Perennial Rhinitis: Symptoms, Diagnosis, and Treatments

Perennial allergic rhinitis is a chronic allergic condition that causes nasal congestion and a runny nose. Unlike other types of allergies, it doesn't go away during certain seasons or months of the year. You may feel like you have a permanent cold that won't go away.

Perennial allergic rhinitis is sometimes known as "hay fever," even though it does not always include an allergy to hay and it doesn't cause a fever.

Dust mites are the most common cause of perennial allergic rhinitis, but it can be caused by any allergen (allergy-inducing substance) that you are exposed to year-round. The other most common causes are cats and dogs.

This article will describe symptoms of perennial allergic rhinitis and how common it is. It will also discuss how this condition is diagnosed and treated.

How Common Is Perennial Allergic Rhinitis?

Not everyone with perennial allergic rhinitis has been officially diagnosed, so it's not clear how many people actually have the condition. Some research suggests that up to 23% of the population experiences perennial allergic rhinitis.

During childhood, boys are more likely than girls to experience perennial allergic rhinitis. During adulthood, men and women are affected equally.

Perennial allergic rhinitis is associated with other conditions as well. Asthma is one of the most common.

Here are some other conditions that may co-exist with perennial allergic rhinitis:

• Allergic conjunctivitis
• Eustachian tube dysfunction
• Fatigue
• Learning disabilities
• Otitis media
• Sleep disorders

If it's not treated, perennial allergic rhinitis can lead to complications, such as chronic sinusitis or abnormal growths such as polyps in the nasal cavities or sinuses.

Symptoms

Nasal inflammation is the the most common symptom of perennial allergic rhinitis.

You may have some or a combination of the following symptoms:

• Congestion
• Itching
• Nasal obstruction or stuffiness
• Runny nose

If your condition has progressed to sinusitis or if it's led to the growth of abnormal tissue, you may also experience the following symptoms:

• Bad breath
• Decreased sense of smell
• Facial pain or fullness
• Fatigue
• Foul-smelling or an abnormal color of nasal discharge
• Headaches
• Postnasal drip
• Toothaches

Diagnosis

Perennial allergic rhinitis can be diagnosed by a primary care healthcare provider or an allergist.

Your healthcare provider will talk to you about your medical history, the symptoms you are experiencing. They will ask if you've noticed anything specific that triggers for your symptoms,

Your physical exam will include an examination of your ears, nose, and throat. Your doctor will look to see if you have conditions such as a deviated septum (in which the cartilage inside the nose is crooked) or fluid in the ears.

The following diagnostic tests may be ordered:

• Blood or skin testing to identify specific allergies
• Computerized tomography (CT) or magnetic resonance imaging (MRI) scans if there is concern about nasal polyps, or, in rare cases, a mass or a tumor that could be causing your symptoms

Treatment

There are several treatment options for perennial allergic rhinitis. If a specific allergy has been identified, avoiding the substance you are allergic to may be helpful for preventing your symptoms.

You may want to work on reducing the allergens in your home with the following strategies:

• Adding a dehumidifier (if you are allergic to dust mites)
• Cleaning and vacuuming living spaces on a regular basis
• Avoiding pets or limiting their access to bedrooms
• Replacing carpet with another type of flooring
• Deep cleaning rugs. furniture, and other areas of your home affected by allergens
  

Nasal irrigation using a neti pot may be helpful in controlling nasal symptoms, including congestion. A humidifier may also be beneficial in helping with congestion. However, if you are allergic to dust mites you should be aware that high humidity levels can increase the number of dust mites in your environment.

Medications

If you are unable to eliminate allergens from your home or environment, your doctor might recommend medications or for treating your allergies.

Over-the-counter (OTC) antihistamines are the most common medications used to treat nasal allergies. These work by blocking histamine, a chemical that is released in response to an allergen. Histamines are responsible for causing allergy symptoms.

Commonly-used antihistamines include:

• Zyrtec (cetirizine hydrochloride)
• Benadryl (diphenhydramine) 
• Allegra (fexofenadine)
• Claritin (loratadine)

While these medications are available OTC, they should only be used under the direction of your healthcare provider. Some antihistamines such as diphenhydramine are known to cause drowsiness.

Other medications may also be used to control symptoms. Many of these medications are available OTC and may include decongestants and nasal sprays.

Decongestant nasal sprays can be associated with a condition called rebound congestion (also referred to as nasal spray addiction) when used longer than three days. If you develop this problem, talk to your healthcare provider about it.

Intranasal steroids are often used in addition to antihistamines and antibiotics are sometimes used to treat chronic sinusitis.

Allergy Shots

Immunotherapy or allergy shots, may be an option for some people with perennial allergic rhinitis. Immunotherapy is a long-term treatment option that can change your body's immune response to the substance you are allergic to. It is not available for all types of allergies, and it can be a time-consuming process since it needs to be given under medical supervision.

Your response to allergy shots may vary and could range from a complete cure of your symptoms to no improvement at all. In general, studies show this treatment to be beneficial and cost-effective.

Allergy shots are generally not used for children under the age of five.

Surgery

If your condition has progressed to chronic sinusitis, or if you have structural abnormalities such as or nasal polyps, surgery may be necessary.

Nasal sinus surgery is common in the United States and is usually done endoscopically as an outpatient surgery.

Summary

Perennial allergic rhinitis, sometimes known as hay fever, causes typical allergy symptoms like nasal congestion and a runny nose. However, unlike some other allergies, symptoms are present year-round and not just during certain seasons or months of the year. This type of allergic rhinitis can be treated with lifestyle measures as well as OTC medications, allergy shots, or outpatient surgery.

A Word From Verywell

If you have chronic allergy symptoms, the first step should be to identify and avoid the allergens that bother you.

If avoiding your allergy triggers isn't helping, then talk to your healthcare provider about medical or surgical treatments that may be helpful.