Allergic Rhinitis
Expert diagnosis and treatment for seasonal and perennial allergies with personalized immunotherapy options
What is Allergic Rhinitis?
Allergic rhinitis, commonly known as hay fever, is an inflammatory condition of the nasal passages caused by an overreaction of the immune system to airborne allergens. When a susceptible person inhales an allergen, the body releases histamine and other chemicals, causing symptoms such as sneezing, itching, nasal congestion, and runny nose.
Allergic rhinitis affects approximately 10-30% of adults and up to 40% of children worldwide. In the United States alone, over 60 million people suffer from allergic rhinitis. The condition significantly impacts quality of life, sleep, work productivity, and school performance.
Types of Allergic Rhinitis:
Seasonal (Hay Fever)
Occurs during specific seasons due to pollen from trees (spring), grasses (summer), and weeds (fall).
Perennial
Occurs year-round due to indoor allergens such as dust mites, pet dander, mold spores, and cockroaches.
Occupational
Triggered by workplace allergens such as latex, flour, grain, wood dust, or chemicals.
Common Triggers
Outdoor Allergens
- Tree pollen: Oak, birch, cedar, maple
- Grass pollen: Bermuda, Timothy, rye
- Weed pollen: Ragweed, sagebrush
- Mold spores: Alternaria, Cladosporium
Indoor Allergens
- Dust mites
- Pet dander: Cats, dogs, rodents
- Cockroaches
- Indoor molds
Signs & Symptoms
Nasal
- Sneezing (paroxysmal)
- Runny nose (clear discharge)
- Nasal congestion
- Nasal itching
- Postnasal drip
Eye
- Itchy, red eyes
- Watery eyes
- Swollen eyelids
- Allergic shiners
- Light sensitivity
Respiratory
- Throat clearing
- Cough (especially at night)
- Wheezing
- Shortness of breath
Systemic
- Fatigue and malaise
- Poor sleep quality
- Difficulty concentrating
- Headaches
Allergic March: Allergic rhinitis often precedes asthma (30-40% of patients). Early treatment may prevent progression.
When to See a Doctor
- Symptoms affecting quality of life or sleep
- OTC medications provide inadequate relief
- Symptoms persist year-round
- Development of asthma symptoms
- Recurrent sinus or ear infections
Diagnosis
- Medical History: Symptom patterns, triggers, seasonality.
- Physical Exam: Nasal mucosa examination, allergic shiners.
- Skin Prick Testing (SPT): Gold standard for identifying specific allergies.
- Specific IgE Blood Tests: For patients unable to stop antihistamines.
Treatment
First-Line Treatments
Intranasal Corticosteroids (INCS)
Most effective single therapy. Fluticasone, mometasone, budesonide.
Second-Generation Antihistamines
Oral: cetirizine, loratadine, fexofenadine. Intranasal: azelastine.
Combination INCS + Antihistamine
Dymista (azelastine/fluticasone) - superior to either alone.
Allergen Immunotherapy (AIT)
The only disease-modifying treatment:
- SCIT (Allergy Shots): Weekly then monthly injections for 3-5 years.
- SLIT (Tablets/Drops): Daily tablets under tongue. Convenient, safer.
- Benefits: Reduces symptoms, prevents new allergies, reduces asthma risk by 50%.
Complications
- Chronic sinusitis
- Nasal polyps
- Otitis media with effusion (especially in children)
- Sleep-disordered breathing
- Asthma exacerbation
- Reduced quality of life
Why Choose Our Allergy Center?
Board-certified allergists with advanced immunotherapy expertise
Comprehensive Testing
Skin prick and specific IgE
Immunotherapy Experts
SCIT, SLIT, and OIT programs
Patient Education
Avoidance strategies and action plans
Lifelong Follow-up
Long-term management
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