You have been diagnosed as having non-allergic rhinitis, which is sometimes also called vasomotor rhinitis. This means that your allergy skin tests were negative, or you had a few positive skin tests that do not fully explain your symptoms. It is often a surprise to patients that they do not have allergies, because often they have had allergy-like symptoms for many years. Actually the symptoms of allergic rhinitis (AR) and non-allergic rhinitis overlap quite a bit: patients with both conditions may have nasal congestion (stuffiness), drip and drainage, sinus headaches and frequent sinus infections.
We often say that having NAR rather than AR is both good news and bad news. The good news is that the NAR patients do not have to close windows on beautiful spring and fall days, get rid of their pets, or take allergy shots. The bad news is that closing windows, getting rid of pets and allergy shots will not help NAR patients.
The triggers for NAR are not the usual ones for AR (pollens, molds, mite, and animal danders). Triggers for NAR are generally irritants:
- Fragrances (perfumes, colognes, air fresheners such as Glade “plug-ins”)
- Aerosols (hair sprays, cleaning products, etc.)
- Dusts (house dust, dry wall dust, dust from dirt roads or grass cutting)
You are not allergic to these things; rather they irritate your inflamed non-allergic nose.
Other triggers for NAR include "physical factors":
- Temperature changes (e.g., going from hot outdoor air into an air-conditioned room in the summer)
- Barometric pressure changes (e.g., falling barometric pressure before rains)
- Hot or cold or spicy food
Treatment of NAR, too, is different. Antihistamines (e.g., Zyrtec, Allegra, and Claritin) are important treatments for AR, but generally do not help people with NAR. The most commonly used treatments for NAR are:
- Nasal anti-inflammatory sprays
- Nasal steroid sprays (e.g., Flonase, Rhinocort, Nasonex)
- Astelin nasal spray
- Mucolytics (guaifenesin)
- Atrovent (ipratropium) nasal spray (for very drippy noses)
Finally, although the official name of our specialty is “Allergy,” we are happy to take care of your NAR. In fact, the allergist is probably the specialist best qualified to take care of this sometimes difficult condition.
Allergy and Asthma Consultants, P.C.
Robert F. Onder, M.D.
Office # (314)569-0510