Allergic Rhinitis (Nasal Allergy)

Allergic Rhinitis

(Nasal Allergy)

Allergic rhinitis arises when your immune system overreacts to otherwise harmless substances like pollen, dust mites, pet dander, or mould, causing inflammation in the nasal passages. This reaction triggers symptoms such as sneezing, congestion, runny nose, itchy eyes, and postnasal drip. In Singapore’s tropical climate, this condition is common and often persistent.

Types:

Seasonal: Triggered by outdoor allergens like pollen, though less distinct in Singapore’s climate.

Perennial: More common, caused by indoor allergens—especially dust mites and mould.

Symptoms, Causes & Triggers

Allergic rhinitis often resembles a cold or sinus infection and may include:

Nasal congestion or runny nose
Frequent sneezing
Itchy nose, throat, or palate
Clear, watery nasal discharge
Postnasal drip and hanging cough
Itchy or watery eyes
Fatigue, poor sleep, or "allergic shiners" (dark circles under eyes)

Common triggers in Singapore include:

House Dust Mites – the most prevalent cause, thriving in warm, humid environments found in bedding and fabrics
Pollen – from Casuarina, Acacia, and palm trees, particularly in landscaped areas
Mould Spores – in damp, poorly ventilated spaces like bathrooms or air-con units
Pet Dander – microscopic flakes from cats or dogs; exposure has increased with relaxed public housing pet rules
Cockroach Allergens – common in densely populated areas
Indoor Air Pollutants – from cooking, cleaning agents, and building materials in enclosed spaces where people spend 90% of their time

Diagnosis

Accurate diagnosis is key since symptoms overlap with other conditions. The process may involve:

Skin Prick Test

Tiny droplets of allergens are placed on the forearm and tested for reactions in 15–30 minutes
RAST (Blood) Test

Used when skin testing isn’t viable (e.g. skin conditions, medications), with results in ~2 weeks

Treatment Options

1. Allergen Avoidance

Reducing exposure is foundational:

2. Medications

Dependent on symptoms and severity:

Antihistamines – modern, non-sedating options to relieve sneezing, itching, and runny nose
Decongestants – short-term relief for congestion (nasal or oral)
Possible additions: nasal steroid sprays for inflammation, leukotriene antagonists like montelukast (if indicated)

3. Immunotherapy

Suitable for long-term control when avoidance and medications are inadequate:

Allergy shots (SCIT) – injections over several years to build tolerance
Sublingual immunotherapy (SLIT) – allergy drops or tablets administered under the tongue

Frequently Asked Questions

Can allergic rhinitis go away?

Some children may outgrow it, but for many, it persists—though immunotherapy can offer long-term relief.

When should I see an ENT specialist?

If symptoms persist despite OTC medicines for more than 10 days, or impact sleep, work, or quality of life.

Does exercise help?

Yes. Moderate, low-impact exercise, ideally indoors or when allergen levels are low, can help reduce inflammation.

Are natural remedies effective?

Natural strategies may help reduce reliance on medication, but should support, not replace medical treatment.

How long does it last?

Symptoms continue as long as exposure lasts: days, weeks, or even months.

Next Steps

If your allergy symptoms persist or significantly affect your daily life, booking a consultation with one of our ENT specialists can help. We’ll tailor a diagnosis and treatment plan to your needs so you can breathe easier and feel better.