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Johns Hopkins Health Alert

Finding Relief From Allergies

With some 10% to 30% of adults suffering form allergic rhinitis, the condition can seem as ubiquitous as pollen on a dry spring day. Because it is so common and causes few obvious complications, sufferers often don't seek treatment for their condition. But lifestyle changes, medication, and even allergy shots can help many people find relief.

Allergic rhinitis is an immune response to an airborne allergen, and its symptoms occur in two phases -- a response immediately upon exposure and a delayed response. Immediate symptoms include an itchy, runny nose; sneezing; and itchy, watery eyes. The main delayed symptom is nasal congestion.

If untreated, allergic rhinitis may decrease quality of life even further by leading to chronic nose blowing, fatigue, sleep problems, and difficulties with learning and concentration. It may also contribute to asthma, inner ear or respiratory infections, and nasal polyps.

There are two types of allergic rhinitis: seasonal and perennial. Seasonal allergic rhinitis, sometimes called hay fever, is triggered by outdoor, seasonal allergens such as pollen from trees, grasses, and weeds as well as outdoor molds. Perennial allergic rhinitis is caused by allergens that can be in the home year-round -- for example, animal dander, indoor mold, and droppings from dust mites and cockroaches. Rhinitis can also be nonallergic -- in which case symptoms are caused by irritants in the air and do not involve an immune-system reaction.

Treatment Strategies -- Treatment for allergic rhinitis involves limiting exposure to specific allergens and often taking medication to control symptoms. Allergy shots may help those who don't respond adequately to these measures.

  • Limiting exposure. The first step is to try to avoid, if practical, your allergens. Steps may include keeping house and car windows closed and using air conditioning with a regularly cleaned filter system whenever possible if you are allergic to pollen; frequently dusting, vacuuming, and washing sheets and blankets to avoid dust mites; and limiting exposure to family pets to avoid pet dander.
  • Medications. Medications such as oral antihistamines and inhaled antihistamines are first-line medications for mild to moderate symptoms of allergic rhinitis. These medications are best at targeting immediate symptoms such as a runny nose, itching, and sneezing as well as allergic conjunctivitis. For patients with more severe symptoms, inhaled corticosteroids are considered first-line treatments.
  • Immunotherapy. Patients whose symptoms persist despite lifestyle and medication treatment may need immunotherapy ("allergy shots"). This treatment involves a series of injections (over three to five years) of a diluted form of the patient's particular allergens. Over time, an immunity should develop to the allergens, potentially decreasing reactions.

Posted in Healthy Living on May 13, 2009
Reviewed July 2009

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Health Alerts registered users may post comments and share experiences here at their own discretion. We regret that questions on individual health concerns to the Johns Hopkins editors cannot be answered in this space.

The views expressed here do not constitute medical advice, and do not represent the position of Johns Hopkins Medicine or MediZine LLC, which has no responsibility for any comments posted on this site.


Regarding your allergy article posted May 13, 2009: You did not mention regular, home nasal irrigation as an adjunct treatment for nasal allergies. This treatment works for me and seems to be supported by research.

Posted by: robertr | May 13, 2009

I didn't know that AR occured in two phases, in fact, I used to think that all symptoms could be present at the same time and in first instance. Here is a detailed video about Allergic Rhinitis: http://www.symposier.com/video/263/Allergic-rhinitis

Posted by: Symposier | July 9, 2009



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