Causes and Symptoms of Chronic Rhinitis

Chronic rhinitis is best described as a set of symptoms that persists for months or even years. These symptoms usually consist of a runny nose, an itchy nose, sneezing, congestion, or postnasal drip. Depending on the root cause of your rhinitis, it may be further classified as allergic or non-allergic.

Allergic Rhinitis

Allergic rhinitis is a common condition and even when you are able to identify a trigger for your symptoms, the condition can still become chronic in nature. This may be because you have multiple allergies and the triggers are difficult to avoid because you do not respond well to treatment or other factors.

In addition to nasal symptoms, many people with allergic rhinitis suffer from itchy or watery eyes. Controlling the symptoms of chronic allergic rhinitis is important to prevent complications such as chronic sinusitis.


If your specific allergies have not yet been identified this can be an important first step in managing your condition. This is often done by a specialist called an immunologist but can also be ordered by an allergist, ear, nose, throat doctor (otolaryngologist) or even a general practitioner. The most common culprits for year-round (perennial) chronic rhinitis are dust, mold, and pet dander.

Once your allergy triggers have been identified you should take measures to avoid them if possible. For example, if you are allergic to dust mites regular cleaning and reducing the humidity in your home may be helpful. If you are allergic to pet dander, keeping your pets out of your bedroom at night can help to control your symptoms. 


Your symptoms may also be controlled with medications such as antihistamines. Many different antihistamines are currently available over-the-counter in the United States including diphenhydramine, loratadine, cetirizine, and fexofenadine. Astepro (azelastine hydrochloride) is a nasal spray that has also been approved for nonprescription use.

Second-generation antihistamines such as loratadine, fexofenadine, and cetirizine tend to be less sedating than first-generation antihistamines such as diphenhydramine. It's a good idea to consult your healthcare provider or pharmacist before taking an antihistamine. Make sure you inform them of any allergies you have as well as other medications you might be taking.

Nasal decongestants can be used in addition to antihistamines to help control your symptoms. While Afrin (oxymetazoline), a nasal vasoconstrictor, is available over-the-counter, it is more likely to cause rebound congestion than prescription nasal decongestants if used for more than three days.

allergic reaction triggers
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You may also wish to try a neti pot or a cool-mist humidifier to help you to control symptoms. These are available at most drug stores and can help to thin your secretions, relieving symptoms such as congestion and postnasal drip.

You should also be aware that symptoms such as a fever, extreme fatigue, foul-smelling nasal discharge, facial pain, or toothaches can be symptoms of a sinus infection—a common complication of allergic rhinitis. If you have these symptoms you should see a healthcare provider since additional treatment may be needed (such as antibiotics).

Chronic Non-Allergic Rhinitis

You've probably guessed, but non-allergic rhinitis is rhinitis that is not caused by an allergy or an infection. This condition may also be called non-infectious rhinitis, idiopathic rhinitis, vasomotor rhinities, or intrinsic rhinitis. Symptoms must persist for no less than a year to be considered chronic.

Chronic non-allergic rhinitis is characterized by the same symptoms as allergic rhinitis, specifically nasal symptoms such as congestion and runny nose. However, people with non-allergic rhinitis rarely experience eye symptoms.

People with this condition may also be extremely sensitive to strong odors. Coping with non-allergic rhinitis can be tricky since pinning down a cause for your symptoms can be difficult. 

Depending on the root cause of your non-allergic rhinitis you may be at risk for developing complications such as sinus infections or nasal polyps.

If symptoms of rhinitis are accompanied by fever, facial pain, headaches, toothache, extreme fatigue, or foul-smelling nasal discharge, see your healthcare provider immediately. This may be a sign of a sinus infection in need of antibiotic treatment.

Conditions that mimic chronic non-allergic rhinitis include rebound congestion, medication side effects, and laryngopharyngeal reflux.


It's worth noting that even though people with non-allergic rhinitis have negative skin testing for allergies some studies show that up to half of people with the condition have localized allergic reactions (mainly in the nasal passageways). There are many other theories as to what causes this condition, many including abnormalities in the nervous system.

Even though it can be hard to pin down the exact cause of your symptoms some triggers have been identified. These include cold weather or extreme temperature changes, eating spicy foods, and exposure to chemicals or other substances that may be irritating (for example air pollution).

You may need to keep a journal to help to identify things that trigger your symptoms so that you can do your best to avoid these triggers. 


Medications can be used to cope with the symptoms of chronic non-allergic rhinitis but most people with this condition find oral antihistamines unhelpful.

Over-the-counter oral decongestants such as pseudoephedrine or phenylephrine may or may not be helpful in controlling your symptoms. Just make sure you consult your healthcare provider or pharmacist before trying these and be aware of decongestants that can cause rebound congestion when used longer than three days at a time.

Medications that aid in the treatment of chronic non-allergic rhinitis include intranasal steroids like fluticasone, an intranasal antihistamine called azelastine, and an intranasal bronchodilator called Atrovent (ipratropium).

There is also a newer nasal spray called Dymista that contains both fluticasone and azelastine. All of these medications are available in the United States and some require a prescription. Your healthcare provider can help you to decide if one or a combination of these is right for you.

Other things that may help you to cope with chronic non-allergic rhinitis may include using a cool-mist humidifier and drinking plenty of water to help thin your secretions. You can also try using an over-the-counter saline nasal spray, or try nasal irrigation using a neti pot, bulb syringe, or other devices. These are sold at most pharmacies. 

Natural remedies have been helpful for some people in controlling symptoms but the evidence of their effectiveness if very limited. These may include remedies such as capsaicin nasal spray with eucalyptol or acupuncture. 

You may wish to try some of these therapies if medications have not been effective in controlling your symptoms. However, be aware that there is not enough positive research for these treatments to be recommended at this time.

In rare cases, surgery may be needed to repair a deviated septum, remove nasal polyps, or reduce the turbinates (the portion of the nose that warms and moisturizes air).

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Kristin Hayes, RN
Kristin Hayes, RN, is a registered nurse specializing in ear, nose, and throat disorders for both adults and children.