Prevention & care

Allergic rhinitis: hay fever, triggers, medicines, and nasal rinses

8 sources · Latest source check 2026-10-13 UTC

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Allergic rhinitis is an allergic reaction affecting the nose. Pollen, dust mites, animal dander and mould can trigger sneezing, itching, a runny or blocked nose, and watery eyes. Hay fever usually refers to pollen-related symptoms; nasal allergy is not limited to one season.[1]

An allergy is not the only reason for a runny nose

Nonallergic rhinitis can be triggered by temperature changes, smoke, perfume, some medicines or overuse of decongestant sprays. Symptoms can overlap with allergy. A blocked or runny nose alone therefore cannot establish a pollen, pet or food allergy. Exposure patterns and assessment help clarify the cause.[2]

Persistent symptoms affecting sleep or daily life, uncertainty about the cause, failure of pharmacy treatments or worsening asthma are reasons to discuss further assessment. Referral may help when symptoms are severe or unclear.[1]

A tablet, nasal spray and eye drop are different interventions

The 2026 ARIA–EAACI update compares oral and ocular medicines alongside intranasal treatment. It favors intranasal corticosteroids over oral antihistamines overall and oral antihistamines over leukotriene-receptor antagonists. These are class-level recommendations for allergic rhinitis, not proof that every person prefers or responds to the same product. Eye symptoms, nasal symptoms, delivery, cost and preference can produce different reasonable choices.[7]

Common approaches and their distinctions

Common approaches and their distinctions
Approach	What to understand
Antihistamines	Block the action of histamine; some cause more drowsiness than others. Available as tablets and some local preparations.[3]
Intranasal corticosteroids	Medicines such as fluticasone reduce swelling and irritation in the nose; they are a different class from decongestants.[6]
Nasal decongestants	Temporarily relieve blockage; overuse can worsen congestion. Check the specific product’s limits.[1]
Saline irrigation	Rinses nasal passages. Water safety and device cleaning are part of safe use.[4]

Drowsiness, rebound congestion, and rinse safety

Sedating antihistamines can impair coordination, reaction speed and judgment. Even products described as non-drowsy can occasionally cause sleepiness. Dry mouth and other adverse effects differ by medicine; alcohol or another sedating medicine can complicate use. A “non-drowsy” label is not a guarantee of unchanged alertness.[3]

NHS guidance warns that nasal decongestant sprays used for too long can worsen blockage; its current rhinitis page gives a five-day limit. Product instructions, age restrictions and pharmacist advice remain important because formulations and national guidance vary.[1]

For nasal irrigation, FDA advises distilled, sterile or appropriately boiled and cooled water, with proper device cleaning. Ordinary tap water is not automatically safe to put in the nose even when it is safe to drink. This precaution addresses rare but potentially serious infections; saline alone does not sterilize contaminated water.[4]

Allergen immunotherapy needs a relevant allergy and a safety assessment

Allergen immunotherapy exposes the immune system to selected relevant allergens through a structured treatment course. Subcutaneous and sublingual routes have different practical requirements. The 2024 guideline concerns people aged five and older with inhalant allergies, with or without allergic asthma. It requires assessing asthma before starting and uncontrolled asthma before subsequent treatment. A positive allergy result or the hope of a cure is not enough to establish eligibility.[8]

Recommendation changes do not mean every older medicine stopped working

The ARIA revision changed some recommendation directions or strengths as comparisons and evidence developed. Choosing a medicine still considers variable disease, patient values and affordability. A recommendation ranks a decision in a defined setting; it does not establish that a particular individual’s previous symptom relief was unreal or that treatment should change without assessing current needs.[7]

Evidence & uncertainty

Treatments can relieve symptoms, but tablets, nasal medicines and rinses are not equivalent. A review of trials in people aged 12 and older favored intranasal treatments over oral treatments for seasonal allergic rhinitis symptoms. Most included trials had unclear risk of bias, and this does not rank every product for every person.[5]

Selected-source overview · Independent review pending

Published questions

Is hay fever the same thing as every type of allergic rhinitis?

Selected-source overview · Independent review pending. Read the evidence context.

Hay fever usually means pollen-related rhinitis. Allergic rhinitis also includes reactions to dust mites, animal dander or mould, which may occur outside a pollen season.[1]

Evidence behind this answer

Allergic rhinitis
agency explanation · 2026
Selected relevant page text or original publication abstract inspected · Allergens, symptoms, assessment and current decongestant limit