Non-Allergic Rhinitis

Allergy Services

Rhinitis, the term for nasal congestion and a runny nose (rhinorrhea), often has an allergic trigger, but for up to one-third of patients with negative allergy skin testing, the cause may be non-allergic rhinitis. 

Treatment includes identifying the likely cause and may also be supplemented by antibiotics, saline rinses, sinus surgery, antihistamines, inhaled steroids, or nasal sprays. 

Causes include:

  • Viral Upper Respiratory Infections – typically diagnosed by history and short-lived.
  • Chronic sinusitis – the persistent fluid that can harbor infection within the cavities found in the skull called sinuses. It can be associated with headaches, postnasal drip, ear discomfort, and discolored nasal secretions.  
  • Vasomotor rhinitis – occurs when the nasal mucosa is easily irritated by precipitants including strong odors, chemical fumes, weather changes, or spicy foods
  • Rhinitis Medicamentosis – overuse of decongestant nasal sprays such as Afrin induce an “addiction” resulting in worsening of nasal discharge when attempting to stop the decongestant. It can also be triggered by aspirin, ibuprofen, beta-blockers, alpha-blockers, antidepressants, sedatives, and erectile dysfunction medications
  • Endocrine Hormone Changes – hormone changes including hypothyroidism, pregnancy, menstruation, and the use of estrogen and oral contraceptives may cause sinus drainage