Atlanta Allergy & Asthma Clinic
Categories: Sinus, Sinus
All Cases of Rhinitis Caused by Allergies?
inflammation of the nose and sinuses, may result from many causes other than
allergy. Not all rhinitis symptoms are the result of allergies. The
most common condition causing rhinitis is the common cold, an example of
infectious rhinitis. Irritant rhinitis or “vasomotor rhinitis” or “non allergic
rhinitis describes a group of other causes of rhinitis, with symptoms not
caused by infection or allergy. Many people have recurrent or chronic nasal
congestion, excess mucus production, either runny nose or post nasal drip,
itching, and other nasal symptoms similar to those of allergic rhinitis but the
disorder is not caused by allergy.
What Triggers Vasomotor Rhinitis?
Triggers of vasomotor
rhinitis include any irritant. Strong odors such as cigarette smoke, perfume,
hair spray, and other cosmetics, laundry detergents, cleaning solutions, pool
chlorine, car exhaust and air pollution are all common triggers. Other
irritants are spices used in cooking, alcoholic beverages (particularly beer
and wine), aspirin and certain blood pressure medications. Some people are very
sensitive to abrupt changes in weather or temperature, humidity or barometric
pressure. Skiers often develop a runny nose, but in some people any cold
exposure may cause a runny nose. Others start sneezing when leaving a cold, air
conditioned room or sitting under forced air. Even high quantities of dust,
mold or pollen particles, which are potential allergens, can serve as an
irritant trigger in a sensitive person who is not truly allergic. Occasionally,
one or two positive skin test may be observed, but they do not match with the
history and are not relevant or significant. However, some people have both
allergic and vasomotor rhinitis concurrently.
The cause of
vasomotor rhinitis is not well understood. In a sufficiently high
concentration, many odors will cause nasal irritation in almost anyone. Some
people are unusually sensitive to irritation and will have significant nasal
symptoms even when exposed to low concentrations of irritants.
rhinitis seems to be an exaggeration of the normal nasal response to
irritation, occurring at levels of exposure that don’t bother most people. It
occurs more often in smokers and older individuals and women. Although
vasomotor rhinitis can’t be cured, symptoms can be kept under control by
limiting exposure to substances that cause symptoms and by taking medication
when needed. People with vasomotor rhinitis should not smoke or permit smoking
in their homes.
Another form of
rhinitis is dryness of the nasal tissue. It can be a normal effect of
aging or a characteristic of a nasal condition associated with a foul smelling
nasal discharge. Rhinitis also can be a feature of endocrine disease, like
hypothyroidism, or can occur during pregnancy caused by hormonal changes.
Alcoholic beverages can cause the blood vessels in the nose to enlarge
temporarily and produce significant nasal congestion.
You Know What Kind of Rhinitis You Have?
physician. Sometimes several conditions can coexist in the same person. In a
single individual, allergic rhinitis could be complicated by vasomotor
rhinitis, septal deviation (curvature of the bone separating the two sides of
the nose) or nasal polyps or infections. Any of these conditions will be made
worse by catching a cold. Nasal symptoms caused by more than one problem can be
difficult to treat, often requiring the cooperation of an
allergist-immunologist and an otolaryngologist (a physician specializing in the
ears, nose and throat). Most infections are relatively short-lived, with
symptoms improving at three to seven days. Colds can be caused by any one of
over 200 viruses. Children, particularly young children in school or day care
centers, may have from eight to 12 colds each year. Fortunately, the frequency
of colds lessens after immunity results from exposure to many viruses.
begin with a sensation of congestion, rapidly followed by runny nose and sneezing.
Over the next few days, congestion becomes more prominent, the nasal mucus may
become discolored, and there may be a slight fever and cough. Cold symptoms
resolve within a couple of weeks, although a cough may sometimes persist. Cold
symptoms that last longer may be due to other causes, such as chronic rhinitis
What are other
causes of rhinitis? Not all symptoms in the nasal passage are caused by allergy
or infection. Similar symptoms can be caused by mechanical blockage, use of
certain medications, irritants, temperature changes or other physical factors.
Rhinitis can also be a feature of other diseases and medical conditions.
Drug-induced nasal congestion can be caused by birth control pills and other
female hormone preparations, certain blood pressure medications, and prolonged
use of decongestant nasal sprays.
Rhinitis caused by topical decongest sprays like Afrin, 4-way, Dristan
and others, is called rhinitis medicamentosa. Decongestant nasal sprays work
quickly and effectively but they alter how the nasal passages normally work.
After a few weeks of use, nasal tissues swell after the medication wears off.
The only thing that seems to relieve the obstruction is more of the medicine
but continued use of the medicine results in a shorter duration of action.
People often become dependent on these sprays, using them frequently throughout
the day and night. Permanent damage to the nasal tissues may result.
Consultation with a physician to relieve this condition is often necessary.