Medical therapies
There are many symptomatic treatments available both over the counter and through prescription, for the range of allergic symptoms, including antihistamine tablets, nasal sprays, inhalers and creams. They can be very effective, but if stopped the symptoms will return. It is important to understand if the treatment you are using is treating the symptoms (suppressing the allergy) or the underlying cause of the allergy.
If an allergy occurs in childhood, it may be important to treat the underlying cause of the allergy with allergen immunotherapy and avoid the development of more allergies and allergic asthma, known as the “allergy march”.
ASCIA (The Australian Society of Clinical Immunologists and Allergists) is also an excellent independent source of information.
Antihistamines
Antihistamines are recommended as the first-line therapy for mild intermittent allergic rhinitis and can be taken as nasal drops or in tablet form. They are widely available, usually without a prescription. They work by stopping the release of histamines in the body following exposure to an allergen. They are effective in treating mild and intermittent symptoms. In Australia, the pollen season may last for many months, so symptomatic treatments may need to be used over an extended period. Antihistamine eye drops may be effective in controlling allergic conjunctivitis.
Corticosteroids
Intranasal corticosteroids are the first-line treatment in patients with moderate to severe allergic rhinitis. Corticosteroids are administered intra-nasally, commonly known as nasal steroid sprays, in allergic rhinitis or inhaled in allergic asthma. They work by inhibiting the body’s inflammatory response caused by an allergen. Corticosteroids are generally well tolerated.
Effective treatment of allergic rhinitis with intranasal corticosteroids also improves allergic asthma.
Beta-2-mimetics
These medications are a symptomatic treatment for asthma and their main effect is to relieve bronchial spasms. Taken before inhaled corticosteroids, beta-2-agonists help the corticosteroids work more effectively.
What about decongestants?
Nasal and oral decongestants are available over the counter, should only be used for short term relief and are not recommended in the long term treatment of allergic rhinitis. Nasal decongestants can actually make symptoms worse and can cause chronic damage to the nasal membranes if used for long periods of time. Nasal decongestants can also cause rebound congestion if used for longer than five days.
Can symptomatic treatments stop my allergic rhinitis?
No. Treatments for allergies either treat the symptoms or the cause. Symptomatic treatments for respiratory allergies, including allergic rhinitis and allergic asthma, are effective. However, they only act on the symptoms and have no effect on the cause of the allergy. When you stop taking them, the symptoms return. Symptomatic treatments have no effect on allergic disease progression, which means many sufferers may go on to develop sensitivities to more allergens and more types of allergic reactions such as allergic asthma.
Although symptomatic treatments are the most common first-line treatment of allergic rhinitis, their efficacy may not be optimal in severe cases.
Many allergic rhinitis sufferers self-medicate and may not be getting the right treatment. There are treatments that treat the cause of the allergy and may be more effective depending on the severity of your allergic rhinitis.