Treatment of Rhinitis

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There is no specific treatment for cold rhinitis, but it seldom lasts for longer than about a week.

Allergic rhinitis is treated with antihistamine drugs or local steroid sprays. Various drugs can be used to dry up excessive watery nasal secretions, and decongestants can sometimes be helpful.

Atrophic rhinitis is very difficult to treat. Sometimes a syringe, antibiotics or moistening sprays may be used to remove the crust blocking the airways.

Antihistamine drugs, taken by mouth, are convenient and relieve eye symptoms, running nose, sneezing and nasal irritation, but not nasal congestion. All are equally effective, but different people may find different methods more or less effective.

Steroid drugs (corticosteroids), taken as nose drops or a nose spray, are highly effective in treating all nasal symptoms, but ideally they should be started at least a week before the hay fever season starts. They can be combined with antihistamine taken by mouth for the first week or so until they start to take effect. Overuse can cause problems with the lining of the inside of the nose.

Sodium cromoglycate is a drug that prevents the release of the substances that cause the symptoms of allergic rhinitis. Taken as a nose spray it is less effective than nasal corticosteroids, but may be useful in young children as an alternative to betamethasone nose drops (no other corticosteroid preparation is licensed for use in young children).

Ipratropium is a natural substance that has many effects including the production of saliva, tears, sweat and respiratory secretions and narrowing of the air tubes. Taken as a nose spray, it can be useful when a runny nose is the main symptom, but it does not relieve nasal itching, blockage or sneezing.

For watering eyes, antihistamine eye drops work quickly and are suitable for people with eye symptoms that come and go.

Desensitisation injections can certainly be helpful, especially if started after the hay fever season and then continued all the year round. This must be done very carefully to avoid severe reactions and is usually used after other treatments have failed.