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Aalergic rhinitis

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allergic rhinitis treatment guideline intranasal corticosteroid official

Allergic rhinitis is an allergy-related inflammation of the nose, often called hay fever. It is triggered by allergens such as pollen, house-dust mites, mold, or animal dander.
Typical symptoms
  • Sneezing, especially in bouts
  • Itchy nose, throat, or eyes
  • Clear, watery runny nose
  • Blocked or stuffy nose
  • Watery, red eyes
  • Postnasal drip or cough
What helps
  1. Reduce exposure: keep windows closed during high-pollen days, shower after being outdoors, wash bedding weekly in hot water, and minimize dust and pet exposure if relevant.
  2. Saline nasal rinse/spray: helps clear mucus and allergens.
  3. Non-drowsy antihistamine: such as cetirizine, loratadine, or fexofenadine, particularly for sneezing/itching/runny nose.
  4. Steroid nasal spray: such as fluticasone, mometasone, or budesonide is usually the most effective option for persistent nasal blockage. It needs regular daily use and may take several days for full benefit. Current ARIA guidance generally favors intranasal corticosteroids over oral antihistamines when nasal symptoms are more troublesome, with combination intranasal antihistamine plus steroid used for more significant symptoms. See the ARIA guideline overview.
  5. Avoid decongestant nasal sprays such as oxymetazoline for more than 3 days, because they can cause rebound congestion.
See a clinician if symptoms persist despite treatment, interfere with sleep/asthma, occur year-round without a clear trigger, or you have facial pain, fever, thick colored discharge, recurrent nosebleeds, or one-sided blockage. Allergy testing and allergen immunotherapy may help when symptoms are persistent and triggers are identifiable.
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