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Allergic Rhinitis (Hay Fever)

Annoying rather than dangerous — but easy to under-treat for years.

Allergic rhinitis is an immune response to inhaled allergens — pollen, dust mites, animal dander, moulds. It's seasonal or perennial depending on the trigger. Untreated, it worsens asthma, disturbs sleep, and significantly reduces quality of life, so effective treatment is worth pursuing.

Causes & risk factors

  • Pollen (tree, grass, weed) — seasonal
  • Dust mites — perennial
  • Pet dander
  • Mould spores
  • Occupational allergens (flour, wood dust, latex)

Symptoms

  • Sneezing fits, especially on waking
  • Clear runny nose and nasal congestion
  • Itchy eyes, nose, and throat
  • Post-nasal drip and chronic cough
  • Fatigue and poor concentration from disturbed sleep

How it's diagnosed

  • Clinical pattern — symptoms with known triggers
  • Skin-prick testing or specific IgE blood testing when trigger identification matters
  • Assessment for coexisting asthma ("one airway" concept)

Evidence-based treatment

  • Intranasal corticosteroids — the most effective single treatment
  • Non-sedating oral antihistamines (cetirizine, loratadine, fexofenadine)
  • Saline nasal irrigation twice daily during flares
  • Allergen immunotherapy for moderate-severe cases unresponsive to drugs
  • Eye drops (antihistamine or mast-cell stabiliser) for ocular symptoms

Prevention

  • Keep windows closed during high pollen counts; shower after outdoor exposure
  • Dust-mite covers on bedding; wash linens weekly at 60°C
  • HEPA filtration for homes with pets
  • Identify and, where practical, reduce workplace exposures

Related symptoms

Allergic Rhinitis (Hay Fever) — FAQ

Are nasal steroid sprays safe long-term?

Yes — at licensed doses they're safe for ongoing use and are first-line for moderate-severe allergic rhinitis.

Can allergies cause asthma?

Allergic rhinitis and asthma commonly coexist. Poorly controlled rhinitis makes asthma worse, and treating one usually helps the other.