Nasal allergies, also known as allergic rhinitis, affects one of five adults in the USA. However, even though it affects a large segment of the population, it remains undiagnosed, undertreated and underestimated.
Jonathan A. Bernstein, MD, an allergist at the Univeristy of Cincinnati College of Medicine, says, “Allergy rhinitis is a trivialized disease”. He further adds, ““Obviously, nobody dies from it. But it does cause a tremendous amount of sickness and suffering.”
However, it’s inevitable that the existence of these symptoms in the body for a long period of time, including sneezing and congestion, inevitably takes its toll on the body. The consequence of this is the billions of dollars that rhinitis costs the country every year. An added problem is that nasal allergies also carry the potential to develop into other conditions, such as sinus problems. However, that may not be the case if proper steps and precaution are not taken in time.
Bernstein says, “Allergic rhinitis is a treatable problem”. He further goes on to say, “And when people get diagnosed and treated properly, they do very well.” If nasal allergies has affected you throughout your life, you should get them treated as early as possible.
Nasal Allergies and Sinus Problems
As if allergy symptoms weren’t irritating and troublesome enough, allergic rhinitis can lead to other complications and conditions, and in many cases, worsen the already existing condition. However, this begs the question, what is the connection between allergies and sinus problems?
Sinuses exist as hollow pockets in the skull which are connected to nasal passages. When allergies trigger swelling in the mucous membranes, the inflamed tissue can block off the sinuses. The sinuses therefore lose the ability to drain, thereby causing the accumulation of the mucus along with the air inside. The consequence of that is the occurrence of pain and pressure.
Take Allergy Symptoms Seriously
Its quite confounding why, despite the existence of allergies and their complications, a lot of people ignore, or don’t take the symptoms of nasal allergies, seriously. They fail to recognize the effect that allergies have on their lives, particularly over a long period of time, according to Leonard Bielory, MD, professor of allergy and immunology at Rutgers University.
Over time, they get accustomed to living with congestion, chronic sinus problems and mouth breathing. Disturbed sleep and fatigue is regarded as part of their everyday life. When the symptoms worsen, quick fix solutions are tried, such as over-the-counter medicines available at the drugstores. They try various methods to eliminate their allergies along with half-hearted attempts to control their exposure, however, getting a diagnosis is the last thing on their minds.
However, experts caution against adopting such a casual attitude towards nasal allergies. Nasal allergies can have an enormous impact on one’s life, and as such, the proper way, they say, is to go for medical evaluation and treatment.
Allergic Rhinitis Treatments: Over-the-Counter Medicine
Over the counter medicines are usually enough for mild allergic rhinitis, or other symptoms that strike a few times a year. The OTC treatments for allergic rhinitis include:
Steroid nasal sprays: The swelling in the nasal passages is reduced through these drugs. However, due to its effectiveness and simplicity of use, this treatment is usually the first choice of doctors. Although several of them are available by prescription, but only two, Nasacort and Flonase, are available over the counter.
Antihistamines: Histamine, a chemical that causes various allergy symptoms to appear, is blocked through the use of this drug. They help in reducing itching and sneezing. Some of the examples include cetirizine, fexofenadine, and loratadine. It should be known, however, that antihistamines chlorpheniramine and diphenhydramine cause the onset of drowsiness and lethargy. If sneezing and itching are what troubles you the most, then these drugs maybe prescribed by your doctor.
Decongestants: The main drawback of antihistamines is that although they keep several allergy symptoms in check, they don’t relieve congestion. That role is effectively played by drugs such as phenylephrine and pseudoephedrine (Sudafed, Sudogest). Not only do they reduce swelling in the nasal passages, they also open them up. The use of nasal sprays decongestants like naphazoline (Privine), oxymetazoline (Afrin, Dristan, Duramist), or phenylephrine (Neo-Synephrine, Rhinall, Sinex) should not be used for more than three days at a stretch. Using them for a long period of time causes a rebound effect by making the symtoms worse.
Other drugs: There are a few over-the-counter drugs which may help too. Others are available by description. One of these is Cromolyn sodium (NasalCrom), a nasal spray which helps with a runny itchy nose, along with a stuffy nose caused due to allergies. If you happen to be troubled with red eyes, allergy eye drops, which include the ingredients, naphazoline (Naphcon-A, AK-Con-A) and tetrahydrozoline (OptiClear), helps to reduce them substantially. Other eye drops which contain the ingredient, ketotifen (Zaditor, Alaway), an antihistamine, also helps in reducing itchy, red eyes.
Prescription Treatments for Allergic Rhinitis
There may be cases where over-the-counter medicines may not be enough to provide you complete relief. In such cases, you will require prescription drugs. The prescription treatments for allergic rhinitis are mentioned below.
Steroid nasal sprays: They are the recommended prescription treatment for allergic rhinitis. Corinna Bowser, MD, an allergist in Narbeth, Pa, says, ““The great thing about steroid sprays is that with just one medication, you can treat the congestion, the itchiness, and the sneezing.” Some of the examples include beclomethasone diproprionate (Qnasal, Beconase AQ), budesonide (Rhinocort), fluticasone propionate (Flonase), mometasone (Nasonex), and trimcinolone (Nasacort). The drugs available without a prescription are Flonase, Nasacort, and Rhinocort.
The question here is, should you be concerned about taking steroids? Absolutely not, as these are safe and effective drugs recommended by doctors and experts. One of the main advantages of nasal sprays is that they focus exclusively on the affected area, i.e. in the nose, and do so with the minimum of risks involved.
Prescription antihistamines and decongestants: In some cases, the doctor may also recommend a prescription antihistamine pill like desloratadine (Clarinex) or levocetirizine (Xyzal). Some prescription antihistamines also contain a decongestant. Azelastine (Astelin) is a nasal spray antihistamine that’s often used alongside steroid sprays. Antihistamines are also available in the form of eye drops.
Other medications: Singulair, a medicine which is also called a “leukotriene modifier”, aids in relieving the symptoms of allergic rhinitis. However, it should not be used as the main form of treatment. The other options for treatment which should be considered after checking the symptoms are sprays and eye drops. In case of severe flare-ups, oral steroids also can help, although prednisone is the standard cure.
Immunotherapy: Although most treatments for allergic rhinitis are a temporary fix, immunotherapy, in the form of allergy shots, oral tablets or drops, are an effective and permanent cure. They expose you to tiny amounts of allergen, with the result that the body gradually becomes used to it. Allergy shots are effective in about 85% to 90% of people.
Another form of treatment which you might consider is allergy shots, if you are tired of long term drug use. The tablets currently in use for this kind of treatment are Grastek, Ragwitek, and Oralair. After an initial dose at the doctor’s office, this type of treatment is usually continued at home.
Allergic Rhinitis Self-Care: There can be no alternatives to medications when it comes to handling nasal allergies and sinus problems. However, there are a lot of steps which you can take to handle this problem by yourself. Some of the suggestions are mentioned below.
Nasal irrigation: At first, it would seem rather eccentric to flood your nose with salt water for taking care of nasal allergies. It should be noted however, that it’s an effective and proven treatment. It has been adequately proven that nasal irrigation relieves sinus symptoms.
The main principle behind its working is quite simple. When the nasal passage and sinus is washed out with water, the allergens that trigger the symptoms are completely cleared out, along with bacteria and excess mucus. Bernstein says, “It’s just like cleaning your furnace filter.” “If you want good air quality in your home — or your lungs — the filters have to be clean.” In case you happen to be irrigating, flushing or rinsing your sinuses, it’s better to use distilled, sterile or previously boiled water to compose the irrigation solution. After each use, it’s important to rinse the irrigation device and leave it open to air dry.
According to experts, simple neti pots or squeeze bottles work as effectively as more expensive devices. It’s important to remember that nasal irrigation (which flushes out the nasal passages) is different from spray bottles of saline (which merely moisten them).
Neti pots, along with other nasal irrigation devices, are available in drugstores, supermarkets, as well as online. Basic neti pots cost about $10 to $15, while fancier irrigation devices can cost $100 or more.
Environmental control: The lesser the exposure to an allergen, the greater your chances of reducing your symptoms. Towards this end, it’s important to take some precautions at home. Happen to be allergic to dust mites? A mattress cover will ensure that they remain out. If the air contains a huge amount of pollen, keep the windows shut and use air conditioners to filter the air. For cat dander, its best to keep it outside the bedroom. Make use of a HEPA (high efficiency particulate air) filter. However, you should know that there is only so much you can do to keep your home allergen free. It’s next to impossible. Bowser says, “Environmental control is a great first step, but in most cases it’s not enough to control symptoms.”
Moist air: If the cause of your sinus problems is dry air, its best to keep your nasal passages moist. Make use of a humidifier or vaporizer, while remembering to keep it clean at all times. Other steps you could take are, long showers, applying warm compresses over your nose and mouth, and breathing in steam from a pot on the stove. However, at the same time, ensure that the house does not become too swampy. Dust mites, a common cause of allergies, are known to flourish in humidity.
Protection: It would be best to take some precautions if you know you are going to be exposed to allergen. Should the need to rake outside arise during pollen season, remember to wear a mask and goggles to protect yourself at all times. If not, let someone else do it.
Supplements: There is a segment of the population which likes treating their allergies without drugs by relying on natural causes. There is evidence that supplements such as butterbur and guercetin can help with allergy symptoms.
Fighting Allergic Rhinitis: Where to Start
If over the top counter allergy treatments do the trick for you, fine! If not, you may want to see a doctor.
There are chances when you may assume that you have allergies, when, in actuality, you may really be having non allergic rhinitis. This is triggered by irritants like cigarette smoke or fumes, instead of allergens. The symptoms could also stem from colds, sinus problems, asthma, thyroid dysfunction, medication side effects or other issues. However, if allergies are not the problem, then the allergy drugs will not do you any good.
In case your doctor says you have allergic rhinitis, it would be a good idea to find the source of your allergies. Allergy testing is the way to go about it.
Hugh H. Windom, associate clinical professor of allergy and immunology at the University of South Florida, says, “Some people with allergic rhinitis spend a lot of time and money focusing on the wrong thing. They assume that they’re allergic to dust mites, so they spend thousands renovating their homes, pulling up carpets, and cleaning air ducts. But it turns out to be the oak tree outside the bedroom window.”
That is why it’s very important to test anything before undertaking drastic steps.