In spring, shifts in temperature often bring a runny nose and feelings of malaise as people battle acute rhinitis during viral infections such as SARS, yet the flowering season can trigger allergic rhinitis with a similar symptom set. An allergist-immunologist from INVITRO-Ural, Anastasia Brown, explains to readers how to tell viral rhinitis from allergic rhinitis based on common signs, timing, and triggers.
According to Brown, the core symptoms of rhinitis include nasal congestion caused by pronounced swelling of the nasal mucosa, a sequence of watery nasal discharge, frequent sneezing, and a sense of weakness. These features appear in both infectious rhinitis associated with acute viral illnesses and allergic rhinitis, making distinguishing features essential for proper care and treatment.
Brown notes that in acute viral illnesses, histamine released to irritate the neurovegetative centers can contribute to headaches, fatigue, and a runny nose. Some research shows that mast cells release histamine at levels that resemble allergic reactions. Because of this, the primary symptoms can look very similar across the two conditions. Yet the timing and the pattern of symptoms often provide clues. If itching and sneezing are the dominant issues, especially during the flowering season or after new exposure to a food or substance, an allergic rhinitis is more likely. In contrast, higher fevers around 38°C or above lean toward a viral origin, particularly when other systemic symptoms are present.
Brown explains that when fever accompanies the main symptoms, or if symptomatic relief is not achieved after several days, or if the runny nose becomes a yellow-green color and the overall condition worsens, a viral rhinitis or rhinosinusitis with bacterial involvement is more probable. In these cases, professional evaluation is advised to determine the correct course of treatment and to rule out bacterial superinfection that might require antibiotics.
In terms of what to do next, Brown advises consulting a general practitioner first, followed by a referral to an ear, nose, and throat specialist (ENT) or an allergist. A clinician can guide based on the described symptoms, but only a physician present for the examination can establish an accurate diagnosis. An ENT specialist may perform rhinoscopy, a diagnostic procedure that examines the nasal mucosa. If the mucosa appears edematous, pale, or even bluish, the signs point to allergic rhinitis. On the other hand, a viral exposure typically yields mucosal hyperemia, with a red or pink hue accompanying increased blood flow, according to the allergist.
For infectious rhinitis, treatment depends on the severity of mucosal involvement and whether antibiotics are warranted. Self-prescribing antibiotics is discouraged because improper use can promote resistance and fail to address the underlying infection.
When an allergic reaction is the culprit, antihistamines and vasoconstrictor sprays or nasal drops are commonly used to relieve symptoms. These medications, however, should be limited to a short course—roughly 3 to 5 days—because longer use can lead to rebound congestion and a mixed nature of the rhinitis, combining drug-induced and allergic or non-allergic symptoms. The goal is to reduce mucosal inflammation while avoiding dependence on decongestants that perpetuate the cycle of congestion.
In allergic rhinitis management, identifying and avoiding the allergen is a crucial step. Pharmacologic therapy aims to control inflammation and alleviate symptoms; the approach is tailored to the severity of the condition, whether mild, moderate, or severe. Individuals rarely determine their best plan in isolation, and professional guidance remains important for an effective regimen.
Lastly, Brown mentions that regular shampooing can help people with pollen allergies during the flowering period. Pollen tends to accumulate on hair, and cleansing can reduce exposure, potentially easing symptoms for some patients during peak pollen times. This practical tip complements medical strategies as part of a broader approach to managing seasonal allergies. (Source: Anastasia Brown, INVITRO-Ural)