What exactly is a

allergic rhinitis?

Allergic rhinitis, also known as hay fever, is an inflammatory reaction of the nasal mucosa to certain allergenic substances. Typical symptoms include sneezing, a runny or blocked nose, itchy eyes and an irritated throat. Pollen, house dust mites, animal dander and mold are among the most common allergens that can trigger this disease. A precise diagnosis and identification of the triggers are important in order to take appropriate measures to control symptoms.

About the symptoms

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Important facts about allergic rhinitis

Symptoms and consequences of allergic rhinitis:

Sneeze
Itchy, runny or blocked nose
Itchy, watery or reddened eyes
Irritation or tingling in the throat area
Cough irritation
Tiredness and exhaustion due to sleep disorders
Restriction of physical performance
Impairment of concentration and memory
Worsening of asthma symptoms with concomitant asthma disease
Impairment of quality of life, e.g. due to reduced productivity and social restrictions

What forms of allergic rhinitis exist?

There are two main forms of allergic rhinitis:

Seasonal allergic rhinitis: Also known as hay fever, this form occurs mainly during certain seasons when certain plant pollens are widespread in the air. Symptoms usually occur at certain times of the year and can change depending on the types of pollen present.
Perennial allergic rhinitis: This form occurs all year round and is caused by year-round allergens such as house dust mites, molds, animal dander or certain foods. The symptoms are often constant or worsen indoors where the allergens are present.

What causes allergic rhinitis?

Allergic rhinitis is caused by an overreaction of the immune system to certain allergy-causing substances, also known as allergens. The most common causes of allergic rhinitis are.

It is important to note that individual allergies and triggers can vary, and it is advisable to consult an allergist to get an accurate diagnosis.

Pollen

House dust mites

Animal hair and dander

Molds

Food allergens

How is allergic rhinitis diagnosed?

Diagnosis is usually based on the patient’s medical history. During this consultation, the doctor gets a picture of the symptoms and their environment. In the case of hay fever, the symptoms occur seasonally. This usually gives the doctor an initial indication quickly. But there are also allergens that are difficult to track down. In this case, it is important that an allergist clarifies the symptoms.

Skin test

An allergy skin test (prick test) provides clarity about the triggering allergen. Allergen solutions are dripped onto the inside of the forearm and scratched on the surface with a fine needle. An allergic reaction is characterized by redness, itching and wheal formation.

Blood test

The determination of total and allergen-specific IgE antibodies in the blood provides additional information. Elevated total IgE values indicate an allergy, while specific IgE antibodies identify the allergen in question.

Provocation test

A nasal provocation test is carried out by applying the suspected allergen directly to the nasal mucosa under controlled conditions. This checks whether and which complaints it triggers.

What to do with allergic rhinitis

When treating allergic rhinitis, it is initially important that those affected avoid the triggering allergens or at least reduce contact to a large extent. Your allergist will provide you with comprehensive information about your allergy.

Self-help measures for allergic rhinitis

Keep windows closed to limit the ingress of pollen. Wash your hair after being outside before entering the bedroom. Change your clothes if you have been out and about during the pollen season. Use allergen-proof covers for bed linen and pillows to minimize dust mite allergies. Frequent washing of bed linen, pillowcases and blankets in hot water is also helpful. Avoid contact with pets to which you are allergic. If you have a pet that you are allergic to, limit it to certain rooms.

Drug treatment for allergic rhinitis

Mild symptoms can be treated with antihistamines either as a nasal spray or in tablet form. The effect sets in within a short time. A nasal spray with cortisone is used for more severe symptoms. It takes a few weeks for the maximum effect to be achieved. It is also possible to combine them with antihistamines to enhance the therapeutic effects.

Hyposensitization for allergic rhinitis

Hyposensitization, also known as specific immunotherapy, is the only therapy that specifically targets the cause of an allergy. In this treatment, affected people are given either injections or tablets containing small amounts of the allergen or substance that triggers the allergy over a longer period of time in order to gradually accustom the immune system to it. The main aim of this therapy is to reduce the allergic reaction to the specific allergen. By gradually acclimatizing the immune system to the allergen, the aim is to alleviate the excessive reaction and the associated symptoms.

Sources

Please note that all content provided regarding individual medical conditions, treatments, procedures, etc. is general information and may vary depending on the physician:in and individual case and initial situation.
For more detailed information, please always consult your doctor.

German Society for Ear, Nose and Throat Medicine, Head and Neck Surgery e.V.: Rhinosinusitis; (as of April 2017), (retrieval date: 03.05.2021)

www.awmf.org

Guideline of the German Society for Allergology and Clinical Immunology: Allergic rhinoconjunctivitis. Allergo J 2003;12:182-94

Klimek L. Allergic rhinitis - diagnosis and treatment options. Drug Res 2020; 70: 7-9.

www.thieme-connect.com

Klimek L, Bachert C, Pfaar O, et al. ARIA guideline 2019: treatment of allergic rhinitis in the German health system. Allergol Select 2019; 3(1): 22-50