An allergy is defined as a condition characterized by an exaggerated response of the immune system to a foreign substance called allergens. It is a hypersensitive reaction in view of the natural defense mechanism against foreign bodies through IgE antibodies. Allergens are usually common substances found in the environment. These include pollen, certain food contents, insect bites, plant extracts, metal etc. Allergic reaction can also be triggered by certain medications and chemicals. The symptoms present itself as rashes, hives, red eyes, itchiness, runny nose, swelling, breathing difficulties, throat discomfort, fever etc. The most common type of allergies includes nasal allergies or allergic rhinitis, food allergies, contact dermatitis, allergic asthma and seasonal allergies.
What is Nasal Allergy?
Nasal allergy is one of the most common types of allergic reaction. It is also known as allergic rhinitis or hay fever. Nasal allergies are characterized by nasal discomfort, sneezing, stuffy nose, sore throat, watery eyes etc. There are 2 kinds of nasal allergy. These are:
- Seasonal Allergies: This is caused by sensitivity to pollen. The amount of pollen in the environment increases during certain times of the year. Hence, the incidence of seasonal allergies rises during those seasons.
- Perennial Allergies: This type of allergy is common throughout the year. This is generally caused by hypersensitivity to pets, dust mites, cockroaches etc.
Causes of Nasal Allergy
When an individual with nasal allergy inhales the causative agent, it provokes the immune system of the body to release chemical stimulants and antibodies. These are proteins that release histamine, which cause the blood vessel to dilate and release chemicals that brings about a chain of reaction. These reactions present itself as inflammation, swelling, skin reactions, respiratory issues etc. Besides pollen other causative agents of nasal allergy include:
- Grass.
- Animal dander.
- Mold.
- Cat saliva.
- Dust.
- Certain food and perfumes.
- Cockroaches.
- Cigarette smoke.
- Fumes and vehicle exhaust.
Seasonal allergies are caused by change in seasons based on the presence of pollen in the environment. Tree and flower pollen are common in spring whereas grasses and weed are more common in summer and fall.
Signs and Symptoms of Nasal Allergy
Symptoms of nasal allergy usually start shortly upon exposure to the allergen. These symptoms include:
- Itchy nose.
- Itchiness in eyes, mouth and throat.
- Nasal discharge.
- Continuous sneezing.
- Smell issues.
- Watery eyes.
- Skin reactions such as hives, dryness, and itchiness.
Most of the nasal allergy symptoms develop immediately when the individual comes in contact with the triggering agent. However, certain symptoms of nasal allergy develop gradually at a later stage. These include:
- Stuffy nose.
- Cough.
- Sore throat.
- Postnasal drip.
- Clogged ears.
- Decreased sense of smell.
- Headache.
- Fatigue.
- Swelling and puffiness of nose and face.
The magnitude of these nasal allergy symptoms varies from person to person. While some people may experience upon exposure to small quantity of the allergen, some may need exposure to a larger quantity to elicit the same response.
Epidemiology of Nasal Allergy
Nasal allergy is a very common medical condition and can affect an individual at any age. Studies have shown that about 10 to 30 percent of the world’s population may have nasal allergy. In the United States, 8 percent of the adult population have a history of nasal allergy or allergic rhinitis.
Prognosis of Nasal Allergy
Most of the symptoms associated with nasal allergies are treatable. Severe cases may need allergy shots. It has been seen that many individuals outgrow an allergy on recurrent exposure to the same allergen. This is generally seen in children, who become less sensitive to the allergen as they grow older. However, pollen in particular can have long-term effect.
Risk Factors of Nasal Allergy
Risk factors of nasal allergies include exposure to external agents such as:
- Cigarette smoke.
- Pollution.
- Chemicals.
- Smokes, fumes, exhausts.
- Daily toiletries such as hairspray, perfumes, colognes etc.
- Weather changes such as cold temperature, humidity, and windy weather.
Besides the above, a known family history of allergic rhinitis increases the risk of developing allergies.
Diagnosis of Nasal Allergy
The first step in diagnosis of nasal allergy would be a through physical examination by an experienced professional. Obtaining a detailed case history is very important in allergic rhinitis as it can help in identifying the causative agent. Certain tests may be performed for further evaluation and management. Specialized allergy tests are usually carried out by an allergist or an immunologist. These include:
- Skin Prick Test to Diagnose Nasal Allergy: Here the suspect is exposed to multiple substances to check how the body reacts upon exposure. It helps in identification of the allergen.
- RAST to Diagnose Nasal Allergy: RAST (Radioallergosorbent test) is a special blood test that is used to measure the production of IgE antibodies upon exposure to the suspected allergen.
Treatment of Nasal Allergy
- Anti-histamine Drugs to Treat Nasal Allergy: These drugs control the reaction by inhibiting the production of histamines. E.g.: Allegra, Claritin, Zyrtec, Clarinex, Xyzal.
- Decongestants to Manage Nasal Allergy: Decongestants help in management of stuffy nose and sinus discomfort. E.g.: Sudafed, Zyrtec-D, Afrin nasal spray.
- Eye Drops and Nasal Sprays: These drugs provide symptomatic relief for a short period of time from nasal allergy. Over usage of these drugs can have a rebound effect and lead to secondary infections.
- Corticosteroids: Steroids can help in controlling inflammation and other immune responses. They are usually administered in the form of injections, creams, eye drops or as nasal sprays.
- Immunotherapy: In extreme cases, allergy shots may be considered to treat nasal allergy. This may be used in conjunction with other medications.
- Treating Nasal Allergy with SLIT (Sublingual immunotherapy): This works by placing a mixture of multiple allergens under the tongue. E.g. Oralair.
- Home Remedies to Treat Nasal Allergy: Specific remedies based on the causative agents are suggested to control the allergy. E.g. use of air conditioner instead of fresh air, use of air filter or HEPA filter etc. in case of dust or pollen related nasal allergy.
Prevention of Nasal Allergy
Individuals with a history of nasal allergy should take utmost care to avoid exposure to the specific agents. In case of seasonal nasal allergies, it is advised to start medications before the season starts. The following tips are advised to prevent nasal allergies:
- Limit outdoor activities.
- Take immediate shower post outdoor activities.
- Cover mouth and nose while doing yard work.
- Take adequate measure for maintaining pet’s hygiene.
- Avoid carpets at home.
Conclusion
Nasal allergies or allergic rhinitis is a common form of allergy. It is most commonly caused by exposure to pollen. However, less frequently it is caused by other allergens such as dust, pets, food, etc. It is usually associated with symptoms such as nasal congestion, watery eyes, itchy throat etc. Treatment modality for nasal allergy includes administration of medications such as antihistamines, decongestants, steroids. Other treatment plan includes immunotherapy and SLIT. Nasal allergy can be very irritating or frustrating if it starts and hence appropriate measures must be taken to avoid the onset. However, if it does, nasal allergies are easily manageable and treatable.
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