Perennial Allergic Rhinitis Overview

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

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.

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Prevalence

The actual prevalence of perennial allergic rhinitis is hard to pinpoint, as this condition can be undiagnosed. During childhood, boys are more likely than girls to experience perennial allergic rhinitis. During adulthood, differences by gender tend to disappear.

Some research suggests that the prevalence of this condition could be quite high (up to 23% of the population).

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

These other conditions may co-exist with perennial allergic rhinitis:

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 hallmark 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, and if you've noticed any triggers for your symptoms, as well as your family's medical history.

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 deviated septum or fluid in the ears.

Sometimes, the following diagnostic tests may be ordered:

  • Blood or skin testing may be used to identify specific allergies.
  • Computerized tomography (CT) or magnetic resonance imaging (MRI) scans may be needed if there is concern about either another disorder (such as a mass or a tumor) that could be causing your symptoms or concern about complications, such as polyps.

Treatment

There are several treatment options that your doctor might recommend for the management of your 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
  • Avoid pets or limit their access to bedrooms
  • Occasional deep cleaning with carpet cleaning, steam cleaning, or dry cleaning
  • Replace carpet with another type of flooring

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.

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

Medications commonly used for controlling allergy symptoms include the following antihistamines:

  • Cetirizine hydrochloride
  • Diphenhydramine
  • Fexofenadine
  • Loratadine

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


Make sure your healthcare provider and pharmacist know all the medications you are taking to avoid interactions and inform them of any medication allergies you might have.


Other medications may also be used to control symptoms. Many of these medications are available over-the-counter 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 that 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 5.

If your condition has progressed to chronic sinusitis or if you have structural abnormalities such as a deviated septum or nasal polyps, additional treatments may be necessary.

This condition often requires surgery. This is especially true if you have a deviated septum, enlarged turbinates, or nasal polyps. Nasal sinus surgery is common in the United States and is usually done endoscopically as an outpatient surgery.

A Word From Verywell

Perennial allergic rhinitis is a chronic condition that may cause a variety of complications if it isn't treated. The first step in your treatment should be to try to avoid allergens.

If avoiding your allergy triggers isn't helping, then medical or surgical treatments may be helpful for reducing your symptoms.

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3 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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  2. Kim H, Bouchard J, Renzi PM. The link between allergic rhinitis and asthma: a role for antileukotrienes?. Can Respir J. 2008;15(2):91-8. doi:10.1155/2008/416095

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