Allergic rhinitis

Allergic rhinitis: what is it?

Allergic rhinitis, also called hay fever, is the most common manifestation of respiratory allergy [1]. It is a group of symptoms that appear following exposure to an allergen [4]. Allergens are generally harmless substances encountered in daily life that can cause an allergic reaction [4]. Allergic rhinitis can be seasonal, as it is often related to pollen production. However, it also occurs following exposure to dust mites and their waste products, animal hair, certain chemicals [2] or dust [1].

Rhinitis can be intermittent or persistent.

• Intermittent rhinitis is defined as rhinitis that lasts less than 4 weeks [2].
• It is said to be persistent when it lasts for more than 4 consecutive weeks [2].

What are the symptoms of allergic rhinitis? And when should I contact a doctor?

Allergic rhinitis is characterized by symptoms that are easily identified outside of cold or flu episodes such as:

• Tingling in the nose [2].
• Bursts of sneezing [1].
• Nasal discharge and obstruction [1].
• Redness of the eye [1].
• Tearing [1].
• Feeling of sand in the eyes [1].
• Swelling of the eyes [2].

For severe forms: sleep disorders, coughing, breathing difficulties or even asthma attacks [2].

If you experience the following symptoms, it is imperative that you contact a doctor within the day:

• Swelling of the tongue [5].
• Associated respiratory discomfort [5].

If the following symptoms occur, they are also of a serious nature and it is important to make an appointment with your doctor in the next few days:

• A persistent cold (more than 10 days) with the symptoms of rhinitis discussed above [5]
• A persistent occurrence of symptoms throughout the year [5].
• Presence of blood in nasal secretions repeatedly [5]
• Appearance of itchy red spots or patches [5].
• The patient has asthma [5].

Finally, in cases where a diagnosis has already been made and a treatment has already been prescribed, the patient may self-medicate [5].

How to treat allergic rhinitis?

There are three main ways to prevent and treat allergic rhinitis: allergenic avoidance, drug treatment and desensitization [1].

• Allergenic avoidance

Allergenic avoidance aims to reduce the allergenic load as much as possible, that is to say the quantity of allergen presents in the environment, by implementing simple daily measures (vacuuming, ventilation etc.) [1]. Eviction is particularly effective against dust mite allergies. In this case, most of the measures to be implemented are concentrated in the bedroom [1].

• Drug treatment

If eviction measures are not sufficiently effective, your doctor may prescribe a treatment to relieve your symptoms. H1 antihistamines are the recommended drug treatments for allergic rhinitis. In fact, they represent more than 90% of prescriptions and are given once daily, on demand or continuously depending on the type of rhinitis [1].

• Desensitization

In cases of allergies to pollens or dust mites, when it is difficult or impossible to avoid contact with these allergens, the allergist performs desensitization [5]. Desensitization consists of making the patient more tolerant to allergens, based on the principle of vaccine treatment [1]. The patient regularly receives allergenic extracts for 3 to 5 years, but the benefits are visible from 3 to 4 months [1]. It is administered by weekly and then monthly subcutaneous injections. Even after the treatment is stopped, the beneficial effects of the treatment continue to be felt.

How to prevent allergic rhinitis?

• Prevention of allergic rhinitis due to pollen

As pollen is one of the common causes of allergic rhinitis, it is important to take preventive measures related to this allergen:

• Encourage walking outdoors right after rain, as the air contains less pollen [3].
• Wear sunglasses when outdoors to protect your eyes from pollen [3].
• Sleep with the window closed to avoid pollen entering the room [3].
• Drive with the windows closed to prevent air from getting in [3].
• Go on vacation outside the flowering periods [3].
• Air your home briefly and when it is not windy [3].
• Reduce or quit smoking [3].

• Prevention of allergic rhinitis caused by dust mites

In cases of allergic rhinitis caused by dust mites, preventive measures should focus on the bedroom:

• Avoid having carpets, rugs, double curtains and stuffed animals in the bedroom if possible [3].
• Put dust mite protective covers on mattresses and pillows [3].
• Wash bedding regularly, at least twice a month at 60°C [3].
• Air the room daily to reduce humidity [3].
• Vacuum the room frequently [3].

If, despite these preventive measures, symptoms persist, there are other solutions and treatments. Talk to your doctor who will be able to direct you to the most appropriate treatment for your situation.

SOURCES :

[1] Allergic rhinitis- Inserm- Available at: https://www.inserm.fr/dossier/rhinite-allergique/#:~:text=The%20allergic%20rhinitis%20is%20the,treatment%20m%C3%A9drug%20and%20the%20d%C3%A9sensitization 

[2] Allergic rhinitis – VIDAL – Available at: https://www.vidal.fr/maladies/nez-gorge-oreilles/rhinite-allergique-rhume-foins.html 

[3] Prevention of allergic rhinitis – VIDAL – Available at: https://www.vidal.fr/maladies/nez-gorge-oreilles/rhinite-allergique-rhume-foins/prevention.html#:~:text=wash%20the%20linge%20of%20lit,aspirate%20fr%C3%A9respectively.

[4] Understanding Allergies- AMELI – Available on: Understanding allergies | ameli.fr | Insured

[5] Understanding allergies – VIDAL – Available on: How to react to allergic rhinitis? – VIDAL

POI 0715-09/22