What is the best treatment for allergic rhinitis?
Corticosteroid nasal sprays
Nasal sprays that contain medicines that reduce inflammation in
the lining of the nose (corticosteroids) are the most effective
treatment for allergic rhinitis.
Corticosteroid nasal sprays are effective for controlling itching
and sneezing, runny nose, blocked nose, and eye symptoms (itching or
wateriness). Most people with allergic rhinitis will benefit from using
these medicines. Some corticosteroid nasal sprays are available from
pharmacies without a prescription. Stronger versions are also available
on prescription. Your doctor can advise which is best for you. For best
results, these medications are taken regularly and long term, just like
preventers for asthma.
Corticosteroid nasal sprays for allergic rhinitis have a good
safety record, including in children and in people of all ages. It can
take up to 2 weeks before the medicine becomes fully effective. Your
doctor or pharmacist may suggest that you also use another medicine for a
short time to relieve your symptoms quicker.
People who experience allergic rhinitis symptoms throughout the
year may need to continue treatment indefinitely. Most people with
allergic rhinitis will need to continue treatment for at least several
months at a time.
Getting the most from your nasal spray
If you take any type of nasal spray, read the manufacturer’s
instructions carefully and follow the directions to make sure you get
the most benefit. Ask your pharmacist or doctor to explain anything you
don’t understand.
What to do
- Follow the manufacturer’s instructions
- Shake the bottle before each use
- Clear any mucus from your nose by blowing gently, or use a saline rinse before spraying
- Put the nozzle into your nostril gently, without pushing it in hard
- Point the spray bottle away from the wall that divides your nostrils (septum)
- Spray once into your nostril, then repeat the steps for your other nostril
- After using the spray, wipe the tip with a dry tissue, and put the cap back on.
Don’t:
- tilt your head back while spraying
- push the nozzle too hard or far into your nose (you could damage your septum or cause bleeding)
- blow your nose hard after spraying (the medicine is lost)
- sniff hard after spraying (the medicine ends up in your throat instead of your nose)
- use a saline rinse after using the medicine
Other medicines
Antihistamine nasal sprays (available over the counter) can
provide quick relief of itching and sneezing and may help with blocked
nose. They can be used in addition to a corticosteroid nasal spray.
Antihistamine tablets (available over the counter) are effective for
controlling itching and sneezing, but they are less effective for
clearing a blocked nose. Avoid the older type of antihistamines that
cause sleepiness.
What to do
- Follow the manufacturer’s instructions
- Shake the bottle before each use
- Clear any mucus from your nose by blowing gently, or use a saline rinse before spraying
- Put the nozzle into your nostril gently, without pushing it in hard
- Point the spray bottle away from the wall that divides your nostrils (septum)
- Spray once into your nostril, then repeat the steps for your other nostril
- After using the spray, wipe the tip with a dry tissue, and put the cap back on.
Don’t:
- tilt your head back while spraying
- push the nozzle too hard or far into your nose (you could damage your septum or cause bleeding)
- blow your nose hard after spraying (the medicine is lost)
- sniff hard after spraying (the medicine ends up in your throat instead of your nose)
- use a saline rinse after using the medicine.
Some people with mild allergic rhinitis just use these medicines.
Others use them in combination with corticosteroid nasal sprays when
they need extra control. For example, someone who is allergic to pollens
may take antihistamine tablets during springtime. Someone who is
allergic to pets may take them before visiting a friend’s house where
there are pets.
Decongestant nasal sprays and decongestant tablets are used to
unblock the nose. These should never be taken for more than a few days
at a time. Your doctor or pharmacist may suggest other medicines for
you.
Other things you can do
Saline rinses: Your doctor may recommend that you use a salt water
(saline) solution daily to help clear your nose and soothe the lining
of the nose. Syringes and rinse bottles are available from pharmacies.
Avoid smoke: People with allergic rhinitis should not smoke and
should avoid other people’s cigarette smoke. Smoking makes asthma and
rhinitis worse, and can prevent medicines from working properly.
Bushfires and wood smoke may also worsen allergic rhinitis and
asthma. Avoid allergens: Your doctor can help you work out which
allergens trigger your allergic rhinitis and asthma. Try to avoid your
allergy triggers if you can.
Before taking any medication for allergic rhinitis, you should tell your doctor or pharmacist if:
- you have any other medical conditions or are pregnant
- you are taking any other medicines (including over-the-counter medicines or complementary medicines)
- you have been experiencing nose bleeds
I’m pregnant – can I take allergic rhinitis medicines?
If your allergic rhinitis is troublesome, or if effective
treatment for your allergic rhinitis helps control your asthma symptoms,
your doctor might recommend that you take the medicine while you are
pregnant.
If you discover that you are pregnant while using medicines for
allergic rhinitis, tell your doctor straight away. Some corticosteroid
nasal sprays have a good safety rating during pregnancy and most
allergic rhinitis medicines have no particular safety concerns for
pregnant or breastfeeding women. Talk to your pharmacist or doctor
before taking any medicines when you are pregnant.
How is allergic rhinitis treated in children?
Some corticosteroid nasal sprays can be used for children as young
as 2 years. Antihistamine tablets can be used for children with mild
allergic rhinitis or young children who will not tolerate nasal sprays.
Some can be taken by children as young as 12 months. Only newer
antihistamines, which cause less sleepiness, should be given to
children. Montelukast tablets are effective for some children, but your
doctor may recommend other medicines.
Follow-up
After you have begun any allergic rhinitis treatment, tell your
doctor so that your allergic rhinitis can be checked whenever you have a
check-up.
You may need to visit a specialist or doctor with expertise in allergy if:
- your symptoms are severe or are not getting better with treatment
- you think you may have to change jobs or move house to improve your allergic rhinitis
- the diagnosis is not certain
Avoiding allergens
The most common allergens for people with allergic rhinitis are
pollens, house dust mite, pets, molds and cockroaches. There is no point
attempting to avoid allergens unless a doctor has confirmed that you
are allergic to these and that they are causing your allergic rhinitis
or asthma.
More information about how to avoid allergens is available
here.
