Overview
Allergic rhinitis is an allergic reaction causing sneezing, congestion, runny nose, and itchy eyes, nose, and throat. It affects the mucous membranes of the nasal passage when exposed to an allergen. Seasonal allergic rhinitis (hay fever) is triggered by outdoor allergens like pollen. Perennial allergic rhinitis persists year-round, usually triggered by indoor allergens. It is extremely common and significantly affects quality of life, sleep, and productivity.
Causes and risk factors
The following factors are associated with the development of Allergic Rhinitis (Hay Fever):
- Immune system overreaction to harmless allergens
- Seasonal: grass, tree, and weed pollens
- Perennial: dust mites, pet dander, mould, cockroaches
- Air pollution worsens symptoms
- Family history of allergies or asthma
- Having other allergic conditions (atopy)
- Early childhood exposure patterns affect immune development
Signs and symptoms
Common signs and symptoms of Allergic Rhinitis (Hay Fever) include:
- Runny and itchy nose
- Sneezing — often repeatedly
- Nasal congestion
- Itchy, red, and watery eyes (allergic conjunctivitis)
- Itchy throat, mouth, or ears
- Reduced sense of smell
- Postnasal drip
- Fatigue due to disrupted sleep
- Ear pressure or popping
- Dark circles under eyes (allergic shiners)
Diagnosis
Allergic Rhinitis (Hay Fever) is typically diagnosed through a combination of medical history, physical examination, and appropriate investigations such as blood tests, imaging, or specialist review, depending on the specific condition and presentation. Your doctor will consider all relevant symptoms and risk factors before making a diagnosis.
Treatment options
Treatment approaches for Allergic Rhinitis (Hay Fever) may include:
- Antihistamines: cetirizine, loratadine, fexofenadine — first-line treatment
- Intranasal corticosteroid sprays (fluticasone, mometasone) — most effective
- Nasal decongestant sprays for short-term use only
- Antileukotriene medications (montelukast)
- Allergen immunotherapy (desensitisation) for long-term management
- Eye drops for conjunctivitis: sodium cromoglicate, antihistamine drops
- Nasal saline irrigation
- Avoiding triggers — pollen filter in car, keeping windows closed in high pollen season
Prevention
Cannot prevent allergies from developing, but minimising allergen exposure, monitoring pollen counts, and early appropriate treatment reduces symptom burden.
Complications
If left untreated or poorly managed, Allergic Rhinitis (Hay Fever) can lead to complications including:
Sinusitis, nasal polyps, ear infections, sleep disturbance, aggravation of asthma, and reduced quality of life.
Sources and references: This article is written in accordance with NHS UK, WHO, and Mayo Clinic clinical guidelines. It is reviewed for accuracy by the SymptomSense content team. ICD-10 code: J30. Last reviewed June 2026.