Perennial allergic rhinitis, also known as perennial hay fever, is a chronic allergic condition that doesn't subside throughout the year and causes nasal congestion and a runny nose. You may feel like you have a permanent cold that does not go away. Perennial means occurring throughout the year.

Dust mites are the most common cause of perennial allergic rhinitis but it can be caused by any allergy that is present year-round. The other causes are dander, ticks from cats and dogs, pollen, and molds. Perennial allergic rhinitis can also be triggered by indoor pollen such as saliva on pet dander, urine, dried flaky skin, etc.

Perennial allergic rhinitis causes a type of inflammation (redness, warmth, swelling, and pain around the tissue, that occurs as your body’s response to injury/illness) in the nose when you breathe in certain allergens. This condition, not very severe in most cases, can be treated with simple medications and remedies.

An allergy occurs when you react to substances in the environment that are harmless to most people. These substances that are recognized by the immune system and cause a reaction are known as allergens. 

How to Identify Perennial Allergic Rhinitis

It might be difficult for you to differentiate between a cold or the flu and a perennial rhinitis allergy. Striking characteristics of perennial allergic rhinitis such as sneezing, watery, itchy eyes, and sore throat; fever, headaches or body aches, etc., for more than 2 weeks, can help you differentiate.

If your allergic rhinitis is caused by asthma (a chronic condition in which your airways swell and inflame) or other respiratory conditions, it can present with body aches and fatigue.

Symptoms 

  • Sneezing 

  • Itchy eyes, runny nose (most common symptom)

  • Nasal congestion 

  • Postnasal drip (when your nose or your sinuses produce extra mucus and it drips down from the back of your throat)

  • Sometimes, you may experience a loss of sense of smell, mainly due to a blocked or congested nose. 

  • Cough. After postnasal drip, the mucus in the throat will cause chronic cough and sore throat.

Diagnosis

The easiest way to diagnose is if you are suffering from more than one perennial allergic rhinitis symptom. Your doctor may perform the following tests:

  • Skin Prick Tests are used to confirm if you are allergic to a substance. Small quantities of various allergens are injected under the skin of the forearm to see if they excite an allergic response. A positive test will show a response that includes redness, swelling, and itching.

  • Radio Allergo Sorbent Testing (RAST testing) is similar to a skin prick test. However, it is more expensive and so is only used if the skin prick test is not suitable or unavailable.
    Various allergens are exposed to a blood sample taken from you and the levels of antibodies produced are measured. Antibodies are a protective protein produced in the blood to fight the disease (allergy) in the presence of a foreign substance.

Treating Perennial Hay Fever With Medications and Home Remedies

Over-the-counter (OTC) medications such as decongestants and antihistamines are helpful. 

  • Antihistamines are generic drugs to treat allergies and allergic rhinitis.

  • Decongestants (medications in the form of sprays, nose drops, eye drops, etc.) are used to relieve a stuffy nose and postnasal drip that can cause hay fever cough.

You can also take the help of home remedies to reduce your symptoms and get relief. Try:

1. Inhaling steam. Steam inhalation from an electric steamer or from a hot shower will open up your blocked nasal passages and moisten them, preventing them from drying out due to the warmth from the steam.

2. Saline Nasal Irrigation. When rinsed through your nasal passages, saline (salt water) can wash away allergens, mucus, and other debris, and help to moisten the mucous membranes.

3. Use Air Purifiers. HEPA (high-efficiency particulate air) filters are a type of mechanical air filter, which works by forcing air through a fine mesh that traps harmful allergy-causing particles such as pollen, pet dander, dust mites, and tobacco smoke. You can find HEPA filters in most air purifiers.

4. Eat Foods Rich in Bromelain. Papaya and pineapple contain the enzyme bromelain. Natural healers consider bromelain to be effective at improving breathing by reducing swelling. Try to include papaya or pineapple in your diet to reduce the incidence of allergic rhinitis. 

5. Consume Probiotics. Including probiotics like curd, idli, fermented soya bean, etc., can help improve symptoms of allergic rhinitis due to their antihistamine action. 

6. Spirulina Powder. Spirulina is a blue-green alga, which has antiallergic protective effects towards allergic rhinitis. It helps in improving the symptoms of allergic rhinitis like nasal discharge, sneezing, nasal congestion, and itching by blocking histamines. Add spirulina powder in your smoothies or juices for maximum effect. 

7. Stinging Nettle Leaves. Natural healing practitioners suggest stinging nettle as a natural antihistamine to help with allergy treatment. Add leaves to boiling water and let it sit for about 5 to 7 minutes. Strain it and drink it fully.

8. Eat Quercetin. Quercetin (a plant pigment) stabilizes the release of histamines and helps to control allergy symptoms. It’s naturally found in broccoli, cauliflower, green tea, and citrus fruits.

9. Use Peppermint & Eucalyptus Oil.  These oils work by decreasing inflammation, have anti-inflammatory effects that reduce the symptoms of bronchial asthma and allergic rhinitis. 

You can consume peppermint tea or add peppermint oil to your humidifiers. Eucalyptus essential oil is an antimicrobial agent and you can add it to each load of wash during the allergy season. You can use eucalyptus oil as a room freshener in oil diffusers. 

Prevention

The most important way to prevent perennial allergic rhinitis is by avoiding the allergens, triggers, or the condition which causes the symptoms. If you have frequent episodes of perennial allergic rhinitis, it might help to:

  • Keep windows closed, especially during high-pollen seasons (during the months of spring).

  • Wash your hands immediately after coming home from outside, petting animals, or playing/walking in the garden.

  • Keep your bedding and mattresses clean. Vacuum them regularly to get rid of dust mites and molds.

  • Wear glasses, when outside to protect your eyes from dust, pollen, etc.

If you know the cause/allergen of your rhinitis, it is advisable to stay away from the allergen by staying indoors, keeping the doors and windows closed, and washing your hands frequently, and changing clothes regularly. If your symptoms don’t go away for more than 2 weeks, get yourself checked with an allergy specialist/ENT/general physician.


References:

1. The American Academy of Allergy, Asthma & Immunology. 2021. Rhinitis | AAAAI. [online] Available at: <https://www.aaaai.org/conditions-and-treatments/allergies/rhinitis> [Accessed 8 March 2021].

2. ACAAI Public Website. 2021. Hay Fever (Rhinitis) | Symptoms & Treatment | ACAAI Public Website. [online] Available at: <https://acaai.org/allergies/types/hay-fever-rhinitis> [Accessed 8 March 2021].

3. Aafp.org. 2021. Diagnosing Rhinitis: Allergic vs. Nonallergic. [online] Available at: <https://www.aafp.org/afp/2006/0501/p1583.html> [Accessed 8 March 2021].


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