Allergic Rhinitis (Hay Fever)

Allergic rhinitis is inflammation of the nasal mucosa caused by exposure to allergens (pollen, house-dust mites, animal dander/epidermis, mold, etc.). It presents with sneezing, itching, watery nasal discharge, and congestion. It often accompanies allergic conjunctivitis and may coexist with bronchial asthma.

Types and causes

  • Seasonal (pollinosis): pollen from trees, grasses, and weeds (peaks during “flowering” periods).

  • Perennial: house-dust mites, animal dander, molds, cockroaches.

  • Occupational: workplace allergens (flour, latex, chemical aerosols, etc.).

Symptoms

  • Frequent sneezing; itching in the nose and palate.

  • Watery rhinorrhea, nasal congestion, reduced sense of smell.

  • Tearing, eye redness and itching (allergic conjunctivitis).

  • Cough and post-nasal drip (mucus down the back of the throat).

  • In children: mouth breathing, “allergic shiners” under the eyes, a horizontal nasal crease from frequent nose rubbing.

When to seek urgent care

  • Shortness of breath, wheezing.

  • Generalized swelling of lips, eyelids, tongue; difficulty swallowing/speaking.

  • Suspected anaphylaxis.
    In these situations call emergency services at 1-03/112 (Armenia).

Diagnosis

  • Consultation with an allergist/ENT; assessment of symptoms and seasonality.

  • Skin prick tests with allergens or measurement of specific IgE in blood.

  • Rhinoscopy (nasal exam); CT of paranasal sinuses if complications are suspected.

  • Exclude other causes: viral rhinitis, vasomotor rhinitis, medication-induced rhinitis.

Treatment (stepwise)

  1. Allergen avoidance

    • Pollen: plan outings outside peak times, keep windows closed on windy days, shower after being outdoors, consider glasses/mask.

    • Dust/mites: regular damp cleaning, protective encasings for mattresses/pillows, wash bedding at ≥60 °C, HEPA filters, minimize dust-collectors (carpets, heavy curtains).

    • Animals: limit contact, zone living spaces, use air filtration.

  2. Medications (prescribed by a physician, especially for children/pregnancy)

    • Intranasal corticosteroid sprays — first-line for moderate/severe disease.

    • Second-generation antihistamines (oral or nasal/ophthalmic) for rapid control of itch, sneezing, tearing.

    • Combination nasal sprays (antihistamine + steroid) for pronounced symptoms.

    • Saline solutions/nasal irrigation as supportive therapy.

    • Decongestants (vasoconstrictor drops) — no longer than 3–5 days to avoid rebound/medication-induced rhinitis.

    • As indicated: leukotriene receptor antagonists, cromones, anti-allergic eye drops.

  3. Allergen-specific immunotherapy (ASIT)

    • Subcutaneous or sublingual therapy with your specific allergen.

    • Course lasts 3–5 years; reduces sensitivity and the risk of progression to asthma.

    • Works best when sensitization is clearly confirmed (pollen, mites, etc.).

Lifestyle and prevention

  • Keep a “symptom diary” and note triggers/seasons.

  • Use pollen forecasts/apps and plan activities accordingly.

  • Maintain indoor humidity at 40–50%; air out rooms outside pollen peaks.

  • Avoid tobacco smoke and strong fragrances/aerosols.

Children and pregnancy

  • Pediatric therapy is individualized with emphasis on safe formulations and dosing; environmental control is crucial.

  • During pregnancy/lactation, any medication must be approved by a physician; local therapies and strict trigger control are often preferred.

Which specialist to see

Allergist-immunologist, otorhinolaryngologist (ENT), pediatrician (for children). If asthma is present — pulmonologist.