Is it a cold or an allergy?

Do you find yourself sneezing nonstop and wiping your nose whenever the seasons change or you step into the morning chill? Many people think they “catch colds easily,” but in fact, allergic rhinitis might be the real culprit. About one-fourth to one-third of adults have allergic rhinitis, and the prevalence is even higher among children. While it’s not life-threatening, chronic nasal congestion and runny nose can seriously affect sleep quality, work efficiency, and everyday life.

Why am I allergic?

Allergic rhinitis is an “overreaction” of the nasal mucosa’s immune system. When the respiratory tract encounters specific allergens, the immune system misidentifies them as threats, releasing histamine and other inflammatory chemicals. This causes swelling, congestion, and excessive secretion from the nasal lining.

Common allergens include:

1.          Dust mites: The most common allergen in Taiwan (more than 80%), found in pillows, bed sheets, and carpets.

2.          Air pollutants: PM2.5, cigarette smoke, vehicle exhaust.

3.          Animal dander: Hair and skin flakes from cats and dogs.

4.          Mold and pollen: Found in bathroom mold or seasonal blooms.

Self-check: Allergy vs. Cold

1.          Duration: A cold usually resolves within 5–10 days; allergies last for weeks or recur at specific times.

2.          Nasal discharge: Allergies produce clear, watery mucus; colds often progress to yellow-green, thick mucus.

3.          Accompanying symptoms: Allergies cause nasal itching, eye itching, and dark circles; colds bring sore throat, cough, and muscle aches.

Environmental control and lifestyle adjustments

Avoiding allergen exposure is the first step in treatment.

1.          Fight dust mites: Use mite-proof bedding, wash sheets in water above 55°C every two weeks, and keep indoor humidity around 50%.

2.          Purify the air: Use an air purifier with a HEPA filter and replace filters regularly.

3.          Wear a mask: When riding a scooter, cleaning, or moving between air-conditioned rooms, wear a mask to keep nasal passages moist and block pollutants.

Medical treatment

If environmental control doesn’t fully relieve symptoms, doctors may prescribe medications based on severity:

1.          Oral antihistamines: The most common remedy for sneezing and runny nose. Second-generation antihistamines are preferred — long-acting and less sedating, suitable for long-term control.

2.          Intranasal corticosteroid sprays: Deliver medication directly to the nasal mucosa in very low doses. Safe for long-term use, though effects peak after 1–2 weeks of continuous use. Avoid using them only intermittently.

3.          Decongestant sprays: Provide instant relief but should be used only for emergencies (no more than 5–7 days). Overuse can cause rebound swelling, worsening nasal congestion.

Surgical treatment

If medications fail or structural issues obstruct breathing, surgery may be considered.

1.          For chronic nasal congestion (inferior turbinate hypertrophy):

A.          Partial inferior turbinectomy: Effective and long-lasting improvement.

B.          Minimally invasive turbinate reduction: Removes thickened tissue with minimal bleeding and short recovery time.

C.          Turbinoplasty (radiofrequency): Shrinks tissue using low heat, reducing bleeding and discomfort.

2.          For deviated nasal septum: Septoplasty or septorhinoplasty. Straightens the cartilage to open the airway.

3.          For excessive nasal discharge: Posterior nasal nerve ablation. Interrupts the overactive allergic nerve reflex to reduce sneezing and runny nose.

Living peacefully with allergies