Allergic Rhinitis

Overview

What is allergic rhinitis?

Allergic rhinitis, often called allergies or hay fever, occurs when your immune system overreacts to particles in the air that you breathe-you are allergic to them. Your immune system attacks the particles in your body, causing symptoms such as sneezing and a runny nose. The particles are called allergens, which simply means they can cause an allergic reaction.

People with allergies usually have symptoms for many years. You may have symptoms often during the year, or just at certain times. You also may get other problems such as sinusitis and ear infections as a result of your allergies.

Over time, allergens may begin to affect you less, and your symptoms may not be as severe as they had been.

What are the symptoms of allergic rhinitis?

In most cases, when you have allergic rhinitis:

• You sneeze again and again, especially after you wake up in the morning.
• You have a runny nose and postnasal drip. The drainage from a runny nose caused by allergies is usually clear and thin. But it may become thicker and cloudy or yellowish if you get a nasal or sinus infection.
• Your eyes are watery and itchy.
• Your ears, nose, and throat are itchy.

Which allergens commonly cause allergic rhinitis?

You probably know that pollens from trees, grasses, and weeds cause allergic rhinitis. Many people have allergies to dust mites, animal dander, cockroaches, and mold as well. Things in the workplace, such as cereal grain, wood dust, chemicals, or lab animals, can also cause allergic rhinitis.

If you are allergic to pollens, you may have symptoms only at certain times of the year. If you are allergic to dust mites and indoor allergens, you may have symptoms all the time.

How is allergic rhinitis diagnosed?

To find out if you have allergies, your doctor will ask about your symptoms and examine you. Knowing what symptoms you have, when you get them, and what makes them worse or better can help your doctor know whether you have allergies or another problem.

If you have severe symptoms, you may need to have allergy tests to find out what you are allergic to.

• Your doctor may do a skin test. In this test your doctor puts a small amount of an allergen into your skin to see if it causes an allergic reaction.
• Your doctor may order lab tests. These tests can find substances in your blood or other fluids that may mean you have allergic rhinitis.

How is it treated?

There is no cure for allergic rhinitis. One of the best things you can do is to avoid the things that cause your allergies. You may need to clean your house often to get rid of dust, animal dander, or molds. Or you may need to stay indoors when pollen counts are high.

Unless you have another health problem, such as asthma, you may take over-the-counter medicines to treat your symptoms at home. If you do have another problem, talk to your doctor first. Others who also should talk to their doctor before starting self-treatment include older adults, children, and women who are pregnant or breast-feeding.

If your allergies bother you a lot and you cannot avoid the things you are allergic to, you and your doctor can decide if you should get allergy shots (immunotherapy) to help control your symptoms. For allergy shots to work, you need to know what you are allergic to.

Finding the treatment that works best for you may take a little time.

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	Should I take allergy shots (immunotherapy) for allergic rhinitis and allergic asthma?
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	Allergies: Avoiding indoor triggers
	Allergies: Avoiding outdoor triggers

Frequently Asked Questions

Cause

Allergic rhinitis, often called hay fever, occurs when your immune system overreacts to particles in the air that you breathe-you are allergic to them. Your immune system attacks the particles in your body, causing symptoms such as sneezing and a runny nose. The particles are called allergens, which simply means they can cause an allergic reaction.

See a picture of how an allergen affects the body .

Several types of allergens cause allergic rhinitis, including pollens, mold, dust mites, animal dander, and cockroaches. Although polluted air is not an allergen, it can irritate your nose and lungs. An irritated nose or lungs may make an allergic reaction more likely when you breathe in an allergen.

Symptoms

Symptoms of allergic rhinitis may develop within minutes after you breathe in an allergen, or they may not occur for another 4 to 8 hours. Symptoms often last longer than 10 days.

The most common immediate symptoms include:

• Sneezing repeatedly, especially after you wake up in the morning. Sneezing can occur as soon as 1 to 2 minutes after you breathe in an allergen.
• A runny nose (rhinorrhea). The drainage from a runny nose caused by allergies is usually clear and thin but may thicken and become cloudy or yellowish if a nasal or sinus infection develops. A runny nose can occur as soon as 3 minutes after you breathe in an allergen.
• Postnasal drip, which often feels like a tickle in your throat. It can trigger a cough as you try to clear your throat.
• Watery, itchy eyes. This may be allergic pinkeye.
• Itchy ears, nose, and throat.

Symptoms that may take longer to develop include:

• A stuffy nose, possibly with sniffing. This is the most common symptom in children and may be their only complaint.
• Eyes that are sensitive to light.
• Feeling grumpy or moody.
• Loss of energy.
• Poor sleep.
• Breathing through your mouth because your nose is blocked.
• An altered sense of smell.
• A long-lasting (chronic) cough.
• Problems with sinuses and the tubes that run between the inside of the ears and the back of the throat (eustachian tubes).
• A sense of pressure in an ear or difficulty hearing.
• Discomfort or pain in the face.
• Dark circles or patches under the eyes (allergic shiners).
• Rubbing the nose, which may cause a crease on the bridge of the nose (allergic crease).
• Rubbing the nose upward with the palm of the hand to reduce itching and open the nasal passages (allergic salute). This is often seen in children.

Variation in symptoms

If your allergies occur only at certain times of the year, your symptoms are likely to be itching, sneezing, a runny nose, and watery and itchy eyes. If you have allergies often or year-round, common symptoms include a stuffy nose and postnasal drip, although sneezing and a runny nose may also occur.

You generally have symptoms for life, although the types and how severe they are may vary. Symptoms may get worse at certain times, but the allergens may also affect you less as you grow older.

Irritating substances in the air, such as air pollution, diesel fumes, cigarette or wood smoke, insecticides, strong odors, or perfume, may make your symptoms worse.

If you are allergic to dust mites, animal dander, or indoor mold, your symptoms may be more severe in winter when you spend more time indoors.

Your symptoms may be worse if you are pregnant. Although you and the baby (fetus) are not in danger, allergic rhinitis can make your asthma and sinusitis worse. It is important to discuss this with your doctor, as some medicines might be better for you and your baby than others.

Other problems with symptoms similar to allergic rhinitis include upper respiratory infections (URIs), nasal defects, and inflammation (rhinitis) not caused by an allergen (nonallergic rhinitis).

What Happens

Allergic rhinitis, often called hay fever, occurs when your immune system overreacts to particles in the air that you breathe-you are allergic to them. Your immune system attacks the particles in your body, causing symptoms such as sneezing and a runny nose. The particles are called allergens, which simply means they can cause an allergic reaction.

An allergic reaction occurs only in people who have a condition called atopy. It means that allergens are likely to cause an allergic reaction. An atopic person often develops more than one allergy. Experts don't know why people become atopic and have allergic reactions. Most people who have allergies have family members who also have some kind of allergy.

The first time you are exposed to an allergen in the air, your body's immune system may recognize the allergen as a foreign substance. Your body reacts by making antibodies against the allergen. The next time you are exposed to the allergen, the antibodies attack it, releasing histamine and other chemicals that cause the symptoms of your allergy. This is called sensitization. If sensitization occurs, it tends to be after age 3. Children who develop allergic rhinitis after age 3 generally become allergic to many allergens, including dust mites, dander on pets, and pollens.¹

See a picture of how an allergen affects the body .

If you have a pollen allergy, your symptoms may vary according to the climate and the types of plants that grow in your area. If you have symptoms in:

• Winter and spring, you are probably allergic to tree pollens.
• Summer, you are probably allergic to grass and weed pollens.
• Late summer and fall, you probably are allergic to ragweed or other weed pollens, such as tumbleweed or sage.

Complications

Allergic rhinitis can affect your health if you do not treat it. If it lasts a long time, you may have complications such as sinusitis, plugged ears and ear infections. Many people with asthma also have allergic rhinitis, and researchers are looking at whether allergic rhinitis may lead to asthma.

Allergic rhinitis can also affect your quality of life. You may avoid seeing people, have problems sleeping, and feel tired or irritable. You may have trouble with school or work.

What Increases Your Risk

You may be more likely to have allergic rhinitis and other allergies if:

• You have a family history of allergies, especially allergic rhinitis. It is more likely a child will have an allergy if both parents have an allergy or have the same type of allergy.²
• You are exposed to dust mites, animal dander, or other indoor allergens.
• You are exposed to pollens or molds.

When to Call a Doctor

Call your doctor if you have been diagnosed with allergic rhinitis and:

• You have pain in the sinus area and other symptoms of sinus infection (fever, or a creamy, yellow or green discharge from the nose).
• Your symptoms get worse and you don't know why.
• You are taking a prescription or over-the-counter allergy medicine that does not help your symptoms.
• Your allergy medicine is causing side effects that bother you, such as decreased coordination or increased drowsiness.
• You develop a fever or ear pain.
• You have a cough or cold that lasts longer than 1 to 2 weeks.
• You have severe itching of the eyes or nose.
• Your allergy disturbs your life.

Your doctor can help you find which allergens are causing your reaction so you can reduce your contact with them. He or she may be able to prescribe medicines that reduce or get rid of your symptoms.

If you have not been diagnosed with allergies and you have allergy symptoms that concern you, call your doctor.

Watchful waiting

Watchful waiting is a wait-and-see approach. If you get better on your own, you won't need treatment. If you get worse, you and your doctor will decide what to do next.

You can use watchful waiting if you have mild symptoms that do not need treatment or that you can relieve with over-the-counter medicines. If you have severe symptoms or symptoms that last more than a few days, you should see your doctor.

Who to see

Health professionals who can evaluate and treat mild allergic rhinitis symptoms include:

• Family medicine physicians.
• Pediatricians.
• Internists.
• Nurse practitioners.
• Physician assistants.

You may need to see an allergy specialist (allergist) if:

• Your medicines are not working or they give you severe side effects.
• You need help in avoiding allergens.
• You are thinking about getting allergy shots (immunotherapy).
• Your symptoms or medicine side effects are making work or school more difficult.
• You often have complications, such as sinusitis or ear infection (otitis media).
• You have other medical problems, such as asthma.
• You need pill or injected corticosteroids to control your symptoms.
• You have had symptoms for longer than 3 months.

Your doctor may refer you to an ear, nose, and throat (ENT) specialist (also called an otolaryngologist or otorhinolaryngologist). An ENT specialist may be helpful if your doctor thinks you may have nasal polyps or other obstructions in your nose.

Exams and Tests

Your doctor can usually diagnose allergic rhinitis by asking you questions about your symptoms, your activities, and your home life, and examining you. You may need further testing if:

• You and your doctor need to find out exactly what things you are allergic to so that you can take steps to avoid them.
• Treatment is not helping your symptoms.
• You have severe symptoms.
• You are considering allergy shots (immunotherapy).

In these situations, your doctor may suggest:

• Allergy tests. These include:
  • Skin tests. Your doctor will put a liquid containing an allergen on the top layer of your skin and then prick your skin. If the skin reacts with a raised itchy area (called a wheal), it usually means that you are allergic to that allergen. Skin tests are fast, simple, and relatively safe, but results can be false-positive. This means that you do not have an allergy even though results say that you do. If you are very allergic, you cannot have skin testing.
  • Enzyme-linked immunosorbent assay (ELISA, EIA). It measures the blood level of immunoglobulin E (IgE) antibodies that the body may make in response to certain allergens. IgE levels are often higher in people who have allergies or asthma. ELISA may be done instead of or along with a skin test.
• Nasal cytology (nasal smear) testing. This measures eosinophils, a type of white blood cell that may be in the nasal drainage of people who have allergies. Your doctor may use this test to confirm a diagnosis of allergic rhinitis.

Accurate diagnosis of allergic rhinitis is important because many problems have similar symptoms (such as upper respiratory tract infections). Finding what causes your symptoms can help your doctor find the best treatment for you. Your doctor can also see if you have complications, such as sinusitis or asthma.

If your doctor thinks that you have allergic rhinitis, and there are no signs of complications, he or she may decide to treat your symptoms without doing lab tests and then check your symptoms again later.

Other tests for allergies

In most cases, you do not need testing. But your doctor may suggest some tests to eliminate other conditions as the cause of your symptoms. These tests include:

• Imaging tests. Imaging tests of the sinuses, such as X-rays, CT scans, and MRIs, cannot diagnose allergic rhinitis directly. But they can find other diseases, such as a sinus infection (sinusitis), chronic inflammation (thickening) of the sinus lining (often seen in people with asthma), structural defects of the nose, or, in rare cases, cancer.
• Rhinoscopy or nasal endoscopy. In rhinoscopy, your doctor uses a tool called a rhinoscope to see inside the nasal cavity. A nasal endoscopy looks inside the nasal passage with a lighted, flexible tube. Both of these tests look for nasal polyps and other problems that may block the nasal cavity.
• Mucociliary clearance testing. Doctors use mucociliary clearance testing to check for abnormal cilia in people who have very thick nasal discharge. Cilia are tiny hairs on the lining of the nasal passages that beat back and forth to remove particles from the nose. Certain rare diseases can cause problems in the cilia, leading to more nasal secretions.

Treatment Overview

Treatment for allergic rhinitis consists of avoiding the specific allergens that cause your symptoms, using medicines to control symptoms, and, in severe cases, getting allergy shots (immunotherapy). You are more likely to need daily treatment if you have symptoms throughout the year. But if you have allergies during a certain season, you may only need daily treatment at that time.

Because allergic rhinitis cannot be cured and may be frustrating to treat, people may try alternative treatment methods, such as homeopathy. But most of these treatments either have not been studied or have not been proven to work. Such treatments may be expensive, and some can be dangerous to your health.

Avoiding allergens

It is important to avoid allergens that are causing your symptoms. By doing this, you may be able to reduce your allergy symptoms, manage them without medicine or with fewer medicines, and reduce your risk of developing complications such as sinusitis. For more information, see:

Allergies: Avoiding indoor triggers.

Allergies: Avoiding outdoor triggers.

Self-treatment

Some people begin using over-the-counter medicines for allergic rhinitis before they see their doctors. These medicines can work well. But people with other medical problems, older adults, children, women who are pregnant or breast-feeding, and people with more than occasional mild symptoms should see a doctor before beginning self-treatment.

Pregnant women and children

Your symptoms may be worse if you are pregnant. Although you and the baby (fetus) are not in danger, allergic rhinitis may make asthma and sinusitis worse. If possible, do not use medicine for at least the first 3 months of your pregnancy. If you feel you need the medicine, talk to your doctor. If you become pregnant and are already taking allergy shots (immunotherapy), you may continue them, but don't start allergy shots if you are pregnant.

Treatment for children who have allergic rhinitis is much the same as for adults who have allergies. Treating children with medicine may be more difficult because of the possible side effects. Some medicines also may not be approved to treat children.

Initial and ongoing treatment

Treatment for allergic rhinitis usually starts with over-the-counter medicines. These include antihistamines, decongestants, and eyedrops to relieve symptoms. Check with the doctor before giving these medicines to your child. Experts say not to give decongestants to children younger than 2.

If over-the-counter medicines don't work or they cause bothersome side effects, such as drowsiness or decreased coordination, your doctor may prescribe medicine. These include:

• Antihistamines that don't make you sleepy (non-sedating). They generally are very effective at relieving sneezing, runny nose, itching, and watery eyes. You can take them with an over-the-counter decongestant to relieve a stuffy nose. Don't give decongestants to a child younger than 2 unless you've checked with the doctor first. If your child's doctor tells you to give a medicine, be sure to follow what he or she tells you to do.
• Eyedrops, if you have redness, itching, and watery eyes. Eyedrops can be prescription or over-the-counter and may contain an antihistamine or decongestant.
• Nasal corticosteroid sprays, which you may use with antihistamines. These sprays may reduce all symptoms of allergic rhinitis and are thought to be the most effective treatment for most people. They start working quickly, but it may be several weeks before you get the full effect.

Your doctor may suggest other medicines if these do not work or in special cases, such as if you are pregnant. These include:

• Leukotriene modifiers, which can relieve a stuffy nose, itching and sneezing, and a runny nose.
• Cromolyn sodium, which may reduce sneezing, nasal discharge, a stuffy nose, and eye irritation. Children and pregnant women often use cromolyn because it is very safe.
• Ipratropium bromide, which can relieve a runny nose.

If you do not take your medicine, your symptoms may return or get worse. It can be helpful to explain to children why they are taking medicine and how it can help them, as well as what side effects may occur.

You may use medicine daily for quick relief of symptoms that occur suddenly or are getting worse. Or you may use it in advance if you know you may breathe an allergen. For example, if you have severe pollen allergies, your doctor may suggest that you start using a corticosteroid spray 1 to 2 weeks before the pollen season starts.

You can treat a stuffy nose by cleaning your nasal passages with a saline solution (salt water). You may be able to prevent or manage mild sinus infections at home using over-the-counter medicines or other methods.

Different medicines treat different allergy symptoms. It may take a combination of medicines to relieve all of your symptoms. Talk with your doctor about which symptoms are most important for you to treat and which medicines may work best for you.

Treatment if the condition gets worse

If avoiding allergens and using antihistamines or nasal corticosteroids do not help your symptoms of allergic rhinitis, your doctor may suggest you take pill or injected corticosteroids. They are used only for symptoms that are severe. And they are used only for 3 to 10 days. This is because these types of corticosteroids have severe side effects when you take them for a long time.

If medicines do not help your symptoms or if they cause bad side effects, your doctor may suggest allergy shots (immunotherapy). Allergy shots are small doses of allergens that your doctor injects under your skin. This helps your body "get used to" the allergen, so you may have fewer or less severe symptoms. For more information, see:

Should I take allergy shots for allergic rhinitis or allergic asthma?

Although surgery does not cure allergic rhinitis, you may need it to fix something that makes treating your allergies difficult, such as a physical defect of the nose, or when allergies lead to blockage in the eustachian tube that causes chronic ear infections.

What to think about

If you have long-term (chronic) allergic rhinitis, complications such as sinusitis, and plugged ears or ear infections may occur. A severe complication is one of the few times that you may need to seek extra care from your doctor for allergic rhinitis.

Omalizumab (Xolair) is a medicine for allergic asthma. Studies have shown that it can reduce nasal symptoms of allergic rhinitis, such as sneezing and an itchy, runny, or stuffy nose.³ Some doctors may prescribe omalizumab for allergic rhinitis (unlabeled use). But it's not known if omalizumab works as well as nasal steroids. And it is very expensive.

Prevention

Experts do not know how to prevent allergic rhinitis. Being exposed to many allergens, secondhand smoke, and air pollution can irritate the nose and throat and may contribute to developing an allergy.

You can take steps to reduce the symptoms of allergic rhinitis or to make symptoms less severe.

Avoiding allergens

It is important to avoid allergens that are causing your symptoms. By doing this, you may be able to reduce your allergy symptoms, manage them without medicine or with fewer medicines, and reduce your risk of developing complications such as sinusitis. You can do this by:

• Controlling dust and dust mites, which includes dusting regularly and washing bed linens in hot water.
• Controlling animal dander and other pet allergens, which includes restricting pets to certain areas of your home.
• Controlling indoor molds, which includes cleaning bathtubs and showers monthly.
• Avoiding outdoor pollens, which includes staying inside while pollen counts are high.

For more information, see:

Allergies: Avoiding indoor triggers.

Allergies: Avoiding outdoor triggers.

Home Treatment

Allergic rhinitis is a long-term problem. It takes time and effort to control allergies through home treatment.

Avoid allergens

By avoiding or reducing your contact with allergens, you may be able to reduce your allergy symptoms and manage them without medicine or with fewer medicines. Controlling your contact with allergens and reducing your symptoms may also make it less likely you will develop complications such as sinusitis. You do this by:

• Controlling dust and dust mites, which includes dusting regularly and washing bed linens in hot water.
• Controlling animal dander and other pet allergens, which includes restricting pets to certain areas of your home.
• Controlling indoor molds, which includes cleaning bathtubs and showers monthly.
• Avoiding outdoor pollens, which includes staying inside while pollen counts are high.

For more information, see:

Allergies: Avoiding indoor triggers.

Allergies: Avoiding outdoor triggers.

Manage symptoms

If avoiding allergens does not relieve your symptoms or is not possible, you:

• May try taking over-the-counter allergy medicines such as chlorpheniramine (Chlor-Trimeton, for example), diphenhydramine (Benadryl, for example), or loratadine (Claritin, for example) to relieve symptoms. Don't give antihistamines to your child unless you've checked with the doctor first.
• Treat a stuffy nose by using decongestants or cleaning your nasal passages with saline solution (salt water). Don't give decongestants to a child younger than 2 unless you've checked with the doctor first. If your child's doctor tells you to give a medicine, be sure to follow what he or she tells you to do.
• May be able to prevent or manage mild sinus infections by keeping the air in your home moist and drinking plenty of liquids.

It is helpful to track your symptoms and how they affect you, such as when they keep you from sleeping, make it difficult to concentrate, or make you sleepy. Also track your allergens and how long after exposure to them you develop symptoms. This information will help your doctor prevent and treat the problem. You can keep a symptom diary (What is a PDF document?) to track this information.

Medications

Treatment for allergic rhinitis usually starts with over-the-counter medicines. These include antihistamines, decongestants, and eyedrops.

If over-the-counter medicines don't work or cause bothersome side effects, such as drowsiness or decreased coordination, your doctor may prescribe medicine. Options include:

• Antihistamines that don't make you sleepy (non-sedating). They generally are very effective in relieving sneezing, runny nose, itching, and watery eyes. They also come in a form with a decongestant to help relieve a stuffy nose.
• Eyedrops, if you have redness, itching, and watery eyes. Eyedrops can be prescription or over-the-counter and may contain an antihistamine or decongestant.
• Nasal corticosteroid sprays, which you may use with antihistamines. These sprays may reduce all symptoms of allergic rhinitis and are considered the most effective treatment for most people. They start working quickly, but it may be several weeks before you get the full effect.

Your doctor may suggest other medicines if these do not work or in special cases, such as if you are pregnant. These include:

• Leukotriene modifiers, which can relieve a stuffy nose, itching and sneezing, and a runny nose.
• Cromolyn sodium, which may reduce sneezing, nasal discharge, a stuffy nose, and eye irritation. Children and pregnant women often use cromolyn because it is very safe.
• Ipratropium bromide, which can relieve a runny nose.

Pregnant women and children

Your symptoms may be worse if you are pregnant. Although you and the baby (fetus) are not in danger, allergic rhinitis can make your asthma and sinusitis worse. It is important to discuss this with your doctor, as some medicines might be better for you and your baby than others.

Treating children with medicine may be more difficult than treating adults because of the possible side effects. Some medicines also may not be approved for treating children. Check with the doctor before giving antihistamines or decongestants to your child. Experts say not to give decongestants to children younger than 2.

What to think about

Some people begin using over-the-counter medicines for allergic rhinitis before they see their doctors. These medicines can work well; however, people with other medical problems, older adults, children, women who are pregnant or breast-feeding, and people with more than occasional mild symptoms should see a doctor before beginning self-treatment.

You may want to consider using different medicines at different times of the day. For example, during the day, it may be important to avoid the drowsiness that some antihistamines cause. However, if you are at home in the evening and this side effect is not a concern, you can think about using a low-cost, over-the-counter antihistamine. You may also try a combination of medicines to relieve all of your symptoms. Talk with your doctor about which symptoms are most important for you to treat and which medicines may work best for you.

Most non-sedating antihistamines are taken only once a day.

If you do not take your medicine, your symptoms may return or get worse. It can be helpful to explain to children why they are taking medicine and how it can help them, as well as what side effects may occur.

You may use medicine daily for quick relief of symptoms that occur suddenly or are getting worse. Or you may use it in advance if you know you may breathe an allergen. For example, if you have severe pollen allergies, your doctor may suggest you start using a corticosteroid spray 1 to 2 weeks before the pollen season starts.

Omalizumab (Xolair) is a medicine approved by the U.S. Food and Drug Administration (FDA) for use in allergic asthma. Studies have shown that it works well to reduce nasal symptoms of allergic rhinitis, such as sneezing and an itchy, runny, or stuffy nose.³ Some doctors may prescribe omalizumab for allergic rhinitis (unlabeled use). But it's not known if omalizumab works as well as nasal steroids. And it is very expensive.

Surgery

Although surgery does not cure allergic rhinitis, you may need it to fix a physical defect of the nose or sinuses. Problems such as these can make allergic rhinitis more difficult to treat. You and your doctor should not consider surgery unless other treatments have failed.

Possible surgeries include:

• Endoscopic surgery on your nose to correct a crooked nose (deviated nasal septum ) or remove noncancerous (benign) nasal polyps. For information on nasal endoscopic surgery, see the topic Sinusitis.
• Draining fluid from the middle ear (tympanotomy or myringotomy) or inserting tubes to help the ears drain (tympanostomy). This is sometimes done in children who have allergic rhinitis and ear infections. For a description of these surgeries, see the topic Ear Infections.

Other Treatment

If medicines cannot control your allergic rhinitis, you may think about having allergy shots (immunotherapy). Allergy shots are small doses of allergens that your doctor injects under your skin. This helps your body "get used to" the allergen, which can result in fewer or less severe symptoms.

Allergy shots work best if you are allergic to pollens, animal dander, or dust mites. But you may need allergy shots for 3 to 5 years, and there is some risk of severe whole-body reactions (anaphylaxis).

Other treatment choices

Allergy shots (immunotherapy)

Should I take allergy shots for allergic rhinitis or allergic asthma?

What to think about

Although expensive, allergy shots may not cost more than the combined cost of medicine, doctor and emergency room visits, and missed days of school or work over several years. But they require patience and commitment for an effective result. You may need to take regular shots for 3 to 5 years, and it may take 1 year or more for symptoms to improve. If the treatment schedule would be difficult for you to follow, you may want to think about other options.

Researchers are looking at putting the allergen under the person's tongue, rather than giving a shot. This is used more in Europe than the United States.

Doctors use allergy shots mainly to treat an allergy caused by one allergen or a closely related group of them, such as grass pollens. If you are allergic to more than one type of allergen, you may need to get shots for each type of allergen to relieve all of your symptoms. The allergens can usually be combined into one or two shots.

Because allergic rhinitis cannot be cured and may be frustrating to treat, people may try alternative treatment methods. But most of these treatments either have not been studied or have not been proven to work. Such treatments may be expensive, and some can be dangerous to your health.

Other Places To Get Help

Organizations

Related Information

• Allergic Reaction
• Allergy Tests
• Asthma in Children
• Asthma in Teens and Adults
• Atopic Dermatitis
• Drug Allergies
• Environmental Illness
• Food Allergies
• Nonprescription Medicines and Products
• Respiratory Problems, Age 11 and Younger
• Respiratory Problems, Age 12 and Older

References

Citations

1. Von Mutius E, Martinez FD (2003). Natural history, development, and prevention of allergic disease in childhood. In NF Adkinson Jr et al., eds., Middleton's Allergy Principles and Practice, vol. 2, pp. 1169-1174. Philadelphia: Mosby.

2. Fireman P (2000). Therapeutic approaches to allergic rhinitis: Treating the child. Journal of Allergy and Clinical Immunology, 105(6, Part 2): S616-S621.

3. Casale TB, et al. (2001). Effect of omalizumab on symptoms of seasonal allergic rhinitis. JAMA, 286(23): 2956-2967.

Other Works Consulted

• Kishiyama JL, Adelman DC (2007). Allergic rhinitis section of Allergic and immunologic disorders. In SJ McPhee et al., eds., Current Medical Diagnosis and Treatment, 46th ed., pp. 807-810. New York: McGraw-Hill.

• Weber RW (2007). Allergic rhinitis caused by inhalant factors. In RE Rakel, ET Bope, eds., Conn's Current Therapy, pp. 904-908. Philadelphia: Saunders Elsevier.

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