Allergic Rhinitis Symptoms and Treatment

Allergic rhinitis is a common respiratory condition caused by the immune system overreacting to harmless airborne substances, such as pollen, dust, or animal dander. Especially in the spring, as nature awakens and pollen mixes into the air, seasonal allergy complaints reach their peak. Manifesting with a runny nose, sneezing fits, and itchy eyes, this condition can severely reduce your daily quality of life if left unmanaged. Taking early precautions and planning the right treatment will help you enjoy the spring months much more comfortably.

In Brief:
Allergic rhinitis is an extreme sensitivity of the immune system to allergens.
The most common triggers are pollen, dust mites, mould, and pet dander.
Symptoms include sneezing, nasal congestion, watery eyes, and postnasal drip.
Expert medical examination and skin prick tests are highly important for diagnosis.
Treatment involves antihistamines, nasal sprays, and, when necessary, immunotherapy (allergy shots).

What is Allergic Rhinitis?

The clearest answer to what allergic rhinitis is, is the inflammation of the mucous membrane lining the inside of the nose due to contact with allergens. When your body mistakenly perceives a substance like pollen or dust as a dangerous invader, the immune system produces antibodies called immunoglobulin E (IgE). These antibodies stimulate cells in the nose and eyes, causing the release of chemicals called histamine. Histamine release leads to the dilation of blood vessels, swelling of tissues, and excessive mucus production, bringing about the allergy symptoms we know all too well.

Commonly known as hay fever, this condition generally occurs in two different ways. Seasonal allergic rhinitis usually develops in the spring, summer, and early autumn due to tree, grass, and weed pollen. Perennial (year-round) allergic rhinitis stems from dust mites, cockroach droppings, mould, and the skin flakes or dander of pets like cats and dogs. Op. Dr. Ulaş Metin, Ear, Nose and Throat Specialist at BHT CLINIC İstanbul Tema Hastanesi, notes a significant increase in the number of patients visiting outpatient clinics, especially during seasonal transitions when the pollen load spikes.

Causes and Risk Factors

The primary cause of allergic rhinitis is atopy, a genetic predisposition to environmental allergens. If your parents have allergic diseases like allergic rhinitis, asthma, or eczema, your chances of developing this condition are quite high. Living in large, crowded cities like Istanbul, being exposed to air pollution, and spending long hours indoors are among the environmental factors that make it easier for allergic rhinitis to emerge.

Windy spring weather carries pollen for miles. Early mornings and midday are when airborne pollen levels are at their highest. Furthermore, poor ventilation, high humidity, and carpeted floors in homes create an ideal environment for dust mites to multiply, triggering year-round allergy complaints.

Who Gets It More Often?

Although allergic rhinitis can appear at any age, it typically begins in childhood, adolescence, or young adulthood. The incidence of allergic rhinitis is much higher in individuals diagnosed with asthma or atopic dermatitis (eczema). In the medical world, this triad is known as the "atopic march," and one condition often tends to trigger another.

What Are the Symptoms of Allergic Rhinitis?

Spring allergy symptoms can vary from person to person, and their severity depends on the amount of allergen exposure. Symptoms usually start within minutes, immediately after contact with the allergen. Depending on the course of the disease, symptoms can be divided into two main groups.

Mild and Early Stage Symptoms:

Severe, back-to-back sneezing fits.
Clear, watery, and continuous runny nose.
Intense itching felt in the nose, palate, throat, and even inside the ears.
Redness, watering, and a stinging sensation in the eyes.

Progressive and Chronic Symptoms:

Stubborn nasal congestion developing due to the swelling of tissues inside the nose.
Postnasal drip causing throat irritation and a dry cough.
Decreased sense of smell and taste due to nasal congestion.
Dark circles and bruising under the eyes, also known as "allergic shiners."
Sleep disturbances developing due to mouth breathing throughout the night, leading to chronic daytime fatigue.

Allergic rhinitis is not limited to symptoms like nasal congestion and sneezing. By disrupting your sleep quality, it can directly affect your concentration during the day and your overall health.

How is it Diagnosed?

When you visit the hospital suspecting allergic rhinitis, an Ear, Nose, and Throat specialist will first take a detailed medical history. Questions about which seasons your complaints worsen, whether you have pets at home, and if there is a family history of allergies are critical for diagnosis. During the subsequent physical examination, the doctor checks whether the mucosa inside the nose is pale, bluish, or swollen. Additionally, any enlargement in the nasal conchae or deviation in the nasal cartilage (septum) is evaluated using endoscopic methods.

How Are Allergy Tests Performed?

Following the physical examination, allergy tests are used to determine exactly which substance is causing your complaints.

Skin Prick Test: This is the most frequently applied test and provides the fastest results. A drop of solutions containing common allergens is placed on the inner forearm or back. Then, using a sterile, fine-tipped lancet, a very slight scratch is made on the skin to allow the allergen to seep under the surface. If redness and raised bumps resembling a mosquito bite form in the tested areas after about 15-20 minutes, it indicates you have an allergy to that substance. The procedure is quite painless and can be applied to all age groups.

Blood Tests (Specific IgE): In cases where a skin test cannot be performed (for example, in those with severe skin diseases or those who cannot stop taking antihistamine medication), specific IgE antibody levels in the blood are measured using a blood sample.

Treatment Methods

Allergic rhinitis treatment is personalised based on the patient's age, symptom severity, and the type of allergen. The first and most important step of treatment is to stay away from the identified allergen as much as possible. However, in cases where complete avoidance is impossible—such as with pollen—medical treatments come into play.

Medications: Antihistamine tablets or syrups help quickly relieve symptoms like sneezing, itching, and a runny nose by blocking the body's histamine production. New generation antihistamines generally do not cause drowsiness. Corticosteroid nasal sprays are the most effective long-term treatment tools that reduce inflammation and swelling inside the nose. Decongestant sprays that quickly clear nasal congestion can also be used, but since using them for more than 3-5 days can damage the nasal mucosa, they must be used under a doctor's supervision.

Immunotherapy (Allergy Shots): This is a long-term solution applied to patients who do not respond to medication or cannot tolerate their side effects. The patient is given increasing doses of the substance they are allergic to, aiming to desensitise the immune system (develop tolerance). This treatment, which usually lasts 3 to 5 years, can be administered via injection (subcutaneous) or in the form of sublingual drops or tablets.

How to Relieve Spring Allergies: Prevention Methods

Here are some practical steps you can take in your daily life to alleviate allergic rhinitis symptoms and reduce the frequency of attacks:

Avoid outdoor activities between 05:00 and 10:00 in the morning when pollen concentration is highest, and during windy weather.
Change your clothes immediately when you return home from outside and take a shower to wash away pollen stuck to your hair.
Keep home and car windows closed; use air conditioners with pollen filters for ventilation and have these filters cleaned regularly.
Instead of drying your laundry outside in the spring, prefer drying it indoors on a rack or in a tumble dryer.
Minimise pollen contact with your eyes by wearing wide-framed sunglasses and a brimmed hat when going out.
Regularly wash the inside of your nose with sterile saline solutions to remove allergens clinging to the mucosa.

Keeping your immune system strong during this period is also of great importance. You can increase your body's resistance by consuming fresh, seasonal vegetables and fruits. For tips that will contribute to your nutrition in the spring, you can review our article titled The Healing Trio of Spring: Green Almonds, Artichokes, and Strawberries.

Complications and Risk Groups

When left untreated, allergic rhinitis not only lowers your quality of life but also paves the way for other anatomical and physiological problems. When the natural drainage of the sinuses is disrupted due to nasal congestion, the risk of developing acute or chronic sinusitis increases. Especially in children, middle ear infections (otitis media) are frequently seen as a result of the blockage of the Eustachian tube between the middle ear and the nasopharynx.

Allergic rhinitis is a serious risk factor for asthma patients. Since the respiratory tract works as a single unit, uncontrolled inflammation in the nose can trigger asthma attacks or worsen an existing asthma condition. Additionally, constant mouth breathing can lead to deterioration in tooth and jaw structure, snoring, and sleep apnoea.

When to See a Doctor?

If the sneezing and runny nose complaints you experience in the spring last longer than a week, disrupt your sleep patterns, or prevent you from doing your daily tasks, you should definitely consult an Ear, Nose, and Throat specialist. If over-the-counter allergy medications you buy from the pharmacy are not helping, a professional evaluation is essential.

If your nasal discharge is yellow or green rather than clear and watery, if you experience severe facial and headache pain, or if you have a high fever, this may indicate an infection rather than an allergy. On the other hand, if you experience symptoms such as sudden shortness of breath, wheezing in the chest, swelling of the lips or tongue, or severe dizziness after exposure to an allergen, this could be a sign of anaphylaxis (severe allergic shock). In such a case, you should call 112 emergency services without wasting any time or visit the nearest hospital's emergency department immediately.

The Allergic Rhinitis Process at BHT CLINIC

At the BHT CLINIC İstanbul Tema Hastanesi Ear, Nose, and Throat Clinic, the diagnosis and treatment of allergic rhinitis are carried out using the most up-to-date medical approaches. Our expert medical staff accurately identifies the source of your complaints and creates the most appropriate treatment plan for you. In addition to our ENT clinic, we offer comprehensive and multidisciplinary healthcare services to our patients with our General Surgery department, which serves in areas such as digestive system, breast, thyroid, and obesity surgery.

Our 24/7 Emergency Department is always ready for possible emergencies and severe allergic reactions. To get your allergy symptoms under control and breathe easily, you can consult our specialist doctors by booking an appointment without delay.

Frequently Asked Questions

Does allergic rhinitis go away completely?

Allergic rhinitis is a chronic condition and generally does not disappear entirely. However, with correct medication use, allergen avoidance methods, and immunotherapy (allergy shots) applied to suitable patients, symptoms can be completely controlled, and long-term relief can be achieved.

What is good for spring allergies at home?

The best precaution you can take at home is to take a shower to wash off pollen when you come in from outside and to wash the inside of your nose with sterile saline solutions. Additionally, keeping windows closed, using air purifiers with HEPA filters, and reducing dust-collecting items in the bedroom will alleviate your complaints.

Does an allergy test hurt?

No, the skin prick test, which is most frequently used for diagnosis, is a very painless procedure. It is done by making a very slight scratch on the skin surface and does not cause bleeding. During the procedure, only a slight stinging sensation and a temporary itch in the test area afterwards may be felt.

Does allergic rhinitis turn into asthma?

While it is not accurate to say that allergic rhinitis directly turns into asthma, these two diseases are closely related. Untreated allergic rhinitis increases sensitivity in the airways, which can trigger the development of asthma in predisposed individuals or exacerbate existing asthma symptoms.

This article is for informational purposes only; please consult your doctor for diagnosis and treatment.

Allergic Rhinitis Symptoms and Treatment: How to Relieve Spring Allergies