Allergic rhinitis symptoms are common, particularly in spring and summer when pollen levels rise. Often referred to as hay fever, this condition can affect sleep, concentration and overall quality of life.
While many people manage mild symptoms with over the counter medication, persistent or poorly controlled rhinitis may benefit from specialist assessment and targeted treatment.
What is allergic rhinitis?
Allergic rhinitis is an immune reaction to airborne allergens. When a sensitive person breathes in substances such as pollen or dust mites, the immune system mistakenly identifies them as harmful and releases chemicals including histamine. This leads to inflammation inside the nose.
There are two main types:
Seasonal allergic rhinitis, triggered by pollen from trees, grasses or weeds.
Perennial rhinitis symptoms, caused by year round allergens such as dust mites, pet dander or mould.
The difference between seasonal and perennial rhinitis lies mainly in timing and trigger. Seasonal symptoms appear during specific months. Perennial symptoms can persist throughout the year.
What are the symptoms of allergic rhinitis?
Hay fever symptoms can vary in intensity but often follow a recognisable pattern.
Sneezing fits
Repeated sneezing, particularly in bursts, is one of the most common signs of allergic rhinitis. This often happens shortly after exposure to pollen or indoor allergens.
Itchy nose and throat
An intense itch inside the nose is highly characteristic of allergy. Some people also experience itching in the throat or ears.
Runny nose
The nasal discharge in allergic rhinitis is usually clear and watery. This differs from the thicker yellow or green mucus often seen with infection.
Nasal congestion
Inflammation of the nasal lining can cause a persistent blocked nose. This may alternate between nostrils or affect both sides.
Itchy watery eyes
Many patients develop red watery eyes, known medically as allergic conjunctivitis.
Postnasal drip
Excess mucus may drip down the back of the throat, causing coughing or throat clearing.
Does allergic rhinitis cause fatigue?
Yes. Ongoing nasal congestion and disturbed sleep can lead to daytime tiredness and difficulty concentrating. Even mild chronic inflammation can affect sleep quality.
Children and adults with poorly controlled hay fever may feel irritable or less productive during peak pollen seasons.
Seasonal vs perennial rhinitis: understanding triggers
Identifying the trigger is central to effective treatment.
Seasonal allergic rhinitis
This type is triggered by pollen. In the UK:
- Tree pollen peaks in early spring
- Grass pollen is highest in late spring and early summer
- Weed pollen tends to appear in late summer
Symptoms often flare on warm, dry and windy days when pollen counts are high.
Perennial rhinitis symptoms
Year round symptoms are usually linked to:
- House dust mites
- Pet dander
- Indoor mould spores
Symptoms may worsen in the morning or when cleaning dusty areas.
Specialist allergy testing can identify the specific allergen responsible. Not all antihistamines work equally well for all triggers, so targeted treatment can improve control.
Allergic rhinitis vs cold: how to tell the difference
A common question is ‘how do I know if I have hay fever or a cold?’
There are several key differences.
Duration
A cold usually lasts 7 to 10 days. Hay fever can last weeks or months, especially during pollen season.
Fever
Unlike a cold, hay fever does not cause fever.
Itching
Itching of the nose or eyes strongly suggests allergy rather than infection.
Nasal discharge
Allergic rhinitis produces clear watery mucus. A cold often causes thicker mucus that may change colour.
If symptoms persist beyond two weeks without fever and are triggered by specific environments or seasons, allergic rhinitis is more likely.
Complications of untreated allergic rhinitis
Although often considered mild, chronic rhinitis can have longer term consequences.
Sinusitis
Ongoing inflammation can block sinus drainage pathways and lead to sinus infections (sinusitis).
Nasal polyps
Chronic inflammation may contribute to the development of nasal polyps, which are soft, non cancerous growths inside the nose.
Learn more about nasal polyps symptoms and when they require assessment.
Sleep disruption
Persistent congestion can affect sleep quality, leading to snoring or mouth breathing.
Can allergic rhinitis cause nasal polyps?
Long standing inflammation inside the nasal passages can increase the risk of developing nasal polyps in some individuals. Not everyone with hay fever develops polyps, but persistent swelling can alter the lining of the nose over time.
If you notice ongoing blockage that does not respond to medication, specialist examination may be helpful.
When should I see a specialist for hay fever?
Many people manage mild symptoms with antihistamines or nasal sprays. However, specialist assessment is recommended if:
- Symptoms are present all year
- Over the counter treatments are not effective
- You experience frequent sinus infections
- Nasal blockage is severe or persistent
- You are considering immunotherapy
Immunotherapy, also known as allergy desensitisation, involves gradual exposure to the allergen to reduce immune sensitivity. It is available for suitable patients after proper assessment.
What does an ENT allergy assessment involve?
A detailed consultation explores symptom patterns, environmental exposures and previous treatments.
Testing may include:
Skin prick testing, which places small amounts of allergen on the skin
Specific blood tests to measure allergy related antibodies
These investigations help confirm the diagnosis and guide targeted treatment.
Specialist support for persistent symptoms
If antihistamines are not keeping symptoms under control, further evaluation may help clarify the cause and refine treatment.
Our specialists provide comprehensive assessment, targeted testing and tailored treatment plans for patients affected by allergic rhinitis.
Learn more about allergy and hayfever services or arrange diagnostic allergy tests to identify your specific trigger.
