Coping
ByKristin Hayes, RN
Updated on April 03, 2024
Medically reviewed byBenjamin F. Asher, MD
Table of Contents
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Table of Contents
Common Triggers
Home Remedies
Medication Options
Chronic allergic rhinitis is caused by airborne allergy-causing substances (called allergens) that you have a hard time escaping both indoors and outdoors. These include tree and grass pollens, dust mites, pet dander, molds, and cockroaches.
Chronic allergic rhinitis occurs when allergic rhinitis (hay fever) persists for three months or more. It can happen during allergy season when pollen counts are high (seasonal allergic rhinitis) or throughout the year (perennial allergic rhinitis).
This can lead to persistent or recurrent symptoms such as sneezing, nasal congestion, runny nose, and itchy, watery eyes. Antihistamines can help manage allergy symptoms along with the avoidance of known allergens and home remedies like neti pots and humidifiers.
This article lists the triggers of chronic allergic rhinitis and describes the different ways to treat or prevent symptoms with home, over-the-counter (OTC), and prescription remedies.
Chronic Allergic Rhinitis Triggers
Seasonal allergies are due to allergens in the environment that are only present during certain parts of the year. Perennial allergies are due to environmental allergens that are present all year around.
Seasonal Allergy Triggers
While people often associate seasonal allergies with tree pollens in early spring, there are pollens from other plants that can trigger allergy symptoms in the summer, fall, and even early winter.
People can be sensitive to different types of pollens, so you may be fine in the spring but reactive in the fall, while a friend may experience the opposite.
By and large, spring allergies involve tree pollens followed by grass pollens in the late spring to summer. From late summer to spring, weed pollens are at their highest, while outdoor mold can persist from fall right until early winter.
Here are some of the key allergens associated with seasonal allergic rhinitis:
Early Spring | Late Spring to Early Summer | Late Summer to Fall |
---|---|---|
Ash | Bahia grass | Ragweed |
Aspen | Bermuda grass | Burning bush |
Beech | Fescue grass | Cocklebur |
Birch | Johnson grass | Lamb's quarters |
Cedar | Kentucky bluegrass | Mold spores |
Elm | Orchard grass | Mugwort |
Hickory | Sweet vernal grass | Pigweed |
Juniper | Timothy grass | Russian Thistle |
Maple | Sagebrush | |
Oak | Tumbleweed | |
Pecan | ||
Walnut | ||
Willow |
Perennial Allergy Triggers
People with perennial allergies tend to be sensitive to a broad range of allergens, from outdoor allergens that only occur during certain seasons to indoor allergens that may be present year-round.
By definition, perennial allergic rhinitis is when nasal congestion, sneezing, itching, or runny nose occur for an hour or more on most days throughout the year.
The symptoms may occur at more or less the same time every day (such as at night when dust settles and you are lying down) or in certain environments (such as at your workplace or in your car).
In addition to outdoor allergens, perennial allergic rhinitis is associated with the following indoor allergens:
- Dust mites
- Cockroaches
- Pet dander (both cats and dogs as well as horses and livestock)
- Indoor molds (most commonly Alternaria, Cladosporium, and Aspergillus)
Is Chronic Rhinitis Contagious?
Chronic allergic rhinitis is not something you can "catch." It is caused by an abnormal immune response to substances that are otherwise harmless.
There is a form of rhinitis called infectious rhinitis that is contagious. It is caused by infectious agents like rhinovirus (the most common cause of colds) that trigger nasal inflammation along with runny nose, sneezing, and congestion.
List of Environmental Allergens
Are There Home Remedies for Chronic Allergic Rhinitis?
The typical first-line defense for hay fever is antihistamines, but they are not the only options. In some cases, allergen avoidance and home remedies may be all that is needed.
Allergen Avoidance
If you have seasonal or perennial allergies, there are several things you can do to reduce your risk of allergic rhinitis:
- Check the pollen count: Check the local TV news or download apps that can tell you when the pollen count is high. Limit your outdoor exposure when counts are high (or wear a face mask).
- Keep windows shut when counts are high: Turn on the air conditioner in warm weather, making certain the vents are clean and dirty filters are replaced.
- Use a humidifier: Cool-air humidifiers can help draw airborne allergens to the ground. Steam vaporizers can do the same but may also promote mold growth.
- Get an air cleaner: Also known as air purifiers or air sanitizers, these devices contain special filters that capture and reduce allergen levels in the air.
- Vacuum at least once a week: This is especially true if you have pets or wall-to-wall carpeting. You can wear a face mask while cleaning to avoid inhaling "kicked-up" dander or dust.
- Wash bedding regularly: This is particularly important if you sweat at night or live in humid climates. You can also put pillows in a tumble dryer for 10 to 15 minutes to help kill dust mites.
- Avoid pet dander: Keep pets out of your bedroom. Pet dander is sticky, so wash and change your animal's favorite furniture and toys often.
- Prevent mold buildup: Fix all leaks and other causes of dampness in your house. Avoid running hot showers for a long time. Clean damp surfaces, and treat suspected areas of mold immediately.
- Control cockroaches: Do not leave food or garbage uncovered. Use poison baits, boric acid, and in traps instead of chemicals that can cause allergy symptoms.
Home Remedies
If you suffer chronic allergy symptoms, there are things you can do at home to help manage or treat them:
- Use a neti pot: This is a simple device with a spout used for nasal irrigation. The irrigation solution, made with 8 ounces of sterile water, 1/2 teaspoon of non-iodized salt, and 1/3 teaspoon of baking soda, can reduce nasal inflammation.
- Take probiotics: A 2015 review of 23 studies found that probiotics (found in supplements or fermented foods like yogurt, miso, and kombucha) significantly improved chronic hay fever symptoms, although it is not entirely clear why.
- Try spirulina: This blue-green algae sold as a dietary supplement may help ease the overactive immune response that triggers allergy symptoms, says a 2020 study in the International Forum of Allergy Rhinology.
- Make a pot of tea: Different teas have been used for generations as homespun remedies for allergic rhinitis. A 2021 study suggested that black tea, black cumin tea, licorice tea, and anise may all have beneficial effects.
Medical Treatment Options for Chronic Allergic Rhinitis
Chronic allergic rhinitis is commonly treated with oral and nasal medications, both OTC and prescription. For people with severe symptoms, allergy shots may be recommended to gradually reduce your sensitivity to known allergens.
Antihistamines
Antihistamines block an immune chemical called histamine that causes allergy symptoms. These can be taken to relieve immediate hay fever symptoms. Low-dose oral antihistamines can also be taken daily during allergy season to reduce your susceptibility to airborne allergens.
Options include:
- OTC oral antihistamines like Claritin (loratadine), Zyrtec (cetirizine) and Allegra (fexofenadine)
- OTC antihistamine eye dropslike Pataday (olopatadine) and Alaway (ketotifen fumarate)
- OTC antihistamine nasal sprayslike Astepro (azelastine)
- Prescription antihistamine nasal sprayslike Patanase (olopatadine)
Decongestants
Decongestants loosen mucus in the nasal passages to help ease nasal stuffiness. These are often combined with antihistamines for the sustained relief of symptoms.
Options include:
- OTC oral decongestantslike Sudafed (pseudoephedrine)
- Nasal decongestant spraysinclude Neo-Synephrine (phenylephrine hydrochloride) and Afrin (oxymetazoline)
Nasal Corticosteroids
These nasal sprays contain corticosteroids (steroids) that reduce nasal inflammation and, in turn, symptoms like congestion, itching, and sneezing.
Nasal steroid sprays commonly used for hay fever include:
- OTC nasal sprayslike Flonase (fluticasone ), Rhinocort (budesonide ), Nasacort (triamcinolone) and Nasonex (mometasone)
- Prescription nasal sprays include Dymista (azelastine and fluticasone) and Ryaltris (mometasone and olopatadine)
Other Options
Severe cases of chronic allergic rhinitis may require other medications that provide better control of symptoms or faster relief of symptoms like rhinorrhea (runny nose).
These include:
- Cromolyn sodium, an OTC nasal spray used several times daily to avoid hay fever symptoms
- Singulair (montelukast), a prescription oral drug that blocks the action of chemicals called leukotrienes that contribute to allergy symptoms
- Atrovent (ipratropium), a prescription nasal spray that eases severe rhinorrhea by preventing glands in the nose from producing too much mucus
- Oral corticosteroids like prednisone that are only used in extreme cases for a short time when symptoms make it impossible for a person to function
Types of Nasal Sprays Used for Allergies
Summary
Chronic allergic rhinitis is hay fever that persists for three months or more. This includes seasonal allergies that occur in response to seasonal pollens and perennial allergies that occur in response to outdoor and indoor allergens, including dust mites and pet dander.
Arguably the best treatment for chronic allergic rhinitis is the avoidance of allergens. Home remedies like neti pots, humidifiers, and air purifiers can help. Medication options include oral and nasal antihistamines, oral or nasal decongestants, and nasal steroid sprays.
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Kristin Hayes, RN
Kristin Hayes, RN, is a registered nurse specializing in ear, nose, and throat disorders for both adults and children.
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