Allergic Rhinitis (Hay Fever)

This information was reviewed and approved by Rafeul Alam, MD, PhD (2/29/2020).

In the United States, between 30 and 60 million people suffer from a runny or stuffy nose each year. This is a problem known as rhinitis. There are several types of rhinitis, including allergic rhinitis.

The reason why our patients are colonized or infected with staph bacteria is an area of active research, so we don't have the answers, but we know, for example, that that damaged skin barrier creates a favorable environment for colonization. We know research done at this center several years ago now pointed to the fact that a key immune abnormality exists in the skin of our patients that allows these bacteria to set up camp on the skin of the patients with atopic dermatitis. Specifically, our patients' skin cells don't produce a natural antibiotic substance, antimicrobial peptides that are the second line of defense against various microbes.

When we first became interested in atopic dermatitis a number of years ago, we realized that there were several unique features about this chronic skin disease that you don't see in other chronic inflammatory skin diseases, for example, psoriasis. So more than half of our patients with atopic dermatitis will march on and develop asthma, food allergies, allergic rhinitis. So when you think about it, food allergy may be more a consequence of exposure of the skin immune system rather than the GI tract immune system to these various foods, and that's why we typically see food allergies in these patients starting out quite early. And when you think about it, oftentimes those young children who are experiencing those foods for the first time are actually getting more on their skin than into their mouths.

It's important to know about the different types of rhinitis, because often a person has more than one type for a physician to diagnose and treat.

Allergic Rhinitis

Seasonal allergic rhinitis (more commonly known as hay fever) is mainly an allergy caused by outdoor allergens, such as tree, grass and weed pollens, as well as some mold spores. If you sneeze and have a runny or stuffy nose during the spring, summer or fall allergy seasons, you may have hay fever. Hay fever is the most common type of allergy problem, and symptoms include sneezing; itching; runny or stuffy nose; and red, watery eyes.

Read about treatment for hay fever, and learn answers to frequently asked questions.

Nonallergic Rhinitis

This type of rhinitis is not as well understood. Although not triggered by allergy, the symptoms are often the same as seen with allergic rhinitis. Allergy skin test results are negative. Nasal polyps may also be seen with this type of rhinitis.

Vasomotor Rhinitis

Common symptoms of vasomotor rhinitis include nasal congestion and postnasal drip. A person with this type of rhinitis may have symptoms when exposed to temperature and humidity changes. Symptoms may also occur with exposure to smoke, strong odors, including perfumes, and emotional upsets. Vasomotor rhinitis is not caused by allergy. However, it may occur in people who also have allergic rhinitis.

Infectious Rhinitis

This can occur as a cold, which may clear rapidly or continue with symptoms longer than a week. Some people may also develop an acute or chronic bacterial sinus infection. Symptoms include an increased amount of colored (yellow-green) and thickened nasal discharge and nasal congestion.

Rhinitis Medicamentosa

This type of rhinitis is seen with long-term use of decongestant nasal sprays or recreational use of cocaine. Symptoms may include nasal congestion and postnasal drip. Decongestant nasal sprays are intended for short-term use only. Overuse can cause rebound nasal congestion. It is very important for a person with rebound congestion to work closely with a doctor to gradually decrease the nasal spray.

Mechanical Obstruction

This is most often seen with a deviated septum or enlarged adenoids. Symptoms often include nasal obstruction, which may be one-sided.

Hormonal

This type of rhinitis is often seen with changes in the hormones. This often occurs during pregnancy, puberty, menses or hypothyroidism. A very common cause of rhinitis is pregnancy. Symptoms include significant nasal congestion.