Allergic Rhinitis

Key facts

• Allergic rhinitis is an immune reaction in the nasal lining triggered by airborne allergens, mainly affecting the nose, eyes, and throat.
• The hallmark symptoms are sneezing, a clear runny nose, nasal blockage, and itchy or watery eyes; poor sleep and fatigue from nasal obstruction are common but under-recognised.
• Treatment usually combines an antihistamine, such as bilastine or cyproheptadine, with a nasal corticosteroid spray such as fluticasone or budesonide; montelukast helps when asthma is also present.
• See a doctor for symptoms that persist despite treatment, one-sided blockage, bloody discharge, loss of smell, or severe facial pain.

What the symptoms look like

The hallmark cluster is sneezing (often in runs), a clear runny nose, nasal blockage, and itchy or watery eyes. Some people also notice an itchy palate or ears. Symptoms can be intermittent, tied to a specific exposure like a cat or a dusty room, or persistent, present most days. In humid climates, year-round dust-mite and mould exposure means symptoms rarely follow a neat "season" the way they do in drier, temperate regions, where tree pollen instead produces sharp seasonal spikes.

Choosing the right treatment approach

Avoiding triggers where practical is the first step, but it's rarely enough on its own. For most people, treatment combines an antihistamine with a nasal corticosteroid spray. Antihistamines such as bilastine or cyproheptadine reduce sneezing, itch, and watery discharge quickly. Nasal sprays containing fluticasone or budesonide target congestion and inflammation at the source and work best used consistently rather than just on bad days. For rhinitis complicated by asthma or exercise-induced wheeze, montelukast addresses both airways together. Topical antihistamine sprays such as azelastine act within minutes and suit those who prefer not to take a daily tablet; these sit within the broader respiratory health range of treatments.

When to seek further assessment

Rhinitis is rarely dangerous, but a few patterns warrant medical attention: symptoms that persist despite treatment, one-sided nasal blockage or bloody discharge, loss of smell, or severe facial pain. These may point to a structural issue or a different diagnosis rather than simple allergy.

This page is educational and does not replace advice from a doctor or pharmacist who knows your health history.