SEASONAL AND PERENNIAL ALLERGIC RHINITIS
|Marie Cavuoto Petrizzo MD, FAAAI
Board Certified Pediatric & Adult Allergist and Immunologist
About the author: Dr. Marie Cavuoto Petrizzo is an allergist-immunologist in Rockville Centre, New York. She is affiliated with multiple hospitals in the area, including Long Island Jewish Medical Center and North Shore University Hospital. She received her medical degree from Albany Medical College and has been in practice for 15 years. Dr. Cavuoto currently sits on the executive board of the Long Island Allergy and Asthma Society, is a fellow of the American Academy of Allergy, Asthma and Immunology, and a member of the American College of Allergy, Asthma and Immunology.
WHAT EXACTLY IS “SEASONAL” AND “PERENNIAL” ALLERGIC RHINITIS?
Often referred to as “hayfever” or “rosefever” symptoms including runny nose, sneezing, congestion, postnasal drip, itchy nose or throat, when caused by an allergen, are classified as “allergic rhinitis.” Allergic rhinitis affects 20 to 40 million people living in the US and accounts for impaired quality of life, and missed days of work or school. It is common for allergic rhinitis symptoms to appear in childhood and can wax and wane over an individual’s lifetime.
Technically allergic rhinitis is inflammation of the nasal passages. This inflammation occurs when an allergen (usually an airborne particle) enters the nose (or lungs or eyes) causing cells in the body to react, releasing chemicals, which cause the symptoms mentioned above.
Seasonal allergic rhinitis accounts for 20% of cases of allergic rhinitis. As the name implies, the symptoms occur seasonally, corresponding with the prevalence of outdoor allergens including tree pollens, grass pollens, weed pollens and mold spores. Commonly patients complain of watery nose, sneezing, itchy eyes/throat/ears, postnasal drip, coughing and hoarseness. Symptoms remit once the season has ended. Perennial allergic rhinitis is defined as symptoms lasting more than 9 months of the year and accounts for 40% of cases of allergic rhinitis. Allergens triggering perennial symptoms tend to be those an individual is continuously exposed to, including dust mites, house pets (cats, dogs), roaches, and mold. Since these exposures are ongoing, patients tend to experience more congestion, nasal blockage and a decreased sense of smell. 40% of patients have both seasonal and perennial allergic rhinitis. Left untreated, allergic rhinitis can lead to asthma, headaches, sinusitis, and nasal polyps. Cosmetically patients can develop dark circles beneath their eyes, a horizontal crease across the nose and even an elevated palate in the mouth.
Allergen avoidance is the key to preventing symptoms. For seasonal allergic rhinitis, patients must keep their windows closed at all times and run air conditioners (and air purifiers) when possible to keep pollen from entering the home. Similarly car windows should remain closed. If outdoors for an extended time, shower and wash hair once returning home. Wearing sunglasses and a hat when outdoors also reduce symptoms.
For perennial causes, removing the pet from the home is ideal. If this is not desired, keeping the animal out of the bedroom with bedroom doors closed can be of benefit. Consider running an air purifier. If the symptoms are due to dust mites, purchasing dust mite encasings for the mattress and pillows can reduce exposure. Hardwood flooring is preferred to carpet. Bedding should be washed in hot water in order to kill surface dust mites.
If despite all your best efforts, symptoms are still occurring, medications or allergy shots may be indicated. Nasal saline can irrigate the nose, washing away allergens, and reduce nasal mucous. Medications include oral antihistamines, decongestants, nasal steroids, and nasal antihistamines and may block symptoms from occurring. Allergy shots may provide a long-term cure since they can desensitize patients to their allergic triggers. Seek the advice of your local allergist to find relief.