Allergic Rhinitis
Allergic rhinitis is an IgE-mediated allergic response in the nose, guided by the AAAAI/ACAAI Joint Task Force practice parameters and the 2024 JAMA review.
Symptoms
Sneezing, itchy or runny nose, nasal congestion, and itchy or watery eyes, often seasonal or tied to specific triggers.
Causes and risk
Pollen, dust mites, pet dander, and mold are the most common triggers; a personal or family history of allergic conditions (asthma, eczema) raises risk.
How it is evaluated
Diagnosis rests mainly on history; skin or specific-IgE testing is added when symptoms are uncontrolled or when identifying the specific trigger would change management.
Treatment
Intranasal corticosteroids are first-line for persistent or moderate-to-severe disease per AAAAI/ACAAI and the AAO-HNS clinical practice guideline. Second-generation oral or intranasal antihistamines suit mild or intermittent symptoms, and combining an intranasal antihistamine with an intranasal steroid improves control further. Allergen immunotherapy is the disease-modifying option for people who remain inadequately controlled.
When to seek care
Unilateral symptoms, nosebleeds, loss of smell, or clear fluid that might be cerebrospinal fluid are red flags suggesting a different diagnosis and warrant evaluation rather than allergy treatment.