Treatment for allergic rhinitis depends on how severe your symptoms are and how much they're affecting your everyday activities.
In most cases treatment aims to relieve symptoms such as sneezing and a blocked or runny nose.
If you have mild allergic rhinitis, you can often treat the symptoms yourself.
You should visit your GP if your symptoms are more severe and affecting your quality of life, or if self-help measures haven't been effective.
It's possible to treat the symptoms of mild allergic rhinitis with over-the-counter medications, such as long-acting, non-sedating antihistamines.
If possible, try to reduce exposure to the allergen that triggers the condition. See preventing allergic rhinitis for more information and advice about this.
Cleaning your nasal passages
Regularly cleaning your nasal passages with a salt water solution – known as nasal douching or irrigation – can also help by keeping your nose free of irritants.
You can do this either by using a homemade solution or a solution made with sachets of ingredients bought from a pharmacy.
Small syringes or pots that often look like small horns or teapots are also available to help flush the solution around the inside of your nose.
To make the solution at home, mix half a teaspoon of salt and half a teaspoon of bicarbonate of soda (baking powder) into a pint (568ml) of boiled water that's been left to cool to around body temperature – do not attempt to rinse your nose while the water is still hot.
To rinse your nose:
- stand over a sink, cup the palm of one hand and pour a small amount of the solution into it
- sniff the water into one nostril at a time
- repeat this until your nose feels comfortable – you may not need to use all of the solution
While you do this, some solution may pass into your throat through the back of your nose. The solution is harmless if swallowed, but try to spit out as much of it as possible.
Nasal irrigation can be carried out as often as necessary, but a fresh solution should be made each time.
Medication won't cure your allergy, but it can be used to treat the common symptoms.
If your symptoms are caused by seasonal allergens, such as pollen, you should be able to stop taking your medication after the risk of exposure has passed.
Visit your GP if your symptoms don't respond to medication after two weeks.
Antihistamines relieve symptoms of allergic rhinitis by blocking the action of a chemical called histamine, which the body releases when it thinks it's under attack from an allergen.
You can buy antihistamine tablets over the counter from your pharmacist without a prescription, but antihistamine nasal sprays are only available with a prescription.
Antihistamines can sometimes cause drowsiness. If you're taking them for the first time, see how you react to them before driving or operating heavy machinery. In particular, antihistamines can cause drowsiness if you drink alcohol while taking them.
If you have frequent or persistent symptoms and you have a nasal blockage or nasal polyps, your GP may recommend a nasal spray or drops containing corticosteroids.
Corticosteroids help reduce inflammation and swelling. They take longer to work than antihistamines, but their effects last longer. Side effects from inhaled corticosteroids are rare, but can include nasal dryness, irritation and nosebleeds.
If you have a particularly severe bout of symptoms and need rapid relief, your GP may prescribe a short course of corticosteroid tablets lasting 5 to 10 days.
If allergic rhinitis doesn't respond to treatment, your GP may choose to add to your original treatment.
They may suggest:
- increasing the dose of your corticosteroid nasal spray
- using a short-term course of a decongestant nasal spray to take with your other medication
- combining antihistamine tablets with corticosteroid nasal sprays, and possibly decongestants
- using a nasal spray that contains a medicine called ipratropium, which will help reduce excessive nasal discharge
- using a leukotriene receptor antagonist medication – medication that blocks the effects of chemicals called leukotrienes, which are released during an allergic reaction
If you don't respond to the add-on treatments, you may be referred to a specialist for further assessment and treatment.
Immunotherapy, also known as hyposensitisation or desensitisation, is another type of treatment used for some allergies.
It's only suitable for people with certain types of allergies, such as hay fever, and is usually only considered if your symptoms are severe.
Immunotherapy involves gradually introducing more and more of the allergen into your body to make your immune system less sensitive to it.
The allergen is often injected under the skin of your upper arm. Injections are given at weekly intervals, with a slightly increased dose each time.
Immunotherapy can also be carried out using tablets that contain an allergen, such as grass pollen, which are placed under your tongue.
When a dose is reached that's effective in reducing your allergic reaction (the maintenance dose), you'll need to continue with the injections or tablets for up to three years.
Immunotherapy should only be carried out under the close supervision of a specially trained doctor as there's a risk it may cause a serious allergic reaction.