Allergic Rhinitis (Hay Fever)

Author: Op. Dr. Javidan Asafov · ENT / Otolaryngology Specialist · Last medical review: 10.10.2026

What is it?

Allergic rhinitis is inflammation of the nose that occurs when the lining covering the inside of the nose overreacts to substances that are actually harmless, such as pollen, house dust mites, animal dander or mould. The seasonal type caused by pollen is also commonly known as “hay fever” or “seasonal allergies”. It is common, usually starts in childhood or the teenage years, and occurs more often in people with a family history of allergy, asthma or eczema. It is not contagious and is not considered a dangerous disease, but it can noticeably affect sleep and performance at work and school.

Symptoms

Symptoms usually start shortly after contact with the allergen:

• Sneezing: it often comes in bouts, one sneeze after another, and may be more noticeable in the morning.
• Runny nose: a clear, watery discharge; there may also be postnasal drip running down into the throat.
• Itching: itching in the nose, the palate, the throat and inside the ears is a typical sign of allergy.
• Nasal blockage: caused by swelling of the turbinates; it may get worse at night and lead to mouth breathing, snoring and disturbed sleep.
• Eye symptoms: itchy, watery and red eyes often accompany the nasal symptoms.

A reduced sense of smell and tiredness may also occur. Fever and muscle aches are not symptoms of allergic rhinitis.

Causes and triggers

The substances that cause allergic rhinitis are called allergens. The most common are:

• Pollen: tree, grass and weed pollen builds up in the air during the months when plants are flowering.
• House dust mites: tiny creatures, invisible to the eye, that live in mattresses, pillows, carpets and upholstery.
• Animal hair and dander: the allergy is actually caused by skin flakes and saliva from pets such as cats and dogs, which get onto their fur.
• Moulds: they grow in damp, poorly ventilated places.

If symptoms appear only at certain times of the year, for example in spring and summer, this is seasonal allergic rhinitis; the cause is usually pollen. When symptoms last all year round, indoor allergens such as mites, pets and mould are the main culprits; this is called year-round (perennial) allergic rhinitis. Cigarette smoke, strong smells and air pollution are not allergens, but they can make symptoms worse in a sensitive nose.

How it differs from a cold

A cold is a contagious infection caused by viruses; it starts with a sore throat, tiredness and sometimes a mild fever, the discharge may thicken over time, and it usually clears up on its own within a short time. In allergic rhinitis there is no fever, the discharge usually stays clear and watery, and itching of the nose and eyes is prominent. Symptoms can continue for weeks as long as contact with the allergen goes on; they recur in the same season every year or in particular situations, such as a dusty environment or contact with an animal.

Examination and diagnosis

Diagnosis relies largely on a detailed history: you will be asked in which season and in which surroundings your symptoms get worse, whether there are pets, carpets or damp at home, and whether there is a family history of allergy and asthma. On examination the turbinates usually look swollen and pale. Endoscopic examination with a thin camera also shows any accompanying deviated septum, enlarged turbinates, polyps or signs of sinusitis. In general, allergy tests such as skin tests or blood tests measuring allergy-specific antibodies are used to show which substance a person is allergic to; the results are meaningful when interpreted together with the person’s symptoms.

Treatment

The first step in treatment is to reduce contact with the triggering allergens as much as possible: keeping windows closed on high-pollen days, tackling mites and dust in the bedroom and reducing damp in the home are the main measures. Rinsing the nose with sea water or saline clears away allergens and secretions; it is a supportive method that can also be used in children and during pregnancy. The groups of medicines commonly used are:

• Intranasal corticosteroid sprays: they reduce allergic inflammation and swelling of the lining and help not only with blockage but also with sneezing, runny nose and itching. Because their effect builds up gradually with regular use, they are used regularly as recommended by the doctor rather than only when needed, and they are not habit-forming.
• Antihistamines: they come as tablets or nasal sprays and reduce sneezing, itching and runny nose. Tablets have a more limited effect on blockage. Anti-allergy eye drops can be added for eye symptoms.

Decongestant nasal sprays open a blocked nose quickly, but they should only be used for short-term relief; with longer use, the nose becomes more blocked as each dose wears off (nasal spray addiction).

Allergen immunotherapy (also known as desensitisation, and sometimes called an “allergy vaccine”) is a long-term method that aims to get the immune system used to the substance causing the allergy by giving it at regular intervals, starting from very small amounts. In general, it is considered for some people whose allergy has been confirmed by tests and who do not get enough relief from medicines.

If blockage continues despite regular and correct use of medicines, enlarged turbinates (turbinate hypertrophy) or a bend in the septum, the central wall of the nose (deviated septum), may also be present. In this case, turbinate reduction or septoplasty can make breathing easier. Surgery does not cure the allergy; allergy treatment continues for sneezing, itching and runny nose.

When to see a specialist

See an ENT specialist if sneezing, a runny nose, itching or blockage lasts for weeks, recurs every year or affects your sleep and daily life, or if you cannot stop using a decongestant spray. Do not put off an examination if your symptoms are always on the same side of the nose, if there is often blood in the discharge, or if your sense of smell has noticeably decreased; these symptoms may have causes other than allergy. If you also have a cough or wheezing, mention this at your examination.

This article is for general information; please consult your physician for diagnosis and treatment.