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Allergic rhinitis in Adult
Other Resources UpToDate PubMed

Allergic rhinitis in Adult

Contributors: Eve Tranchito, Benjamin L. Mazer MD, MBA, Mary Anne Morgan MD, Paul C. Bryson MD, MBA
Other Resources UpToDate PubMed


Allergic rhinitis (AR) is a common cause of nasal congestion, rhinorrhea, sneezing, and lacrimation. Patients with AR often present with itching of the nose, throat, and eyes as well as cough, postnasal drip, and fatigue. It affects up to 20% of individuals in the United States. There are many triggers, including plants, animal dander, pollens, and molds. These allergens are thought to cause AR through immunoglobulin E (IgE)-mediated mast cell degranulation in the nasal mucosa.

AR may present with a seasonal, occupational, or perennial (chronic) pattern. More recently, however, AR has been categorized as "intermittent," "persistent," "mild," or "moderate," depending on duration and frequency of symptoms. The condition affects people of all demographics and locations; however, there is thought to be a higher likelihood of AR in individuals with a family history of allergies. Of note, it is more common in people with atopic conditions such as asthma, atopic dermatitis, and food allergies. AR typically develops before age 20 and frequently diminishes in severity as patients age.

Although not life-threatening, AR can dramatically impact quality of life and school / workplace productivity.

Related topics: drug-induced rhinitis, vasomotor rhinitis


J30.9 – Allergic rhinitis, unspecified

61582004 – Allergic Rhinitis

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Vasomotor rhinitis – when allergic causes are ruled out; this may be caused by changes in weather, medications, foods, or chronic health conditions
  • Drug-induced rhinitis – from use of cocaine, oral contraceptives, NSAIDs, chlorpromazine, rebound from decongestant use
  • Nasal polyps – can be found on nasal endoscopy
  • Nasal tumor (eg, nasopharyngeal cancer)
  • Foreign body – can be determined by thorough history and inspection; usually presents with purulent unilateral rhinorrhea
  • Deviated septum

Best Tests

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Management Pearls

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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Last Reviewed:03/31/2019
Last Updated:12/20/2020
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Patient Information for Allergic rhinitis in Adult
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Contributors: Medical staff writer


Allergic rhinitis, or hay fever, is a common cause of nasal congestion, runny nose, sneezing, and itchy eyes experienced by about 20% of the population. It is typically in response to certain triggers called allergens, such as pollen, dust, mold, and pet dander, or certain foods.

Allergic rhinitis occurs seasonally during spring and summer when a high amount of pollen is produced by plants and trees. It can also occur year-round in response to dust mites, cockroaches, mold, animals, and other irritants.

Who’s At Risk

Exposure to the following allergens may induce allergic rhinitis:
  • Grass
  • Pollen
  • Dust mites
  • Cockroaches
  • Smoke
  • Perfume
  • Mold

Signs & Symptoms

The symptoms of allergic rhinitis can include:
  • Sneezing
  • Runny or stuffy nose
  • Itchy nose or eyes
  • Coughing
  • Postnasal drip
  • Sore throat
  • Watery eyes
  • Headaches
  • Dry itchy skin
  • Fatigue

Self-Care Guidelines

Steps can be taken to prevent or reduce exposure to allergens:
  • Limit time outdoors on high-pollen days
  • Use air-conditioning rather than opening windows to reduce pollen and dust in the house
  • Use a dehumidifier during damp weather to keep indoor air drier and prevent mold growth
  • Remove mold indoors and outside the house
  • Avoid indoor smoking and strong fragrances
  • Change or clean filters frequently (furnace, air cleaners, air conditioners)
  • Limit allergens in the bedroom (plastic mattress and pillow covers, wash sheets and curtains in hot water, remove rugs, furniture, etc.)
  • If you have pet allergies, consider making changes to the sleeping and feeding areas of your pets

Ask your health care provider for additional recommendations if you work outdoors in agriculture, landscaping, logging, or in other dusty environments with high allergen content.

Some over-the-counter products can help relieve symptoms:
  • Antihistamines such as Allegra (fexofenadine), Claritin (loratadine), Xyzal (levocetirizine)
  • Decongestants such as Sudafed (pseudoephedrine)
  • Nasal sprays and eye drops
  • Saline spray or nasal wash (without antihistamine or decongestant)

Ask your health care provider which products are best to use for your child's symptoms.

When to Seek Medical Care

Seek medical care if you have severe symptoms, or your symptoms are not subsiding after following the self-care guidelines.


You may be referred for allergy testing.

Your health care provider may recommend allergy shots if you have severe allergies. These shots may help decrease your body's histamine reaction to certain allergens.
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Allergic rhinitis in Adult
A medical illustration showing key findings of Allergic rhinitis : Nasal congestion, Recurring episodes or relapses, Rhinorrhea, Sneezing, Ocular pruritus
Copyright © 2023 VisualDx®. All rights reserved.