Allergic Rhinitis
Also known as: Allergic rhinitis, Hay fever, Seasonal allergic rhinitis, Perennial allergic rhinitis, IgE-mediated allergic rhinitis, Pollinosis
Allergic rhinitis is an IgE-mediated inflammatory disease of the nasal mucosa triggered by exposure to allergens such as grass pollens, tree pollens, weed pollens, house dust mites, mould spores and animal dander. Symptoms include repetitive sneezing, nasal itching, clear rhinorrhoea, nasal congestion, itchy palate, itchy throat, watery itchy eyes and postnasal drip. Fatigue, impaired concentration and disturbed sleep frequently occur because of chronic nasal obstruction. Allergic rhinitis commonly coexists with asthma, eczema, chronic rhinosinusitis and allergic conjunctivitis. Diagnosis is based on clinical history supported where appropriate by skin-prick testing or allergen-specific IgE testing. First-line biomedical management includes allergen avoidance where practical, regular intranasal corticosteroids, oral or intranasal antihistamines, saline irrigation and allergen immunotherapy in selected patients. Traditional Chinese Medicine commonly differentiates Wind-Cold, Wind-Heat, Lung Qi deficiency, Spleen Qi deficiency with Dampness, Kidney Yang deficiency or Lung-Kidney deficiency. Acupuncture and Chinese herbal medicine may provide adjunctive symptom management but should never replace emergency treatment of anaphylaxis, severe asthma or significant respiratory disease.
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Lifestyle & Diet
- •Identify and minimise allergen exposure where practical[1].
- •Use HEPA filtration when appropriate.
- •Wash bedding in hot water weekly to reduce dust mite exposure.
- •Shower after high pollen exposure.
- •Monitor pollen forecasts during allergy season.
- •Use saline nasal irrigation with sterile or previously boiled water[1].
- •Follow prescribed intranasal corticosteroid therapy[1][3].
- •Manage co-existing asthma and eczema appropriately[2].
- •Consider allergen immunotherapy after specialist assessment[1].
Cautions & Contraindications
- •Do not use acupuncture instead of adrenaline for anaphylaxis.
- •Do not stop prescribed corticosteroid nasal sprays without medical advice.
- •Avoid unprocessed toxic herbs.
- •Review herb-drug interactions before prescribing.
- •Avoid herbal formulas during pregnancy unless appropriately prescribed.
When to reassess or seek care again
- •New unilateral nasal obstruction or blood-stained discharge
- •Persistent facial pain, fever or orbital swelling suggesting sinusitis
- •Worsening asthma control, night waking or exercise limitation
- •Anaphylaxis-type reaction to a suspected allergen
- •Loss of response to previously effective therapy
- •New systemic symptoms (weight loss, fatigue, night sweats) that don't fit allergic rhinitis
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Sources & Further Reading
Clinical guidance, red flags and safety notes on this page draw on the following current sources alongside the classical references above.
- National Institute for Health and Care Excellence
UK primary-care guidance on diagnosis, stepwise pharmacotherapy and referral criteria.
- Journal of Allergy and Clinical Immunology (Joint Task Force on Practice Parameters) · 2020
International guideline covering classification, treatment and the rhinitis–asthma link.
- Australasian Society of Clinical Immunology and Allergy
Australian practitioner reference on management, immunotherapy and anaphylaxis red flags.
- Cochrane Database of Systematic Reviews
Evidence review on acupuncture as adjunctive therapy for seasonal and perennial allergic rhinitis.
Educational reference for licensed practitioners. Not a substitute for individual clinical assessment. Refer to conventional care for any red-flag or undiagnosed presentation.