Chronic Allergic Rhinitis: Types, Signs, Diagnosis, and Relief

Classic allergy symptoms like a runny nose, itchy eyes, and sneezing can be annoying enough when they occur periodically. An even bigger nightmare is when they become long-term, such as with cases of chronic rhinitis. This article will explain the condition in detail and discuss the various options available to treat it.

What Is Chronic Rhinitis?

Chronic rhinitis is a chronic inflammation of the nasal passages. It affects the mucous membranes in the nose, resulting in symptoms such as a runny or stuffy nose, congestion, sneezing, and itching. It can be caused by allergies, infection, or environmental irritants like dust.

This type of rhinitis is best defined by its duration. Generally, it lasts more than 12 weeks but can last for years if not properly diagnosed and treated. Chronic rhinitis tends to be more common in adults than children and is estimated to make up roughly 25% of all cases of rhinitis.

Allergic vs Non-Allergic Rhinitis

It's important to recognize that chronic rhinitis is just one form of rhinitis. On a broad level, this condition is defined as inflammation of the mucous membranes in the nose and is associated with symptoms like congestion, sneezing, and a runny discharge. The causes behind these symptoms can vary widely but are usually classified into two categories: allergic and non-allergic.

Allergic Rhinitis

Allergic rhinitis is caused by an allergen, such as pollen, pet dander, mold, or dust mites. When you’re exposed to these allergens, your body’s immune system reacts and releases histamine, which causes the symptoms of allergic rhinitis.

Non-Allergic Rhinitis

Non-allergic rhinitis, on the other hand, refers to cases of rhinitis for which there is no known cause. It is similar to allergic rhinitis in its symptoms but lacks an allergenic trigger. The condition is not fully understood but is thought to be due to an overactive response of the nerves in the nose. It may also be attributable to deficiencies in a protective layer of mucus, which normally lines the nose and helps prevent viruses and bacteria from entering.

Acute vs. Chronic Rhinitis

Allergic and non-allergic rhinitis can be further characterized as acute or chronic. Acute rhinitis is short-term and usually resolves within a few days or weeks. Chronic rhinitis, however, can last up to several months or even years.

What Causes Chronic Rhinitis?

Chronic rhinitis can develop in both allergenic and non-allergenic forms, and as such, has plenty of potential causes. In some cases, either version of the condition can become worsened by the factors responsible for the other. The following section will explore the common reasons for chronic rhinitis.

Allergies

Seasonal allergies such as hay fever are notorious for causing the symptoms of rhinitis, whether that's chronic or acute. Allergens such as pollen, pet dander, mold, and dust mites can cause the body to mount an immune response that leads to increased mucus production and congestion. While this usually comes in the form of shorter attacks, prolonged exposure to an irritant can cause the condition to become chronic.

Non-Allergen Irritants

Non-allergenic irritants can also provoke the body's mucus production and lead to rhinitis. These irritants include:

Air Pollution

Pollutants from motor vehicles, factory emissions, and even household products with strong odors such as cleaning supplies can irritate the nasal tissue to cause or intensify the symptoms of rhinitis. Individuals living in heavily polluted areas are at an increased risk of developing chronic rhinitis, as well as other respiratory issues.

Hormonal Changes

Hormone levels fluctuate throughout the body during puberty, pregnancy, and menopause. These fluctuations can cause an increase in mucus production and trigger the classical symptoms of chronic rhinitis.

Medications

Certain medicines, particularly those for high blood pressure and depression, can lead to chronic rhinitis as a side effect. Nasal decongestants, which are used to treat allergies, can cause a condition known as rebound congestion if used in excess.

Tobacco Smoke

Tobacco is an incredibly potent irritant and is known to cause irritation throughout the body. The respiratory system is particularly vulnerable to the effects of smoking, and chronic rhinitis has been noted as a long-term consequence. Inhaling secondhand smoke can also lead to the condition.

Structural Issues

In some cases, chronic rhinitis can stem from structural issues within the nose. A deviated septum or nasal polyps, for example, can prevent air from passing through the nostrils properly, leading to mucus accumulation and nasal congestion. This requires assessment by a doctor and may require surgery to fix.

What Are Chronic Rhinitis Symptoms?

Chronic rhinitis is known to contribute to the development of many symptoms in the body, many of which are local to the nose. Severity may range from mild to severe depending on the nature of your condition and the triggers behind it.

Here's a breakdown of the telltale symptoms of chronic rhinitis and what each looks like:

Sneezing

Sneezing is the body's way of expelling unwanted irritants from the nose. It can be triggered by pretty much anything that affects the nasal passageways, such as allergens, pollutants, chemicals, or infections. In cases of chronic rhinitis, sneezing occurs alongside other symptoms and may be quite frequent.

Itchy Eyes and Nose

Itching of the eyes and nose is a common symptom in those suffering from chronic rhinitis. This usually occurs as an allergic reaction to airborne allergens, such as pollen or dust mites. It can also be caused by environmental irritants like smoke or chemical fumes.

Stuffy Nose

Chronic rhinitis often presents itself with a stuffy nose, as the inflammation causes the narrowing of the nasal passages. This can make it difficult to breathe through the nose, resulting in mouth breathing and sleep disturbances.

Congestion

Congestion is a symptom of chronic rhinitis, and it often goes hand-in-hand with a stuffy nose. It occurs when the inflammation causes the mucous membranes in the nose to swell, blocking air from entering and exiting. This can cause a feeling of pressure that is often accompanied by a dull headache.

Nasal Discharge

A runny or congested nose usually causes the production of excess mucus, which can be clear, watery, or thick depending on the cause. In cases of chronic rhinitis, this discharge can occur for weeks or months at a time.

Postnasal drip

Postnasal drip occurs when excess mucus accumulates in the throat. It's often accompanied by a feeling of mucus running down the back of the throat, as well as a persistent cough.

Long-Term Symptoms

While this isn't necessarily a symptom, it's certainly a defining characteristic of chronic rhinitis. Problems like sneezing, itchy eyes, and a runny nose last for 12 weeks or more with little reprieve. For those living with chronic rhinitis, the symptoms can become disruptive to daily life and difficult to manage without treatment.

Is Chronic Rhinitis Contagious?

No, chronic rhinitis is not contagious. Although it mimics many of the symptoms of a cold or flu, there isn't any actual virus involved. What you see is the body's reaction as it tries to flush an irritant out of its system.

This process is the same as when you're fighting a cold, only in the case of allergic rhinitis there is no transmissible cause. This means that you can't spread it to another person. While the best way to know for sure is by getting checked out by a doctor, symptoms that last for multiple months are less likely to be due to an infection and more likely chronic rhinitis.

When to See a Doctor

Chronic rhinitis isn't an inherently dangerous condition, however, it can require medical care in certain situations. This is especially the case when symptoms become too disruptive, or when the cause of the rhinitis is still unclear.

It's also important to note that chronic rhinitis can mimic the symptoms of other more serious medical conditions, such as sinusitis or a tumor. So if you're experiencing severe symptoms that are not improving, it's important to see a doctor and get checked out.

If you don’t know what is causing your symptoms, it is important to make an appointment with a doctor to identify the trigger. This will make it easier to get proper treatment and find relief.

Diagnosis

The first step you can take in managing your symptoms is identifying their causes. Chronic rhinitis can occur as a result of allergies, environmental, or other biological factors. Knocking allergies off the list is easy, as there are both doctor-administered and at-home tests you can take to identify your allergy triggers.

The traditional method, skin prick testing, involves a trip to an allergy doctor. They'll prick your forearm or back with a series of allergen-laced needles and wait for a possible reaction. If your skin breaks out in a rash or becomes inflamed, it often indicates an allergy to that substance.

At-home testing is much less invasive. Wyndly has a convenient at-home allergy test, you simply order a kit to your front door, draw a small sample of blood with a finger prick, then mail it back to our labs for analysis. The results will tell you what allergies you have.

If your chronic rhinitis isn't due to allergies, another cause is likely to blame. In this case, it is a good idea to visit the doctor for further testing. They may run additional tests, such as an X-ray or CT scan, to get a better look at your sinuses and diagnose the cause of your condition.

Treatment

There are several treatments available to help manage and reduce the symptoms of chronic rhinitis, including lifestyle changes, medications, and immunotherapy. We go into each course of action and its respective options below.

Lifestyle Changes

Individuals with chronic rhinitis may be able to reduce the severity of their symptoms by avoiding the irritant they're sensitive to.

This can be done in many ways, including:

• Wearing a face mask when outdoors in areas with a high pollen count or high levels of pollution
• Cleaning your home regularly to reduce dust, pet dander, and other irritants
• Avoiding smoking and areas with secondhand smoke
• Washing your hands frequently to avoid allergens on the skin
• Avoiding the use of strongly scented soaps, cleaning products, and perfumes

Over-the-Counter Medication

If lifestyle changes aren't enough to relieve your symptoms, you may find relief with certain over-the-counter (OTC) medications. While they won't solve the problem entirely, they can help make your day-to-day life more manageable and temporarily reduce symptoms.

Options include:

Decongestants

These medications help clear up a stuffy nose by reducing the size of your blood vessels and allowing more air to move through your sinuses. Common OTC decongestants include pseudoephedrine, phenylephrine, and oxymetazoline.

Saline Nasal Sprays

Saline nasal irrigation sprays can help reduce blockage and clear mucus from your nasal passages. They come in both OTC and prescription formulations, each with its own benefits. You can also make a saline nasal rinse at home if you don’t want to use a nasal spray.

Antihistamines

Antihistamines, such as cetirizine and loratadine, block the effects of histamine in your body. This helps reduce the severity of your symptoms, such as sneezing and itchy eyes, and provides short-term relief.

Prescription Medications

If OTC treatments fail to provide relief, your doctor may prescribe stronger medications. This could include corticosteroids or immunomodulators, which reduce inflammation and block the allergic response.

Allergy Immunotherapy

Immunotherapy is the best long-term solution to chronic allergic rhinitis. It works by exposing your immune system to small doses of allergens to gradually increase your body’s tolerance to them.

There are two ways of administering immunotherapy:

Allergy Shots

Allergy shots, also known as subcutaneous immunotherapy (SCIT), involve injecting a small amount of an allergen under the skin. Allergy shots are usually given once a week for several months and then monthly for three to five years.

Sublingual Immunotherapy

Sublingual immunotherapy (SLIT), is a newer approach to treating allergies. Rather than requiring needles, it can be administered with allergy drops or tablets. Each dose consists of a small amount of an allergen, which is taken daily for three to five years. SLIT is often more convenient than allergy shots and has fewer side effects.

Take Our Allergy Assessment

If you're suffering from chronic rhinitis and have tried OTC medications with limited success, consider exploring sublingual immunotherapy from Wyndly. Our at-home treatments provide an effective and convenient option for managing your symptoms, with no needles required. Take an allergy assessment today to see if Wyndly is right for you.