution into it
  • sniff the water into 1 nostril at a time
  • repeat this until your nose feels comfortable (you may not need to use all of the solution)

While you do this, some solution may pass into your throat through the back of your nose.

The solution is harmless if swallowed, but try to spit out as much of it as possible.

Nasal irrigation can be carried out as often as necessary, but a fresh solution should be made each time.

Carbon dioxide washing

An alternative to nasal irrigation is carbon dioxide washing. This involves using a pressurized container to send a blast of carbon dioxide gas up into your nasal passages. This can help relieve symptoms quickly.

You can buy carbon dioxide containers from a pharmacist. You do not need a prescription.

In the UK they're sold under the brand name Serenz. Serenz is not suitable for some people, such as pregnant women, so speak to a pharmacist to see if it's suitable for you.

Also read the information leaflet that comes with the product carefully.

Medication

Medication will not cure your allergy, but it can be used to treat the common symptoms.

If your symptoms are caused by seasonal allergens, such as pollen, you should be able to stop taking your medication after the risk of exposure has passed.

Visit your GP if your symptoms do not respond to medication after 2 weeks.

Antihistamines

Antihistamines relieve symptoms of allergic rhinitis by blocking the action of a chemical called histamine, which the body releases when it thinks it's under attack from an allergen.

You can buy antihistamine tablets from your pharmacist without a prescription, but antihistamine nasal sprays are only available with a prescription.

Antihistamines can sometimes cause drowsiness. If you're taking them for the first time, see how you react to them before driving or operating heavy machinery.

In particular, antihistamines can cause drowsiness if you drink alcohol while taking them.

Corticosteroids

If you have frequent or persistent symptoms and you have a nasal blockage or nasal polyps, your GP may recommend a nasal spray or drops containing corticosteroids.

Corticosteroids help reduce inflammation and 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, irritation and nosebleeds.

If you have a particularly severe bout of symptoms and need rapid relief, your GP may prescribe a short course of corticosteroid tablets lasting 5 to 10 days.

Add-on treatments

If allergic rhinitis does not respond to treatment, your GP may choose to add to your original treatment. 

They may suggest:

  • 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 antihistamine tablets with corticosteroid nasal sprays, and possibly decongestants
  • using a nasal spray that contains a medicine called ipratropium, which will help reduce nasal discharge and make breathing easier
  • using a leukotriene receptor antagonist medication, which blocks the effects of chemicals called leukotrienes that are released during an allergic reaction

If you do not respond to the add-on treatments, you may be referred to a specialist for further assessment and treatment.

Immunotherapy

Immunotherapy, also known as hyposensitisation or desensitisation, is another type of treatment used for some allergies.

It's only suitable for people with certain types of allergies, such as hay fever, and is usually only considered if your symptoms are severe.

Immunotherapy involves gradually introducing more and more of the allergen into your body to make your immune system less sensitive to it.

The allergen is often injected under the skin of your upper arm. Injections are given at weekly intervals, with a slightly increased dose each time.

Immunotherapy can also be carried out using tablets that contain an allergen, such as grass pollen, which are placed under your tongue.

When a dose is reached that's effective in reducing your allergic reaction (the maintenance dose), you'll need to continue with the injections or tablets for up to 3 years.

Immunotherapy should only be carried out under the close supervision of a specially trained doctor, as there's a risk it may cause a serious allergic reaction.

Page last reviewed: 29 April 2019
Next review due: 29 April 2022