Director of Mayo Executive Health Program, Michael A. Covalciuc, M.D., M.P.H., discusses allergic rhinitis.

The son of Roman Emperor Claudius, Britannicus, was so allergic to horses that his eyes got so swollen, he could not see where he was going, and he lost the honor of riding in the lead of the young Romans. People in the English countryside in the 19th century noted that some people exposed to cut grass or hay (though the culprit was probably ragweed) developed cough, congestion, sneezing and itchy eyes, making them angry and irritable (“fever” in Old English), hence the common phrase “hay fever.” The medical term is allergic rhinitis. Rhinitis in this case means inflammation or irritation of the nose in reaction to substances in the environment (known as allergens) which trigger the reaction.

Classically, we think of spring and fall as allergy seasons, but, for some, nasal allergies can occur year-round. Pollen seasons are climate- and elevation-sensitive. Locally, January through May are pollen seasons for trees, grasses and weeds while August through November are grasses and weeds. People can also react to nonseasonal substances like mold, dust mites, cockroaches, animal dander and more. Red itchy eyes, runny nose, congestion, sneezing and headache are common but are not the only symptoms of allergic rhinitis. Uncontrolled allergies can be very disruptive causing fatigue, irritability, poor concentration and decreased work performance.

Avoiding contact with allergens is ideal but often not practical. Staying clear of known animal allergens and activities like mowing the lawn and yard work if you react to various plants and pollen are good strategies. Using and changing high-efficiency air-conditioning filters, keeping air ducts clean and minimizing household dust are also helpful.

For mild symptoms, there are a number of nonprescription treatments that can be effective. Sometimes, a combination of treatments is most effective. If you take prescription drugs, you should talk to your doctor before using decongestants if you have high blood pressure. Antihistamines are helpful for sneezing, runny nose and itching while nasal saline irrigation is simple, safe and an effective way to relieve nasal congestion. Decongestant nasal sprays should be used with caution or not at all as overuse can actually worsen symptoms and damage the lining of the nose.

For more severe or persistent symptoms, your doctor may prescribe one or more prescription decongestants, antihistamines, a corticosteroid nasal spray or even allergy shots. Your doctor may consider allergy testing to more precisely define your allergies for more resistant and difficult symptoms. This level of evaluation or treatment is performed by an allergist.

Consult your physician for advice if you are troubled with symptoms suggestive of allergic rhinitis that do not respond to simple nonprescription treatments. Professional organizations like the American College of Allergy, Asthma and Immunology (ACAAI) can also provide important educational information.

For more than a century, Mayo Clinic has given patients peace of mind knowing they received care from the world’s leading experts. Since opening in Arizona in 1987, Mayo Clinic continues its tradition of a team of specialists listening to thoroughly understand and find the answers to patients’ health issues and concerns. Mayo Clinic’s Executive Health Program combines Mayo’s diagnostic expertise with the latest in preventive medicine for an individualized, thorough and expedited healthcare evaluation.

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