Non-Allergic Rhinitis

Table of Contents

Oftentimes, patients present symptoms of runny nose, congestion, and sneezing with no allergic cause. The major difference between individuals that have allergic rhinitis and individuals with non-allergic rhinitis is that patients with non-allergic rhinitis don’t react to your typical allergic triggers like dust mites, cat dander, mold spores, or tree, grass, or ragweed pollens. Rather, rhinitis patients will react to irritants such as strong smells, pollution, particulate matter in the air, smoke, or other irritants. Symptoms can flare with atmospheric pressure changes and temperature changes. Pregnancy, hypothyroidism, and even some medications can also cause symptoms of non-allergic rhinitis.

Another type of non-allergic rhinitis is called NARES: Non-allergic rhinitis with eosinophilia. Eosinophils are white blood cells that are typically elevated in the blood of individuals with allergies. They are also often found in the nasal tissue of individuals diagnosed with allergic rhinitis. These individuals have recurrent bouts of sneezing and runny nose.

Rhinitis Medicamentosa is also a form of non-allergic rhinitis. Rhinitis Medicamentosa is a condition characterized by rebound nasal congestion and a runny nose when topical decongestants such as Afrin or Neosynephrine are abused for a prolonged period of time (possibly as little as 4 days). Your nasal tissue becomes “addicted” and must be weaned off of this medication. One of our top allergists at NY Allergy and Sinus Centers will help to taper you off this medication and search for the underlying cause of your initial congestion. Prolonged use of topical decongestants can lead to permanent nasal damage including a perforated nasal septum.

Symptoms of Non-Allergic Rhinitis 

Symptoms of non-allergic rhinitis can include:

  • Blocked nose
  • Runny nose 
  • Mild to moderate sneezing
  • Mild irritation or discomfort in and around the nose
  • Reduced sense of smell
  • Nasal polyps (in some cases)

In rare cases, non-allergic rhinitis may cause a crust to develop inside the nose, which may produce a foul-smelling odor and cause bleeding if you try to remove the crust. If you experience crusting around the nose, try using a humidifier to loosen it rather than picking at it.

Non-Allergic Rhinitis Diagnosis

This condition is often difficult to diagnose. Our NYC allergists can review your symptoms and medical history to help diagnose non-allergic rhinitis, but there isn’t an exact test to confirm it. We may also perform a skin prick test or allergy blood test to confirm that your rhinitis is not allergy-related. If the test results suggest you do not have an allergy, you may be diagnosed with non-allergic rhinitis.

Our Allergists can see you at one of our Manhattan or Queens locations for an evaluation. We can determine if your condition is truly allergic or is actually one of these forms of non-allergic rhinitis. Our top allergy specialists are specially trained in allergy testing, ensuring that you will get the best care in allergy diagnosis and treatment.

Non-Allergic Rhinitis Treatment

Non-allergic rhinitis conditions are usually treated with a nasal steroid such as fluticasone, triamcinolone, or mometasone. In most cases, avoiding certain triggers and undertaking self-care measures, like rinsing your nasal passages, may prevent symptoms. 

The most common cause of non-allergic rhinitis is a respiratory tract infection. They can be caused by a virus resulting in an Upper Respiratory Infection (URI) or a bacterial sinus infection necessitating antibiotics. Common antibiotics used to treat sinus infections include:

  • Amoxicillin
  • Augmentin
  • Cefdinir
  • Azithromycin
  • Levofloxacin
  • Avelox
  • Ciprofloxacin

Our trained premier allergists will evaluate you and perform any appropriate testing, including allergy testing and, if necessary, a sinus CT scan. By using one of our state-of-the-art Minicat Sinus CT Scan machines, we can confirm that you have a sinus infection and can initiate the appropriate medications necessary to get you back on the road to sinus health. A sinus scan using the Minicat Sinus CT Scan may also demonstrate the presence of a structural abnormality that can lead to sinus infections or simply cause year-round nasal congestion. Examples of these abnormalities include:

  • Deviated Nasal Septum
  • Concha Bullosa
  • Nasal Polyps

A deviated nasal septum can be caused by trauma such as a broken nose or can be congenital. The deviated septum may get worse over time, resulting in progressively greater symptoms. If medical management is not effective, surgical correction with an Ear, Nose, and Throat Physician may be an option.

Nasal polyps are growths from the mucosal tissues in the nose that cause an obstruction and can change or augment your sense of taste or smell. They can be associated with patients who also have aspirin allergy and asthma. The anatomical blockage can also lead to recurrent and chronic sinusitis. Again, if medical management with medication, allergy treatment, and avoidance is not effective, you will be referred to an otolaryngology doctor in Manhattan or Queens for evaluation of possible surgery. Our ear, nose, and throat referrals all operate out of premier New York City hospitals like Beth Israel, St. Luke’s Roosevelt, New York-Presbyterian Hospitals, Mount Sinai, and Lenox Hill. Nasal polyps that are surgically removed have a tendency to recur and underlying causes should be identified and dealt with prior to surgery, if possible.

Medicines like Sudafed, Benadryl, and Afrin are available over the counter and may temporarily relieve some of the symptoms related to non-allergic rhinitis. However, it is important to identify the causes of your rhinitis rather than simply taking medication to treat the symptoms. One of our top allergy and sinus specialists can help identify the cause of your rhinitis symptoms and fix the underlying cause rather than just treat the symptoms. NY Allergy & Sinus Centers has multiple locations located in Manhattan and Queens. 

Our NYC locations include Murray Hill, Upper West Side, Chelsea, Upper East Side, and Glendale, Queens. Our Top NYC Allergists will perform testing, including allergy tests, sinus CT scans, and a thorough exam to identify what is causing your nasal symptoms. Your allergist will design a treatment plan to fix your underlying pathology and help you to breathe better naturally without the use of chronic medications. Call (212) 686-6321 or book an appointment online today!

Frequently Asked Questions

What Causes Non-allergic Rhinitis?

Irritants like smoke, perfume, and pollution can cause non-allergic rhinitis. Respiratory tract infection may also cause non-allergic rhinitis.

Can Non-allergic Rhinitis Cause Headaches?

Research suggests that rhinitis Is linked to greater headache frequency. Patients may experience migraines, sinus headaches, or non-sinus related headaches such as TMJ headaches.

How Is Non-allergic Rhinitis Diagnosed?

An allergist can review your symptoms and medical history to help diagnose non-allergic rhinitis. You may also need an allergy test to confirm that your symptoms are not caused by an allergy.

What Is The Difference Between Allergic Rhinitis And Non-allergic Rhinitis?

The difference between individuals that have allergic rhinitis and individuals with non-allergic rhinitis is that patients with non-allergic rhinitis don’t react to allergens. Instead, they react to other irritants in the environment. 

What Is Eosinophilic Non-allergic Rhinitis?

Eosinophilic non-allergic rhinitis is a form of chronic and persistent inflammatory rhinitis. It is characterized by sneezing attacks, nasal obstruction, and, occasionally, loss of smell.

What Is Rhinitis Medicamentosa?

Rhinitis Medicamentosa is nasal congestion brought on by extended use of decongestants and certain oral medications. To prevent this condition, use decongestants only when suggested by your physician and no longer than 10 days at a time.

Can Non-allergic Rhinitis Cause Shortness of Breath?

Non-allergic rhinitis can block the airflow through your nose, making it difficult to breathe. Visit our allergists for rhinitis and asthma relief.

How Is Non-allergic Rhinitis Treated?

Non-allergic rhinitis conditions are usually treated with a nasal steroid such as fluticasone, triamcinolone, or mometasone. You may also need antibiotics to treat certain conditions related to non-allergic rhinitis such as sinusitis or upper respiratory infection. 

What Will Happen If Allergic Rhinitis Is Left Untreated?

When left untreated, allergic rhinitis often becomes chronic and may lead to complications including acute or chronic sinusitis and Otitis Media (ear infection).

How Do You Get Rid of Rhinitis During Pregnancy?

During pregnancy, you should avoid triggers of rhinitis. You should also rinse your sinuses with saline solution or purified water to soothe symptoms and prevent further complications of allergic rhinitis.