Allergic Rhinitis: How to Prevent and Treat It?

The sunny days are here, and they are synonymous with forest walks and picnics on the grass. But for you, like millions of others, this period also marks the return of a persistent hay fever that will last until the fall. A nose that itches and tingles, sneezing, the constant feeling of having clogged ears, puffy eyes upon waking that water at the slightest walk in the fields... The return of the sunny days is not a pleasant experience for some. While the symptoms of allergic rhinitis are not serious, they remain quite difficult to manage daily.

It’s rather annoying to spend your time blowing your nose at a dinner with friends, to have irritated and swollen eyes during a professional meeting, or to sneeze every 5 minutes during a class or an exam.

Here’s how to identify this seasonal allergy, diagnose it, and explore possible treatments.

Allergic Rhinitis: Why Does Our Nose Itch?

Often overlooked by patients who do not consider themselves truly ill, allergic rhinitis is a reaction of the nasal walls to the presence of an external substance capable of triggering an allergic response.

Rhinitis: An Inflammation of the Nasal Mucosa

This substance (then called an allergen) triggers a response from certain immune cells that produce an excessive amount of antibodies (Immunoglobulin E or IgE) in the nasal mucosa, which is the lining inside the nose.

This production is also accompanied by the dilation of blood vessels and the local release of irritating substances.

Since this reaction occurs locally in the entire ENT area, it’s not just the nose but also all the organs connected to it that are affected: the back of the throat, the middle ear, and the eyes.

Allergic Rhinitis in Numbers

25% of the population experiences allergic rhinitis every year, indicating a predisposition to allergies or a sensitivity to certain specific allergens among those affected.

What Is the Difference Between a Cold and a Runny Nose Due to Rhinitis?

While some symptoms of a cold and rhinitis are very similar, the causes are quite different because they are not the same condition.

A cold is an illness that generally affects people with weakened immune systems, usually during sudden temperature changes. If well-treated, it disappears in a few days. Rhinitis, on the other hand, is a recurring condition affecting individuals prone to allergies. Its prevalence increases when there is an increase in pollen in the air, particularly during the spring. The symptoms are similar, but the treatment and prevention of colds and rhinitis are very different!

What Are the Symptoms of Rhinitis?

The symptoms of allergic rhinitis are well known to those who suffer from this condition and can be very bothersome when they occur.

Irritation in the ENT Area (Nose, Throat, Sinuses)

Due to the irritation of the ENT area and the inflammation of the sinuses, a multitude of symptoms are triggered, with varying intensity depending on the individual. Repeated irritation eventually affects the nasal walls, making them more fragile and more sensitive to infections.

Nasal Symptoms:

• Nasal discharge
• Blocked nose
• Itchy nose
• Urge to sneeze

The most common symptom remains a constantly runny nose, with clear nasal discharge like water (known as aqueous rhinorrhea).

Eye Symptoms:

There are often also signs at the level of the eyes: tearing, itching, a feeling of having irritated and swollen eyelids.

Ear Symptoms:

A sensation of having clogged ears is also often associated, linked to the thickening of the Eustachian tube walls, these small channels that go from the throat to the middle ear and are responsible for balancing the pressure between the inside and outside of the eardrum.

What Causes Rhinitis?

In many cases, pollen triggers these attacks: this is then called seasonal allergic rhinitis, or "hay fever."

Indeed, pollen is especially present depending on the region between February and September. However, they are not allergenic by themselves; to have this characteristic, they must contain proteins that are recognized by the immune system and trigger a reaction. The presence of these types of proteins can vary considerably from one region to another, even for pollen from the same species of trees. Moreover, allergenic pollen is only that which is spread by the wind and can thus be inhaled by allergic people; pollen spread by insects does not cause hay fever attacks. Among the plants producing the most allergenic pollen, we can mention grasses (meadow grasses), mugwort, ragweed, nettle, cypresses, birches, oaks, and plane trees.

When the allergenic substance is permanently present in the environment, symptoms persist throughout the year, and this is referred to as perennial allergic rhinitis. This type is primarily due to "domestic" elements: pet hair, feathers; household dust (including the infamous dust mites), cockroaches, etc.

How to Diagnose Allergic Rhinitis?

The hay fever you have been suffering from for years is not a fatality, so do not hesitate to talk to your general practitioner if you frequently experience the symptoms mentioned. They will first try to rule out another cause of rhinitis and nasal discharge by conducting a detailed examination of your throat and nose and will also look for signs of allergies that could be located elsewhere on your body (eczema, asthma, etc.). A thorough interview will help them assess your medical history: if other signs of allergy have already been observed, if other family members have allergies, etc. “When a child has one allergic parent, they have a 50% chance of developing an allergy,” says Dr. Julien Cottet, an allergist. “This rises to an 80% chance if both parents are allergic.”

How to Prevent This Allergy and Avoid ENT Discomfort (Nose and Sinuses)?

Prevention of Seasonal Rhinitis

In the case of seasonal allergic rhinitis, a preventive treatment with antihistamines can be prescribed: it often helps to completely avoid the onset of symptoms and in all cases, significantly reduces them. This treatment should be started at the beginning of the period when your hay fever and associated symptoms usually occur. In the case of pollen allergies, it is also advisable to limit exposure to allergens by following a few recommendations. Allergist Dr. Cottet mentions several tips:

• Open windows only early in the morning or late at night after sunset.
• Wear a mask.
• Shower in the evening to remove accumulated pollen from your hair.
• Wear glasses so that pollen grains stick to the lenses and do not reach the eyes.
• Do not dry laundry outside.
• Do not open the car window.
• Avoid mowing the lawn.

Prevention of Perennial Rhinitis

For perennial rhinitis, it is essential to manage the environment:

• Avoid carpeting.
• Treat all textile items with acaricides in bedrooms.
• Use treated covers in case of dust mite allergies.
• Avoid close contact with animals, and if you have pets, it’s best to keep them out of the bedrooms. Depending on the nature of the allergenic substance, take the necessary measures to reduce contact and inhalation. Using a pollen filter in the car can also reduce exposure to allergens.

Which Medication to Use for an Itchy Nose Due to Rhinitis?

Regardless of the type of allergic rhinitis, symptomatic drug treatment includes courses of antihistamines or nasal corticosteroid sprays, either combined or not. For cough, Ventolin may be prescribed.

How to Treat Chronic Rhinitis Permanently?

Apart from antihistamines administered initially, desensitization—now predominantly prescribed sublingually—is the only treatment that acts durably on the cause of the allergy. The goal is to favorably modify the course of the disease.

Also known as allergen immunotherapy, it applies to patients who suffer from allergies to dust mites, pollen, or even hymenoptera venom.

It involves "finding the starting point of the allergy to change the patient’s immune system. To do this, a dose of the allergen must be administered daily," explains Dr. Cottet. "It works very well and reduces asthma. We have success rates above 90% in children." For pollen allergies, the ideal time to start is 4 months before the pollen season, continuing for six months, for at least three consecutive seasons. "The first effects occur as early as the first year," he adds. Of course, the first thing to do is to avoid contact with the substances responsible for your allergic rhinitis as much as possible... Not always easy!

Natural Remedies: Are Essential Oils Effective?

According to the Pasteur Institute of Lille, several plants (and therefore essential oils) could be interesting in combating seasonal allergies due to their anti-allergenic properties: this is the case with tarragon essential oil, in particular. To help decongest the nose and sinuses, thyme will be your ally, in the form of essential oil for inhalation (or by placing a few drops on a handkerchief). True lavender, on the other hand, reduces the urge to sneeze.