For many us, spring and early summer means sneezing and a runny nose. And while most people experiencing these symptoms tend to think they have hayfever or sinusitis, it’s very likely to be allergic rhinitis. But what is allergic rhinitis, and how and why does it happen?

Allergic rhinitis happens when you breathe in foreign matter or particles – originating from sources like cats, dogs, pollen and mould. Once it’s in your system, your body mistakenly recognises these particles as harmful bacteria or parasites. In an attempt to protect your body against these particles, your immune system will launch an attack to drive them out. It does this by producing histamine (read more about histamines, and antihistamines, here).

You’re most likely to feel your immune system’s reaction in your nose because it’s designed to act as a filter for large and small particles. The cells in your nose will become inflamed, and you’ll feel itchiness in your nose, followed by some sneezing and a runny nose.

As a result of these symptoms, your sinuses are also likely to suffer

Days after the start of the symptoms, the inflamed cells in your nose might still be active. If they are, you will have a blocked, congested nose that, despite your best efforts, will not clear up.

This is the part where people often use “sinus” to describe their symptoms, while it actually is allergic rhinitis.

But how is sinusitis different from allergic rhinitis?

When our sinuses get infected by viruses or bacteria, we develop sinusitis. Some of the symptoms include postnasal drip, discoloured nasal discharge, a blocked, congested nose and tenderness in the face – even headaches. Not all sinusitis episodes need antibiotics. You can also manage it with nasal rinses, intra-nasal cortisones and a fair amount of patience.

When sinusitis persists for more than two weeks, you might start getting symptoms related to this infection in the rest of your body. These symptoms might include fever, body ache, and worsening of conditions like asthma. If this happens, it’s essential to seek medical help.

How can I tell the difference?

One of the ways to determine this might sound unpleasant, but comparing the colour and type of mucus is another way to help determine what’s causing your nasal congestion. Clear nasal drainage often coincides with allergies. Persistent yellow or green nasal discharge in large amounts may be an indicator of sinusitis.

Also remember that itchy nose, sneezing, and itchy, watery eyes are more common with allergic rhinitis and allergies. The inflammation in our sinuses caused by allergic rhinitis also lead to large amounts of mucus in the nose and throat, also referred to as postnasal drip. The level of discomfort and impact on our quality of life makes us believe it is an infection because why else do we feel ill so often.

It’s important to note that allergic rhinitis can also lead to infections like sinusitis. That said, once we diagnose and treat our allergic rhinitis correctly, our sinus problems will be controlled, and we will have fewer episodes of sinusitis.

Nasal spray options

Persistent allergic rhinitis that is mostly congestion is treated with intra nasal cortisones such as Fluticasone, Momethasone, Ciclesonide. The most important factor to remember is consistency of use as your exposure is continuous. The correct administration is important to prevent side effects such as nose bleeds and to ensure maximal efficacy.

  • The purpose of this article is to raise awareness of allergies  and the treatment options that are available for it. This article should by no means be used, or viewed, as a primary source for medical or other professional advice – please arrange for a personal consultation with your medical practitioner before taking any decisions that could affect the wellbeing of you or your loved ones. Read our medical disclaimer for more information.


Marinda McDonald

Dr Marinda McDonald has offered specialised treatments for allergies for most of her professional career. Read more about her on the home page of this website (allergydoc.co.za).