Rhinitis is a condition that typically involves nasal obstruction or congestion, runny nose or post-nasal drip, itchy nose, and/or sneezing.
There are various causes for these symptoms, although they are broadly divided into two types: allergic rhinitis (symptoms related to allergy) and non-allergic rhinitis (symptoms that are not related to allergy).
What causes Rhinitis?
Allergic rhinitis(also known as hay fever) occurs when your body’s immune system over-reacts to specific, non-infectious particles such as plant pollens, molds, dust mites, animal proteins, chemicals, foods, medicines, insect venom, and other triggers. During an allergic attack, the body releases histamine, and other chemicals in the mucus membranes of the body, lungs, and skin. These chemicals cause blood vessels to open which causes swollen membranes. When this happens in the nose, sneezing, itching, runny nose, and congestion occur.
Seasonal allergic rhinitis depends on specific plants that are pollenating at that time. In the United States, springtime allergic rhinitis is typically due to pollinating trees. Early summer allergic rhinitis is often due to grass pollination, and allergic rhinitis in the fall is usually due to weeds pollinating.
Perennial allergic rhinitis is felt year-round and can result from sensitivity to animals, mold, houseplants, and dust mites.
Non-allergic rhinitis, vasomotor rhinitis, or chronic rhinitis is not due to an allergic reaction. It results in frequent or longstanding inflammation in the nose. Some of the causes of non-allergic rhinitis include:
- Side effect of medications (both prescription and over-the-counter)
- Eating and drinking
- Weather or temperature changes
- Hormonal changes or pregnancy
- Consumption of alcohol, especially red wine
- Inflammation or irritation in the nose due to a reaction to an environmental irritant (smoke, pollution, chemicals, perfumes, VOCs)
- Nasal symptoms due to other medical conditions
Over 24 million Americans suffer from chronic rhinitis. While exact causes may not be known, the nerves in your nose become hyperactive and send unnecessary signals to the brain. The results in the nose responding like it is fighting an illness. The nasal linings become congested and mucus production increases which can cause a runny nose or drip down the throat.
What treatment options are available for Rhinitis?
Treating rhinitis depends on the type of rhinitis or specific cause. If there is a specific trigger that can be avoided, this may be a successful treatment. For example, in people with cat allergy, avoidance of cat exposure and direct contact with cats may help to control symptoms.
Often, medications are used to control symptoms. Depending on the specific cause of the rhinitis symptoms, some of the medications that may be used include:
- Saline rinses
- Antihistamines (oral or nasal spray)
- Corticosteroids (usually applied as an intranasal spray)
- Ipratropium bromide nasal spray
For allergic rhinitis, allergen immunotherapy may be an option. This is most commonly provided via allergy shots or liquid drops taken under the tongue. Ask us if allergen immunotherapy is an option for you.
For severe runny nose or nasal obstruction/congestion that does not respond to medications, additional office procedures or surgery may be appropriate.
The ClariFix Cryotherapy device is the only FDA-cleared device for treatment of chronic rhinitis. It is a minimally invasive procedure aimed at treating the root cause of chronic rhinitis—overactive nerves. Cryotherapy uses cold temperatures to interrupt the signals from these nerves. When cold hits these nerves, they no longer tell the nose to drip, run or swell. Due to its self-limited depth of penetration, the adjacent bone and cartilage are not impacted.
ClariFix may be performed in the office or in a surgical setting. In the office it is performed under topical and local anesthetic. The ClariFix device and a small lighted camera (endoscope) are place into the back of your nose. A cooling probe is then applied directly to the area where the out-of-balance nerves are located. Cold therapy is applied for a few minutes. You may feel slight pressure, a cooling sensation, or slight discomfort. In general, there is minimal downtime and recovery. You may experience temporary congestion and slight discomfort for a short time after the procedure. Most patients begin to see improvement 2 to 6 weeks after treatment. 4 out of 5 patients report long-lasting improvement.