Nose

Allergic Rhinitis

WHAT IS AN ALLERGY?

An allergy is a term that describes an extraordinary sensitivity to a substance that is generally harmless to most people. This hypersensitivity may manifest in various organ system resulting in illnesses, like allergic asthma (lungs), allergic rhinitis or hay fever (nose) and atopic eczema (skin).
About 15% of the population suffers from allergic rhinitis. In Singapore, about one in six children suffers from Allergic Rhinitis. It is more common all year round as compared to seasonal rhinitis.

WHAT ARE ALLERGENS?

Allergens are substances that cause allergic reactions. There are many known allergens, and different people can be sensitive to different sets of allergens. These allergens can enter the body by inhalation, eating, or via direct contact with the skin.

Common examples of allergens include house dust mites, cockroaches, mould, and animal dander or hair.

Symptoms

WHAT IS ALLERGIC RHINITIS?

Allergic Rhinitis occurs when an allergen is inhaled. Symptoms include:
  • Blocked nose
  • Running nose
  • Sneezing episodes
  • Nose/ throat
  • Mouth breathing
  • Throat clearing cough
  • Disturbed sleep
  • Eyes that are itchy, watery, or puffy
  • Undereye discolouration or dark eye circles known as allergic shiners

SKIN PRICK TEST

The test is the most common and cost-effective method of determining a person’s sensitivity to various allergens. It can also help to determine a person’s degree of sensitivity to the allergens.

WHY DOES MY CHILD HAVE ALLERGIC RHINITIS?

Most allergic diseases are due to a combination of genetic and environmental factors. This means that there is usually a family member with asthma, allergic rhinitis or eczema. However, this alone does not account for the increase in allergic diseases that is happening all over the world. Factors in the environment may account for this.

WHAT ARE HOUSE DUST MITES?

House dust mites are microscopic creatures that are found everywhere in mattresses, pillows, bed sheets, clothes, soft toys, sofas, and carpets. Allergic individuals who may suffer from asthma, allergic rhinitis or eczema are commonly sensitised (allergic) to these house dust mites. The commonest dust mite in Singapore is called Blomia tropicalis. The droppings of these dust mites are the most common trigger of allergies and asthma.

HOW DO I AVOID THEM?

As people spend most of their time in the bedroom, it is most important to reduce the levels of dust mites there.
Some simple but very effective measures
Once a week, wash bed sheets and pillowcases in hot water (> 60°C).
Avoid pillows, comforters, etc. that are made of natural materials (e.g., feathers) and replace them with items made from synthetic fibres.
No stuffed toys and thick heavy curtains in the bedroom
Clothes and books should be stored in a closed cupboard.
Damp dusting should be used to clean surfaces-avoid feather dusters!
Air-conditioners, if used, should be cleaned regularly.
No carpets in the room.
No pets in the room.
Consider
Cover your mattresses and pillows with special non-allergenic covers.
Vacuum with HEPA (high-efficiency particulate) filter vacuums

Treatment

WHAT MEDICINES ARE USED IN ALLERGIC RHINITIS?
  • Topical (nasal spray) steroids are often prescribed. These are generally safe and should be used as prescribed over a period of time and not on an as-needed basis
  • Antihistamines are safe and effective, even in very young children. They sometimes need to be taken over a sustained period of time to be effective. Some may cause your child to be sleepy. Consult your doctor about this.
  • Other medicines such as nasal decongestants, mucolytics (medicines that thin the mucus) and antibiotics are sometimes used as well.
  • If medical therapy fails, specific Sublingual Immunotherapy (SLIT) may be recommended for your child. This therapy involves allergen drops being deposited under the tongue with a special "pump" delivery system. The minimum duration of treatment is 3–5 years. The main advantage is that the positive effect may be long lasting after the end of treatment.

WILL ALLERGIC RHINITIS DEVELOP INTO ASTHMA?

Many parents are worried that prolonged coughing will develop into asthma. This is a myth. Coughing does not cause asthma. Your child may be coughing because he already has mild asthma. Allergic rhinitis and asthma can co-exist, so it is not surprising that someone with allergic rhinitis later develops asthma.

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