How long does allergic rhinitis last?

Allergic rhinitis, also known as hay fever and nasal allergies is a common condition that appears as the seasons change. It typically occurs when allergens such as pollen, house dust mites, and cockroach droppings are breathed in through the nose or mouth.

Symptoms of allergic rhinitis can be extremely annoying and sometimes affect performance at school or work. How long do these symptoms last? What can you do to minimise how long they last? Before we answer this let’s first take a look at what allergic rhinitis is.

What is allergic rhinitis?

Allergic rhinitis can be described as an allergic reaction to airborne substances such as pollen, dust mites, and animal dander. When this happens the immune system reacts by making allergic antibodies called immunoglobulin E (IgE) and in people sensitised to these allergens symptoms such as a stuffy nose, itchy eyes or sneezing start. The symptoms are similar to a common cold, but are triggered by allergens, not a virus. Those with asthma or eczema are also more likely to develop hay fever.

What are the different types of allergic rhinitis?

Allergic rhinitis is classed into several categories:

• Seasonal

As the name suggests seasonal allergic rhinitis happens at certain times of the year, commonly during the summer months when the pollen count is high from grasses, trees and weeds.

• Perennial

This type of rhinitis can happen all year round and is generally caused by pets, dust mites and mould.

• Non-allergic rhinitis

Rhinitis of this type does not involve an allergy, unlike seasonal allergies. There are many causes including smoke, irritants, pollution, changes in weather and hormonal changes.

• Infectious rhinitis

The common cold falls into this category as it spreads very easily to others. The virus settles into the mucous membranes of the nose and sinus cavities, causing an infection.

How long does allergic rhinitis last?

Symptoms of seasonal allergic rhinitis occur in spring, summer and/or early fall (autumn) and are usually caused by allergic sensitivity to pollens from trees, grasses or weeds, or to airborne mould spores. Allergic rhinitis symptoms could last from March to October depending on which season the pollen you are sensitive to pollinates. Weather and pollution will also be factors in how long the symptoms will last.

Other people experience symptoms year-round, a condition called perennial allergic rhinitis. It’s generally caused by sensitivity to house dust, house dust mites, animal dander and/or mould spores. The duration of symptoms for perennial allergic rhinitis will be influenced by levels in the air and the preventive measures that have been taken. For example, if mould problems in a house are not resolved or an animal still lives in the home the allergy symptoms will persist until changes are made.

For people with nonallergic rhinitis, the duration of symptoms can persist for long periods until the reason for the allergy is uncovered. Causes such as the environment, food, personal and home products, medication, stress and underlying medical conditions can trigger nonallergic rhinitis.

Symptoms of allergic rhinitis

Nasal symptoms

There are a range of nasal symptoms that people can experience due to their body’s reaction to allergens. Symptoms include:

• Nasal congestion: When the nasal passages become inflamed and swollen
• Runny nose: An increase in mucus production leads to a persistent runny nose, often alongside a postnasal drip down the throat causing irritation and sore throat
• Sneezing: The sneezing reflex is triggered by an itchy nose to clear the irritants out

Eye symptoms

Symptoms can significantly affect the eyes, leading to uncomfortable and sometimes frustrating symptoms:

• Itchy eyes: Allergens cause severe itching with the temptation to rub the eyes which can make irritation worse. Eyes can become very sore or infected with frequent rubbing, causing conjunctivitis
• Red eyes: Allergic reactions can cause blood vessels in the eyes to expand, making them appear red
• Watery eyes: The eyes may produce excess tears to flush out allergens due to irritation

Symptoms that might develop later are:

• Fatigue: Poor sleep quality due to nasal congestion and other symptoms often leads to daytime tiredness
• Dark circles under the eyes: Poor sleep quality leads to puffiness under the eyes causing darkness
• Headaches: Sinus pressure from nasal congestion can extend to sinus headaches, causing pain in the forehead, cheeks, and around the eyes

Common causes

Outdoor triggers of allergic rhinitis

Pollen is the major outdoor trigger for allergic rhinitis. The levels of pollen vary by season and geographical location. Typically tree pollen is high in early spring, while grass pollen is more common in late spring through summer. Ragweed pollen peaks in the autumn months.

Indoor triggers of allergic rhinitis

Indoor allergens are present all year round such as dust mites and pet dander. Dust mites live in warm, humid environments so bedding, carpets, and upholstered furniture are ideal homes for them. Covering mattresses and pillows with allergen-proof covers, washing bedding in hot water weekly, and maintaining low humidity can help control dust mite levels. Dusting and vacuuming the home regularly will also reduce dust mites.

Non-allergenic triggers

Smoke, strong perfumes, and various chemicals can irritate nasal passages, making symptoms worse. Avoiding smoking areas, using unscented cleaning products, and ensuring good ventilation when using chemicals can help manage these triggers.

How to avoid allergens

To minimise outdoor allergens:

• Reduce exposure to known allergens, such as staying indoors during the pollen season, especially on dry, windy days or after thunderstorms
• Monitor pollen forecasts to prepare yourself for the days ahead
• Wearing a mask while doing outdoor activities
• Nasal allergen barrier balms may be useful when applied around the nostrils to stop pollen from getting through
• Showering after being outside can also help remove pollen from the skin and hair

To minimise indoor allergens:

• Using allergen-proof mattress covers, washing bedding in hot water weekly, and keeping pets out of the bedroom can be effective
• Using air purifiers with HEPA filters can help keep the air clean

Treatment options

Medication is available in a variety of forms, such as tablets, liquids, nasal sprays and eye drops. Here are some treatment options:

Antihistamines

Antihistamines such as cetirizine or loratadine can be used in two ways. They can be taken when hay fever symptoms appear or when you know the pollen count will be high to prevent symptoms. They can help reduce overall inflammation. They work by blocking the chemical histamine, which your body releases when it thinks you’re under attack from an allergen. This stops allergic reactions and clears up symptoms like itching or sneezing, but it may not help with a blocked nose.

Nasal steroid sprays

Corticosteroid nasal sprays are effective for reducing nasal inflammation and congestion.

Decongestants

Decongestant nasal sprays are useful to use if nasal congestion and a blocked nose are particularly bothersome. It targets the inflammation and swelling of the nasal passages, but this is a short-term treatment option of 7 days. Prolonged use can cause irritation and rebound congestion.

Side effects from treatments will vary depending on the type of medication you are using, these may include drowsiness, headaches, nasal irritation, nosebleeds and cough.

When to seek help from a healthcare provider

When OTC (over-the-counter) treatments are not effective

Over-the-counter treatments can be effective for mild symptoms. However, when symptoms persist or worsen despite these treatments, it may indicate a need for a more tailored approach. For symptoms that last more than 7 days or for severe reactions, consult with a healthcare professional to explore further treatment options.

Allergist

Allergy/immunology specialists can help in diagnosing and treating hay fever and other allergic conditions. They can offer allergy testing, such as skin tests or blood tests to identify specific triggers and develop personalised treatment plans. Allergists can advise on how to avoid allergens, prescription medications, and long-term strategies such as immunotherapy, which may significantly improve quality of life and reduce the frequency and severity of symptoms.

Prescription medications

Prescription medications such as leukotriene inhibitors may also be recommended to manage acute symptoms to provide relief from chronic sinus infections, nasal congestion, and other disruptive symptoms.

Immunotherapy

Those with persistent or severe rhinitis can use immunotherapy to gradually expose the immune system to allergens to build tolerance, potentially providing long-term relief. Both allergy shots and sublingual tablets are available.

Conclusion

The duration rhinitis symptoms persist is dependent on the type of rhinitis you suffer from. Also, several other factors, such as the season, pollen count, proximity to animal dander, moulds, and underlying health issues can affect your symptoms. By using a combination of lifestyle changes and medication, individuals suffering from allergic rhinitis can reduce their symptoms. Early identification of symptoms and triggers is essential for effective management, helping those suffering from allergic rhinitis to lead a more enjoyable quality of life.

Sources

• Allergic rhinitis (hay fever) – Australasian Society of Clinical Immunology and Allergy-  (ASCIA)
• Nasal Allergy, Rhinitis and Allergic Rhinitis – Allergy Asthma Network
• Allergic Rhinitis (Hay Fever): Symptoms & Treatment  – Cleveland Clinic