Year-Round Allergies

The most obvious symptom of perennial allergies is a chronically stuffy nose. The nose runs, producing a clear watery discharge. The nose, roof of the mouth, and back of the throat may itch. Itching may start gradually or abruptly. Sneezing is common.

The eustachian tube, which connects the middle ear and the back of the nose, may become swollen. As a result, hearing can be impaired, especially in children. Children may also develop chronic ear infections. Some people have recurring sinus infections (chronic sinusitis Chronic sinusitis Sinusitis is inflammation of the sinuses, most commonly caused by a viral or bacterial infection or by an allergy. Some of the most common symptoms of sinusitis are pain, tenderness, nasal congestion... read more ) and growths inside the nose (nasal polyps Nasal Polyps Nasal polyps are fleshy outgrowths of the mucous membrane of the nose. Nasal polyps are more likely to develop in people who have allergies or asthma. Some of the symptoms caused by polyps are... read more ).

When affected, the eyes water and itch. The whites of the eyes may become red, and the eyelids may become red and swollen. The skin under the eyes can become dark (allergic shiner).

Many people who have a perennial allergy also have asthma Asthma Asthma is a condition in which the airways narrow—usually reversibly—in response to certain stimuli. Coughing, wheezing, and shortness of breath that occur in response to specific triggers are... read more , possibly caused by the same allergy triggers (allergens) that contribute to allergic rhinitis Allergic Rhinitis Rhinitis is inflammation and swelling of the mucous membrane of the nose, characterized by a runny nose and stuffiness and usually caused by the common cold or a seasonal allergy. Colds and... read more and allergic conjunctivitis Allergic Conjunctivitis Allergic conjunctivitis is inflammation of the conjunctiva caused by an allergic reaction. Allergic reactions caused by, for example, airborne allergens, may inflame the conjunctiva. Redness... read more .

Diagnosis of perennial allergies is based on symptoms plus the circumstances in which they occur—that is, in response to certain activities, such as petting a cat. It can often be diagnosed based on this information alone.

Avoiding or removing the allergen, if possible, is recommended, thus preventing the development of symptoms and the need to take medication.

If people are allergic to house dust, animal dander, or other indoor allergens, some changes in the environment may prevent or lessen symptoms:

Avoiding the allergen is the best way to treat as well as prevent allergies.

Drug treatment of perennial allergies is similar to that for seasonal allergies. It includes corticosteroid nasal sprays, antihistamines, and decongestants.

A corticosteroid nasal spray is usually very effective and is used first. Most of these sprays have few side effects, although they can cause nosebleeds and a sore nose.

An antihistamine, taken by mouth or used as a nasal spray, can be used instead of or in addition to a corticosteroid nasal spray. Antihistamines are often used with a decongestant, such as pseudoephedrine, taken by mouth.

Many antihistamine-decongestant combinations are available over the counter as a single tablet. However, people with high blood pressure should not take a decongestant unless a doctor recommends it and monitors its use. Also, people who take a monoamine oxidase inhibitor (a type of antidepressant) cannot take a product that combines an antihistamine and a decongestant. Antihistamine-decongestant combination drugs should not be given to young children.

Antihistamines may have side effects, particularly anticholinergic effects Anticholinergic: What Does It Mean? . Anticholinergic effects include sleepiness, dry mouth, blurred vision, constipation, difficulty with urination, confusion, and light-headedness.

Decongestants are also available over the counter as nose drops or sprays. They should not be used for more than a few days at a time because using them continually for a week or more may worsen or prolong nasal congestion—called a rebound effect—and may eventually result in chronic congestion.

Side effects tend to be fewer and less severe with nasal sprays than with drugs taken by mouth.

Other drugs are sometimes useful. Cromolyn (a mast cell stabilizer Mast cell stabilizers Allergic reactions (hypersensitivity reactions) are inappropriate responses of the immune system to a normally harmless substance. Usually, allergies cause sneezing, watery and itchy eyes, a... read more ) is available by prescription as a nasal spray and may help relieve a runny nose. To be effective, it must be used regularly.

Azelastine (which is an antihistamine and a mast cell stabilizer) and ipratropium (a drug that inhibits acetylcholine), both available by prescription as nasal sprays, may be effective. But these drugs can have anticholinergic effects similar to those of antihistamines taken by mouth, especially drowsiness.

Montelukast, a leukotriene inhibitor available by prescription, reduces inflammation and helps relieve a runny nose. It is best used only when other drugs are ineffective. Possible side effects include confusion, anxiety, depression, and abnormal muscle movements.

Regularly flushing out the sinuses with a warm water and salt (saline) solution may help loosen and wash out mucus and hydrate the nasal lining. This technique is called sinus irrigation.

When these treatments are ineffective, a corticosteroid Corticosteroids: Uses and Side Effects may be taken by mouth or by injection for a short time (usually for fewer than 10 days). If taken by mouth or injection for a long time, corticosteroids can have serious side effects.