There are a host of different substances that enter the nose as we breath. Dust, pollen, smoke and variety of other chemicals as well as microbes are constantly making contact with both the outer and inner surfaces of the nose. These substances can cause irritation or trigger allergies and the microbes may lead to nasal infections.
Nasal Allergy vs Nasal Irritation
Although there may be irritation or an allergic reaction of the skin of the nose, most of the time it is the effect on the inside of the nose that causes symptoms like sneezing, a runny nose and itching inside the nose. This may be due to either a nasal allergy or nasal irritation. Despite the similarity of symptoms there is a difference between the mechanism behind the nasal inflammation.
An allergy is where the immune system mistakenly identifies harmless substances as being a threat. Pollen, house dust mite and cockroach particles as well as mold are some of the common allergens. The immune defenses are prematurely activated and this causes inflammation of the nasal lining. This is known as allergic rhinitis. Usually the lining of the paranasal sinuses are also inflamed.
Read more on allergic rhinitis.
Irritation of the nasal cavity may affect any person unlike a nasal allergy which only affects hypersensitive people. The nasal lining is delicate and sensitive but can withstand irritation from various substances to a certain degree. Common causes include dust, smoke, smog and strong odors. It may not pose a problem in small quantities but these irritants can eventually trigger inflammation of the nasal lining. This is known as nonallergic rhinitis
However, nonallergic rhinitis may also include other types of rhinitis such as:
- Infectious rhinitis
- Gustatory rhinitis
- Vasomotor rhinitis
- Drug-induced rhinitis
- Rebound rhinitis
- Hormonal rhinitis
- Occupational rhinitis
Causes of Nose Allergy and Irritation
Some of the possible triggers of both a nasal allergy and nasal irritation overlap. It is also important to consider all triggers and causes of non-allergic non-infectious rhinitis (NANIR). Viral and bacterial infections are the more common causes of acute infectious rhinitis. The paranasal sinuses are also commonly affected, hence the term rhinosinusitis (nasal inflammation + sinus inflammation).
Common allergens (triggers of allergic rhinitis) include:
- House dust mite
- Dander (animal hair, fur and feathers)
Any airborne substance can be an irritant if triggers nasal inflammatio but the most common include:
- Chemical fumes
- Strong odors (perfumes, paint, insecticides and so on)
Changes in weather may trigger or worsen rhinitis but certain climatic conditions are more likely to lead to nasal inflammation, such as:
- Cold air, including air conditioning
- Dry air
- Windy environments where there is airborne dust
Foods and Beverages
A number of different foods and beverages can trigger nasal inflammation (gustatory rhinitis) but the more common includes:
- Hot or spicy foods
- Alcoholic beverages
A change in hormone levels can trigger or exacerbate rhinitis. This is more likely to occur with the female hormones – estrogen and progesterone. This may occur during pregnancy and with the use of oral contraceptives (birth control pills) and hormone replacement therapy (HRT).
A number of drugs may trigger or worsen rhinitis. Apart from hormone medication discussed above, certain non-steroidal anti-inflammatory drugs (NSAIDs), antidepressants, antihypertensive (high blood pressure), erectile dysfunction medication and sedatives are more likely to pose a problem. This is known as drug-induced rhinitis.
Sometimes the medication used to treat rhinitis, like decongestants, can also worsen rhinitis. This condition is known as rhinitis medicamentosa or rebound rhinitis. It arises with long term use or overuse of nasal decongestants. Usually it is short-lasting but can lead to chronic rhinosinusitis in some people.
Read more on rhinitis medicamentosa.
Signs and Symptoms
Individual sensitivity may vary. Therefore nasal inflammation symptoms may arise sooner or be worse in some people. Most cases of nose allergies or nasal irritation present with the same signs and symptoms. This includes:
- Runny nose
- Nasal congestion
- Burning and/or itching inside the nose
- Partial or complete loss of smell
There may also be watery eyes and eye redness. A fever is typically indicative of an infection. Due to the nasal congestion, a person usually experiences a nasal tone of the voice. A sore throat and cough may also arise in the event of post nasal drip. There may also be an increased risk of airway infections.
Read more on sensitive nose.
Treatment of Nose Allergy and Irritation
Ideally the irritant or allergen should be avoided altogether. However, this is not always possible and sometimes the causative substance cannot be conclusively identified. The following treatment options should be considered for treating nasal allergies or irritation:
- Saline nasal spray to flush out irritants and thinning excessive mucus that may congest the nose. It may also be helpful in allergic rhinitis.
- Corticosteroids (nasal or oral) to reduce inflammation and immune activity. Oral corticosteroids should only be used if other treatment options fail to yield the desired results.
- Decongestants (nasal or oral) may offer symptomatic relief byreducing mucus production but should not be used long term or without treating the underlying cause.
- Antihistamines (oral or nasal) block immune chemicals that cause nasal inflammation and are more effective for allergic rhinitis.
- Desensitizaion may be considered for chronic allergic rhinitis when it is severe and does not respond effectively to other treatment options.
Prevention of Nasal Allergy and Irritation
- Avoid exposure to allergens and irritants by cleaning thoroughly and removing potential sources from the home or work environment.
- Do not smoke tobacco within closed quarters. If tobacco smoking cannot be stopped, then it should only be done outdoors and away from others, especially children.
- Thoroughly clean the home of dander and if necessary remove pets from the interior of the home. Do not allow pets on the couch or bed.
- Switch off airconditioning or at least do not sit or sleep directly under an airconditioner. Hydrate with a saline nasal spray in airconditioned and dry environments.
- Speak to a medical professional about drugs that may be causing or trigger nasal inflammation. Never stop these drugs without medical supervision.