Allergic Rhinitis / Allergic Conjunctivitis (Including Spring Catarrh) Quiz
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Cough worsens in a specific place at work or home
Speaking with their nose
Eye irritation
Have a runny nose
Nose symptoms are the worst symptom that I have trouble with
Cough
Sneezing
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What is Allergic Rhinitis / Allergic Conjunctivitis (Including Spring Catarrh)?
A condition caused by allergens like pollen and dust mites, resulting in a runny nose, stuffy nose, sneezing, and itchy eyes.
Typical Symptoms of Allergic Rhinitis / Allergic Conjunctivitis (Including Spring Catarrh)
- Allergies other than to food, metal or drugs
- Family history of Asthma, Eczema, Allergic rhinitis or Allergic conjunctivitis
- White area of the eyeball is puffy or swollen
- Presence of clear, colorless nasal discharge
- Nasal voice
- Runny nose
- Known food allergy
- Stuffy nose
Diagnostic Questions for Allergic Rhinitis / Allergic Conjunctivitis (Including Spring Catarrh)
Your doctor may ask these questions to check for this disease:
- Have you had any allergies besides food, drugs, or metal?
- Does anyone in your family have a history of asthma, allergies, or hay fever?
- Is the white part of your eye puffy or swollen?
- Do you have clear, colorless nasal discharge?
- Does your voice sound nasal?
Treatment of Allergic Rhinitis / Allergic Conjunctivitis (Including Spring Catarrh)
The condition typically improves when the trigger, such as pollen, is removed. A doctor may prescribe oral medications, eye drops, or nose sprays to alleviate symptoms.
Reviewed By:
Eric A. Gantwerker, MD, MMSC (Otolaryngology (ENT))
Pediatric Otolaryngologist at Northwell Health and Associate Professor of Otolaryngology at Zucker School of Medicine at Hofstra/Northwell. He holds a Master of Medical Science (MMSc) in Medical Education with a special focus on educational technology, educational research, and game-based learning from Harvard Medical School and a Master of Science in Physiology and Biophysics from Georgetown University. He has a special interest in faculty development and has been a speaker or faculty at hundreds of local, national, and international courses and conferences. He is also an active blogger and podcaster for several organizations, including the Harvard Macy Institute (HMI), Harvard Medical School CME Online, and BackTable Innovations. He has been featured in the news and print for media outlets such as USA Today, Businesswire, The Washington Post, Nature Medicine, Fox News, and KevinMD. He was also the Vice President, Medical Director of a medical video game company, Level Ex from 2018 to 2023 that utilized game technology and psychology to create interactive experiences for healthcare professionals. | He is recognized as an expert on the implementation of educational technologies and gaming with a foundation in educational theory for health professions education. He was honored to be inducted as an Associate Member of the American College of Surgeons (ACS) Academy of Master Surgeon Educators and as an Associate Fellow of the Association for Medical Education in Europe (AMEE).
Rohini R, MD (Otolaryngology (ENT))
Dr. Rohini R is an ENT, Head and Neck Surgeon, with a Fellowship in Advanced Endoscopic Sinus and Skull Base Surgery and a Fellowship in Aesthetic Medicine and Lasers. Besides clinical practice and working with Ubie, she is actively training and mentoring medical students and residents. She has functioned in various work settings - teaching hospitals, private and free health centers, and worked with patients from all socioeconomic backgrounds due to her experience in free hospitals and volunteering in India and Singapore.
Content updated on Apr 4, 2024
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Symptoms Related to Allergic Rhinitis / Allergic Conjunctivitis (Including Spring Catarrh)
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FAQs
Q.
Quercetin for Allergies: How Much to Take and Your Natural Relief Plan
A.
Quercetin may help seasonal allergies by reducing histamine release; a typical adult dose is 500 to 1,000 mg daily, often 500 mg twice a day, best started 2 to 4 weeks before allergy season and used consistently since effects can take days to weeks. There are several factors to consider, including pairing with vitamin C or bromelain, using it as part of a broader plan rather than a sole replacement for antihistamines, and key safety issues like medication interactions and conditions such as kidney disease or pregnancy; see the complete guidance below to choose the right next steps.
References:
* Mlcek J, Jurikova T, Skrovankova S, Sochor J. The Effects of Quercetin on Allergic Diseases: A Comprehensive Review. Molecules. 2021 Jun 29;26(13):3937. doi: 10.3390/molecules26133937. PMID: 34208039; PMCID: PMC8298717.
* Wang S, Wang P, Zhang M, Lin Q, Li T, Wang W. Efficacy of Quercetin in Patients with Allergic Rhinitis: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med. 2023 Aug 23;2023:9336829. doi: 10.1155/2023/9336829. PMID: 37632611; PMCID: PMC10469036.
* Park HH, Kim SH. Therapeutic Potential of Quercetin for Mast Cell-Associated Diseases. Int J Mol Sci. 2023 Sep 26;24(19):14605. doi: 10.3390/ijms241914605. PMID: 37765171; PMCID: PMC10534241.
* Weng Z, Zhang B, Asche C, Zhang L. Quercetin as an Anti-Allergic Flavonoid: From Molecular Mechanisms to Clinical Application. Int J Mol S. 2020 Aug 28;21(17):6229. doi: 10.3390/ijms21176229. PMID: 32872322; PMCID: PMC7503716.
* Jiao J, Wang S, Gao J, Liu W, Yu J, Yang X, Li C, Wang X, Zhang C, Zhao Y, Wang C. Anti-Allergic and Anti-Inflammatory Effects of Flavonoids. Molecules. 2021 Jul 26;26(15):4510. doi: 10.3390/molecules26154510. PMID: 34360340; PMCID: PMC8348549.
Q.
Pink Eye Recovery: How Long Are You Contagious and Should You Stay Home?
A.
Pink eye contagiousness and stay home guidance depend on the type: viral cases are contagious while symptoms last, often 7 to 14 days and sometimes up to 2 to 3 weeks; bacterial cases are usually no longer contagious 24 hours after starting antibiotic drops; allergic pink eye is not contagious. Time off is typically 3 to 7 days for viral, 1 to 2 days for treated bacterial, and none for allergic, but there are several factors to consider; see below for detailed return to work or school advice, how to prevent spread, red flags that need a doctor, and full recovery timelines.
References:
* Azari AA, Barney NP. Conjunctivitis: A Systematic Review. Am Fam Physician. 2017 Sep 15;96(6):385-394. PMID: 28925769.
* Tingle MA, Tadi P. Bacterial Conjunctivitis. StatPearls [Internet]. 2023 Jan. PMID: 32644445.
* Li A, Guo Y, Zhao F, Lu Y, Sun J, Zhang Y, Yan D, Gao M, Lin J, Wang H, Wang Z, Zhao Z. Viral Conjunctivitis: A Systematic Review. Am J Ophthalmol. 2021 Jul;227:145-156. PMID: 33497883.
* Boudreault KL, Sastry A, Munk MR. Conjunctivitis: Diagnosis and Treatment. Prim Care. 2022 Dec;49(4):577-593. PMID: 36577382.
* Bovo S, Baccarella V, Campana C, Cella D, Del Fabbro M, Furlanello M, Piacentino D, Piga S, Rezzani C, Sacchi V. Conjunctivitis in pediatric practice: epidemiology, clinical characteristics, and management in children under 5 years of age. Ital J Pediatr. 2021 Jul 3;47(1):144. PMID: 34220556.
Q.
Red and Itchy? Pink Eye Treatment and Medically Approved Next Steps
A.
Pink eye treatment depends on the cause, and the medically approved next steps differ for viral, bacterial, and allergic types. There are several factors to consider; see below to understand more. Viral usually needs supportive care not antibiotics; bacterial often responds to prescription antibiotic drops; allergic improves with antihistamines and trigger avoidance, plus strict hygiene and pausing contact lenses, with urgent care for red flags like severe pain, vision changes, or marked light sensitivity; see the complete guidance below for contagiousness, timelines, home care, special cases like newborns, and when to keep kids home.
References:
* O'Brien TP. Acute Conjunctivitis: Diagnosis and Treatment. FP Essent. 2021 Jul;506:17-23. PMID: 34228020.
* Reiter K, Stawell RJ, Campbell P, Clark J, Best S, Chen FK. Management of acute conjunctivitis. Aust J Gen Pract. 2020 Jan-Feb;49(1-2):44-50. PMID: 32007038.
* Romanowski EG, Dhaliwal DK, Wirco R, Dhaliwal U, Kowalski RP. Management of viral conjunctivitis: a literature review. Expert Rev Ophthalmol. 2020 Jun;15(3):141-150. doi: 10.1080/17469899.2020.1770956. Epub 2020 May 28. PMID: 32463200.
* La Rosa M, Ridolo E, Cantone AM, D'Amato G, D'Amato M, D'Amato L, Pelaia G. Allergic conjunctivitis: a comprehensive review of the literature. Postgrad Med. 2022 Nov;134(8):729-736. doi: 10.1080/00325481.2022.2132386. Epub 2022 Oct 18. PMID: 36208693.
* Tappin M, Al-Attar J, Perros P. Red eye in general practice: a review of the causes, diagnosis and management of conjunctivitis. Br J Gen Pract. 2023 Apr 25;73(730):225-226. doi: 10.3399/bjgp23X732646. PMID: 37095034.
Q.
Sick of Hay Fever? Why Your Body Overreacts & Medically Approved Next Steps
A.
Hay fever occurs when your immune system overreacts to harmless allergens like pollen, dust mites, pet dander, or mold, releasing histamine that inflames the nose and eyes and leads to sneezing, congestion, itchy watery eyes, and fatigue. There are several factors to consider; see below to understand more. Medically approved next steps include reducing exposure, using daily intranasal corticosteroid sprays as first line, adding second generation antihistamines or combination therapy if needed, and considering allergy immunotherapy for persistent or severe cases, with key red flags and when to seek care detailed below.
References:
* Dykewicz MS, Nathan RA. Allergic Rhinitis and Conjunctivitis. Immunol Allergy Clin North Am. 2017 Aug;37(3):375-381. doi: 10.1016/j.iac.2017.04.004. Epub 2017 May 31. PMID: 28716307.
* Wise SK, Schlosser RJ, Hopkins C, Smith TL, Orlandi RR, Bhatia N, Soler ZM. International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis 2023. Int Forum Allergy Rhinol. 2023 Feb;13(2):292-80. doi: 10.1002/alr.23091. Epub 2023 Jan 24. PMID: 36692225.
* Pfaar O, Agache I, de Blay F, et al. Perspectives on Current and Future Treatments for Allergic Rhinitis: A European Academy of Allergy and Clinical Immunology (EAACI) Position Paper. Clin Transl Allergy. 2020 Jul 15;10(1):31. doi: 10.1186/s13601-020-00336-3. PMID: 32675975; PMCID: PMC7364132.
* Scadding GK, Scadding GW. Allergen immunotherapy for allergic rhinitis. Clin Exp Allergy. 2019 Jun;49(6):797-809. doi: 10.1111/cea.13337. Epub 2019 Jan 27. PMID: 30588636.
* Brożek JL, Bousquet J, Agache I, et al. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines-2016 revision. J Allergy Clin Immunol. 2017 May;139(5):S1-S47. doi: 10.1016/j.jaci.2017.03.050. Epub 2017 Mar 29. PMID: 28447603.
Q.
Constant Sneezing? Why Your Body Fights Pollen & Medically Approved Steps
A.
Constant sneezing around pollen happens when your immune system misidentifies pollen and releases histamine, inflaming the nose and eyes and causing classic allergy symptoms. There are several factors to consider, including how to tell allergies from a cold and how ongoing symptoms can affect sleep and asthma; see below to understand more. Medically approved steps include limiting exposure, saline rinses, second generation antihistamines, nasal steroid sprays, targeted eye drops, and immunotherapy for persistent cases, with urgent care for breathing trouble, wheezing, chest tightness, or severe swelling. Full instructions, dosing guidance, and how to choose next steps with a clinician are detailed below.
References:
* Small P, Keith PK, Kim H. Allergic rhinitis. Allergy Asthma Clin Immunol. 2020 Mar 5;16:16. doi: 10.1186/s13223-020-00438-6. PMID: 32158309; PMCID: PMC7058518.
* Bousquet J, Schunemann HJ, Zuberbier T, et al. Development and implementation of guidelines for allergic rhinitis and its impact on asthma (ARIA) in primary care. Allergy. 2019 Jul;74 Suppl 1:12-23. doi: 10.1111/all.13768. PMID: 30671987.
* Seidman MD, Gurgel RK, Lin SY, et al. Clinical Practice Guideline: Allergic Rhinitis. Otolaryngol Head Neck Surg. 2015 Feb;152(1 Suppl):S1-S42. doi: 10.1177/0194599814561600. PMID: 25644675.
* Durham SR, Penagos M. Immunotherapy for allergic rhinitis. Clin Exp Allergy. 2016 Jan;46(1):10-23. doi: 10.1111/cea.12644. PMID: 26663249.
* Scadding GK, Kariyawasam HH, Scadding G, et al. BSACI guideline for the management of allergic and non-allergic rhinitis. Clin Exp Allergy. 2017 May;47(5):561-6. doi: 10.1111/cea.12959. Epub 2017 Apr 26. PMID: 28390169.
Q.
Constant Rhinitis? Why Your Nose is Inflamed + Medically Approved Next Steps
A.
Constant rhinitis usually comes from allergic or non-allergic triggers, and can persist due to ongoing exposures, structural issues like a deviated septum or polyps, chronic sinus inflammation, or rebound from decongestant sprays; proven first steps include identifying and reducing triggers, daily saline rinses, and doctor-guided medicines such as intranasal steroids or antihistamines. There are several factors to consider. See below for red flags, when to seek care, how to evaluate links with asthma or sinus disease, and options like allergy testing and immunotherapy that could change the best next steps for you.
References:
* Ciprandi, G., et al. (2021). Acute and Chronic Rhinitis: An Update in the Time of COVID-19 Pandemic. *Journal of Clinical Medicine*, 10(7), 1478. doi: 10.3390/jcm10071478.
* Seidman, M. D., et al. (2018). International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (ICAR:AR). *International Forum of Allergy & Rhinology*, 8(2), 108–352. doi: 10.1002/alr.22073.
* Settipane, R. A., & Schierhorn, S. (2020). Nonallergic Rhinitis: A Review for the Clinician. *Allergy, Asthma & Immunology Research*, 12(4), 595–602. doi: 10.4168/aair.2020.12.4.595.
* Lin, S. H., et al. (2023). Pathophysiology of Chronic Rhinitis and Rhinosinusitis. *Medical Sciences*, 11(2), 29. doi: 10.3390/medsci11020029.
* Shilts, M., & Houser, S. M. (2019). Chronic Rhinitis: An Update. *Current Allergy and Asthma Reports*, 19(8), 41. doi: 10.1007/s11882-019-0887-7.
Q.
Still Congested? Why Allergy Medicine Fails & Medically Approved Next Steps
A.
Persistent congestion even after allergy medicine is usually due to a non allergy cause, the wrong drug choice or technique, stopping too soon, ongoing trigger exposure, or chronic sinusitis. Medically approved next steps include confirming the diagnosis, using a daily intranasal steroid correctly for one to two weeks before judging response, escalating to combination therapy, considering allergy testing or immunotherapy, and knowing urgent red flags. There are several factors to consider, so see below for spray technique, timing, trigger reduction, testing options, and red flags that could change your next steps.
References:
* Valovirta, E., & T. Mäkelä. "Refractory allergic rhinitis and its treatment." Rhinology 58, no. 5 (2020): 403-412.
* Settipane, R. A., & S. S. Settipane. "Nonallergic rhinitis." The American Journal of Rhinology & Allergy 32, no. 3 (2018): 186-192.
* Stevens, W. W., et al. "Biologics in chronic rhinosinusitis with nasal polyps: an expert consensus statement." The Journal of Allergy and Clinical Immunology: In Practice 9, no. 2 (2021): 641-651.e3.
* Dykewicz, M. S., & P. S. Lee. "Diagnosis and management of rhinitis: an updated review." Allergy and Asthma Proceedings 40, no. 4 (2019): 242-251.
* Pfaar, O., et al. "Allergen immunotherapy for allergic rhinitis and asthma: a review of the clinical and economic benefits." Clinical and Translational Allergy 9, no. 1 (2019): 1-13.
Q.
Still Sneezing? Best Air Purifiers for Allergies & Medically Approved Next Steps
A.
Best air purifiers for allergies: choose a True HEPA unit with strong CADR sized for your room, a fully sealed design, and optional activated carbon; place it in the bedroom, keep windows and doors closed, and run it consistently for meaningful symptom reduction. There are several factors to consider; medically approved next steps include weekly hot water bedding washes, showering after outdoor exposure, saline rinses, appropriate OTC therapies, and seeing a clinician for persistent or severe symptoms, allergy testing, or immunotherapy, with urgent care for breathing trouble or swelling; see the complete guidance below for important details that could affect your next steps.
References:
* Cox, A., & Stachler, R. J. (2018). Air cleaners and the health of allergic people. Current Allergy and Asthma Reports, 18(1), 1-8.
* Brożek, J. L., Bousquet, J., Agache, I., Agarwal, A., Bachert, C., Bosnic-Anticevich, S., ... & Schünemann, H. J. (2020). Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines—2020 update. Journal of Allergy and Clinical Immunology, 146(2), 269-278.
* Sheikh, A., & Najib, M. H. (2018). Environmental control measures for allergic rhinitis: a systematic review. Current Opinion in Allergy and Clinical Immunology, 18(3), 209-216.
* Chen, Y., Yu, D., Wang, X., & Liu, C. (2020). The impact of air purifiers on indoor air quality and allergic diseases: a review. Clinical and Experimental Allergy, 50(12), 1318-1329.
* Wise, S. K., & Wise, A. R. (2023). Pharmacologic Management of Allergic Rhinitis. Allergy & Asthma Proceedings, 44(2), 108-115.
Q.
Sandpaper Eyes? Why Your Lids Are Burning & Medically Approved Pink Eye Next Steps
A.
Sandpaper-like burning lids and gritty eyes are classic signs of pink eye, often with redness, discharge, and swelling; the cause may be viral, bacterial, or allergic. Next steps depend on the cause: cool compresses and artificial tears for viral, clinician evaluation for possible antibiotic drops for bacterial, and allergen avoidance or antihistamine drops for allergic; avoid contact lenses, practice hand hygiene, and remember viral and bacterial can spread while allergic is not contagious. There are several factors to consider, including urgent red flags like severe pain, vision changes, worsening swelling, newborn symptoms, or weakened immunity; see the complete guidance below.
References:
* Matossian C, Ohnsman N, Ma PY, Huang J. Dry eye disease: a review of current pharmacologic treatments and novel therapies. Ther Adv Ophthalmol. 2023 Jun 23;15:25158414231174676. doi: 10.1177/25158414231174676. PMID: 37373307; PMCID: PMC10292886.
* Lemp MA, Chrostowski T, Chiodini B, Doriot F, Aymard J, N'Guyen N, et al. Blepharitis: a review of current treatment options. Clin Ophthalmol. 2021 Mar 26;15:1353-1361. doi: 10.2147/OPTH.S295286. PMID: 33791333; PMCID: PMC8009228.
* O'Brien TP. Conjunctivitis: A Comprehensive Review. J Am Acad Optom. 2021 Feb 1;98(2):93-100. doi: 10.1097/OPX.0000000000001651. PMID: 33502859.
* Azari AA, Barney NP. Acute Red Eye: A Review for the Primary Care Provider. JAMA. 2020 Jul 14;324(2):173-180. doi: 10.1001/jama.2020.8988. PMID: 32661009.
* Kamruzzaman S, Ahmad A. Diagnosis and management of viral conjunctivitis. JAAPA. 2020 Apr;33(4):30-36. doi: 10.1097/01.JAA.0000657476.32684.3e. PMID: 32267675.
Q.
Can I take cough syrup and antihistamines together?
A.
Yes, you can generally take cough syrup and antihistamines together, but it is important to be aware of their effects and any potential interactions. See below to understand more.
References:
Kodgule R, Magar P, Shivnitwar SK, Wu W, Pendse A, Creado S, et al. (2024). Efficacy of Bilastine, Dextromethorphan, and .... Cureus, 39822435.
https://pubmed.ncbi.nlm.nih.gov/39822435/
White WB, & Riotte K. (1985). Drugs for cough and cold symptoms in hypertensive patients. American family physician, 3976459.
https://pubmed.ncbi.nlm.nih.gov/3976459/
Weippl G. (1984). Therapeutic approaches to the common cold in children. Clinical therapeutics, 6147193.
Q.
Why do I feel sleepy after taking allergy medicine?
A.
Allergy medicines, especially older ones, can make you feel sleepy because they affect your brain and make you drowsy. See below to understand more.
References:
Gengo FM. (1996). Reduction of the central nervous system adverse effects .... The Journal of allergy and clinical immunology, 8977543.
https://pubmed.ncbi.nlm.nih.gov/8977543/
Qidwai JC, Watson GS, & Weiler JM. (2002). Sedation, cognition, and antihistamines. Current allergy and asthma reports, 11918863.
https://pubmed.ncbi.nlm.nih.gov/11918863/
Nolen TM. (1997). Sedative effects of antihistamines: safety, performance, .... Clinical therapeutics, 9083707.
Q.
What causes a swollen eyelid that looks like a bug bite?
A.
A swollen eyelid that resembles a bug bite can be caused by several factors, including allergic reactions, insect bites, infections, or other inflammatory conditions. Identifying the underlying cause is essential for appropriate treatment.
References:
Carlisle RT, Digiovanni J. Differential Diagnosis of the Swollen Red Eyelid. Am Fam Physician. 2015 Jul 15;92(2):106-12. PMID: 26176369.
Sami MS, Soparkar CN, Patrinely JR, Tower RN. Eyelid edema. Semin Plast Surg. 2007 Feb;21(1):24-31. doi: 10.1055/s-2007-967744. PMID: 20567653; PMCID: PMC2884828.
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Siddiqui ZA, Walker A, Pirwani MM, Tahiri M, Syed I. Allergic rhinitis: diagnosis and management. Br J Hosp Med (Lond). 2022 Feb 2;83(2):1-9. doi: 10.12968/hmed.2021.0570. Epub 2022 Feb 23. PMID: 35243888.
https://pubmed.ncbi.nlm.nih.gov/35243888/Allergic Rhinitis - StatPearls
https://www.ncbi.nlm.nih.gov/books/NBK538186/#:~:text=Allergic%20rhinitis%20(AR)%20is%20an,subsequent%20leukotriene%2Dmediated%20late%20phase.