Treating allergic rhinitis

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.

Self-help

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 andhalf a teaspoon of bicarbonate of soda (baking powder) into a pint (568ml) of boiled water that's been left to cool to around body temperaturedo 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

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.

Visityour GP if your symptoms don't respond to medication after two weeks.

Antihistamines

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 sometimescause 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.

Corticosteroids

If you have frequent or persistentsymptoms 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 youhave a particularly severe bout of symptoms and need rapid relief, your GPmay prescribe a short course of corticosteroid tablets lasting5 to 10 days.

Add-on treatments

If allergic rhinitis doesn't respond to treatment,your GPmay choose toadd to your original treatment.

They maysuggest:

• 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 spraythat 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 calledleukotrienes, 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

Immunotherapy, also known as hyposensitisation or desensitisation,is another typeof treatment used for some allergies.

It's only suitable for people with certain types of allergies, such as hay fever , andisusually only considered if your symptomsare severe.

Immunotherapy involvesgradually introducing more and more of the allergen into your body to makeyour immune systemless sensitive to it.

The allergen isoften 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 outusing tablets that containan allergen, such as grass pollen, whichareplaced under your tongue.

When a dose is reached that's effectivein reducing your allergic reaction (the maintenance dose), you'll need to continue with the injections or tablets for up to threeyears.

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.