Exercise-Induced Rhinitis Causes and Treatment

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Rhinitis is a common disorder that is associated with one of the following:

The most common form of rhinitis is allergic rhinitis, which is associated with triggering environmental factors. Seventy percent of people with allergic rhinitis also have accompanying conjunctivitis, or watery eyes that are usually also red and itchy.

A less common form of rhinitis is nonallergic rhinitis (NAR). Nonallergic rhinitis is more difficult to diagnose, as it is a diagnosis of exclusion rather than a disorder that you can be tested for in a doctor’s office. A diagnosis of exclusion means that the doctor test for other identifiable reasons for rhinitis before coming to the conclusion of nonallergic rhinitis.

Normal Nasal Response to Exercise

In the majority of cases, as the heart rate increases during exercise activities, blood vessels in the body constrict (vasoconstriction) in tissues other than the active skeletal muscles (where they dilate). This vasoconstriction is related to the release of adrenaline and leads to a decrease in the resistance of the nasal passage airways. In many instances where blood vessels are dilated, causing nasal obstruction, exercise actually helps to decrease the symptoms.

How Can Exercise Cause My Runny Nose?

Exercise can cause your runny nose by two methods. Allergic rhinitis is best understood. There is increased exposure to allergens due to the larger amount of air that is exchanged while breathing deeper and faster during periods of exercise.

About 15 percent of athletes who have allergies experience a runny nose due to increasing their exposure to allergens.

Nonallergic causes of exercise-induced rhinitis are less understood. There are several factors that are viewed as contributors to runny noses in adults that are unrelated to allergies. The main contributing factors include irritants, emotional, or vasomotor.

Irritant-induced rhinitis like with athletes that experience exercise-induced rhinitis is related to the increased exposure to occupational or environmental exposures that irritate the nares but do not cause allergies. In this instance, the irritants themselves activate the nasal discharge or a runny nose. Decreasing exposure to the irritants can help resolve chronic rhinitis.

Emotional-induced rhinitis is not actually an exercise-induced form of rhinitis, however, is sometimes confused. Intercourse is fairly well documented as causing a runny nose and sneezing. This, however, does not occur during the act of sex, but rather occurs with the thought of having sex or within 5 minutes after having sex. This phenomenon is also known as honeymoon rhinitis.​

Vasomotor rhinitis is the catch-all category of non-allergenic rhinitis and is the diagnosis used when all other forms of rhinitis have been eliminated. It is more common in the elderly than the young.


The early stages of any treatment regimen of nonallergic rhinitis should include avoidance of any known contributing factors. Continued exercise, without exposure of allergens or irritants, may actually reduce the instances of a runny nose due to the body’s natural reaction to adrenaline. A physician may also pursue medical treatment including medications for cases that are unable to be modified through avoidance or lifestyle changes.

Medications tend to come from three groups. Anticholinergics like ipratropium bromide are a topical medication that has a relatively low side-effect profile. Nasal steroid sprays like Flonase or Nasacort are common nasal sprays that have been shown to be effective in treating nasal congestion and rhinorrhea (runny nose). The last group of medications used to help treat rhinitis is antihistamines. Azelastine has been shown to be both effective in the treatment of allergy-related rhinitis as well as nonallergic rhinitis.

If the turbinates (spongy bone inside the nose) become enlarged, a surgical procedure called a turbinate reduction can help reduce symptoms.

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