Diagnosis and Treatment of Allergic Rhinitis
What is Allergic Rhinitis?
Allergic rhinitis is the inflammation of the mucosa lining the inside of the nose due to various allergens (such as pollen, dust, etc.). Its prevalence in the population is quite high, with 2-37% of children and 8-30% of adults affected.
It is more likely to occur in individuals with a predisposition to allergies or a family history of allergic diseases. It typically occurs before the age of 40, with the first symptoms usually appearing in childhood or early adulthood, and the complaints tend to decrease with age. People with allergic rhinitis are also more likely to develop other allergic conditions, such as eczema or asthma.
If allergic rhinitis occurs only during certain seasons (especially spring), it is referred to as “seasonal rhinitis (hay fever).” If it persists throughout the year, it is known as “perennial rhinitis.” Perennial rhinitis is often caused by constant exposure to substances like house dust.
Causes of Allergic Rhinitis
The main causes of allergic rhinitis include allergens such as pollen, dust, mold, grass, animal dander, and house mites. The allergic reaction begins 15-30 minutes after these foreign substances enter the nose and peaks within 6-12 hours. Symptoms persist as long as exposure to the allergen continues.
Mechanism of Allergic Rhinitis
In individuals with an allergic constitution, the immune system perceives substances like pollen and dust as antigens and starts producing antibodies. As a result, the body releases chemical substances such as histamine, prostaglandin, and leukotrienes. These molecules cause swelling, inflammation, excessive mucus production, and nasal congestion in the nasal mucosa, leading to allergic rhinitis.
Symptoms of Allergic Rhinitis
The symptoms of allergic rhinitis include:
- Itching and burning sensations in the nose, throat, mouth, and eyes
- Runny nose
- Sneezing
- Watery eyes, bloodshot eyes
- Nasal congestion and swelling
- Ear congestion
- Headache
- Fatigue
- Swelling and bruising under the eyes
- Cough
- Decreased sense of smell and taste
How is Allergic Rhinitis Diagnosed?
- A detailed medical history is taken by the physician, including the patient’s age, any medications being used, family history of allergies, the season in which symptoms occur, and environments where complaints worsen.
- An ear, nose, and throat examination is performed.
- Allergy tests are conducted, including skin tests or blood tests for allergens. Skin tests are more commonly used.
How is Allergic Rhinitis Treated?
The treatment of allergic rhinitis aims to eliminate symptoms and provide relief to the patient. During treatment, it is crucial to avoid contact with the allergens causing the condition. The treatment methods include:
- Medication therapy
- Vaccine therapy (hyposensitization)
- Rhinolight (phototherapy)
- Surgical treatment
Medication is typically started at least two weeks before the allergy season begins. Antihistamines and steroid preparations are the most commonly used medications. They help alleviate symptoms such as discharge, itching, sneezing, and nasal mucosal swelling.
In vaccine therapy, the allergen is administered in gradually increasing doses to build immunity. Initially, the vaccine is given once a week, and after reaching the maintenance dose, it is administered once a month. Although vaccine therapy can also be administered as oral drops, the physician decides on the appropriate method.
In Rhinolight treatment, high-intensity light with specific wavelengths is applied to the patient’s nostrils. This treatment can successfully reduce or eliminate all symptoms in patients with both seasonal and perennial allergic rhinitis. It is applied to individuals over 14 years of age. The treatment lasts for two consecutive weeks and is completed in 4-8 sessions. The application time is brief, with 2-3 minutes per nostril being sufficient.
Surgical treatment is considered when nasal congestion cannot be relieved. Nasal congestion may result from uncontrolled growth of nasal tissues called turbinates, sinusitis, or polyps. Laser turbinate surgery (with septoplasty if necessary) is performed to reduce the growth of nasal tissues, and endoscopic sinus surgery may be done in the presence of sinusitis.
Things to Consider for People with Allergic Rhinitis
- Avoid environments where allergens are present, but wear a mask if exposure is unavoidable.
- Keep windows closed during seasons when pollen is prevalent.
- Pay attention to the cleanliness and humidity of the indoor air.
- Clean the air conditioner’s filter every month.
- Avoid smoking and smoky environments.
- Do not keep animals or plants at home.
- Avoid carpets, rugs, etc., in the home.
- Prefer synthetic pillows, duvets, and mattresses over feather or wool ones.
Intranasal Phototherapy (Rhinolight)
Rhinolight, also known as Intranasal Phototherapy, refers to intranasal light therapy. Rhinolight, the latest technological approach in the treatment of allergic rhinitis, uses high-intensity light (the safe portion of the visible light spectrum and UV light spectrum) with specific wavelengths.
Phototherapy can successfully reduce or eliminate symptoms such as nasal itching, discharge, congestion, and sneezing in patients with both seasonal and perennial allergic rhinitis. The effectiveness of Rhinolight has been proven by scientific studies worldwide. It is effective in all cases, regardless of the type of allergy.
Who Can Use Rhinolight?
Rhinolight is an effective method that can be safely applied to all patients with allergic rhinitis over the age of 14. However, it is particularly preferred in certain patient groups, including:
- Patients whose allergic rhinitis symptoms cannot be controlled with nasal sprays and oral allergy medications
- Patients for whom standard treatments cannot be used due to side effects or interactions with other medications for other conditions
- Patients who prefer not to use long-term medication
- Pregnant women
- Breastfeeding mothers
- Athletes
- Patients with kidney or liver failure.
Who Cannot Use Rhinolight?
Rhinolight treatment cannot be applied to the following patient groups:
- Patients with severe nasal curvature
- Patients with allergic rhinitis combined with other viral or bacterial rhinitis
- Patients with tumors in the nose or nasal passages
- Patients with severe nasal dryness and crusting
- Patients who have previously experienced skin issues during light therapy for the skin
- Patients under 14 years of age
Rhinolight Treatment Method and Duration
The duration and frequency of Rhinolight treatment are planned according to the patient’s seasonal or perennial allergy diagnosis. Typically, treatment occurs in 4-8 sessions over the course of 2 consecutive weeks. The application time is brief, with 2-3 minutes per nostril being sufficient.
Anesthesia is not required. There is no sensation of heat or pain during the application, making it a safe procedure.
The best option for patients is to start treatment before symptoms appear. In cases where allergy symptoms have already started, it is recommended to begin Rhinolight treatment as soon as possible. Improvements can be seen after just 1-2 sessions. However, to achieve a definitive response, it is important to complete the full treatment. Since no permanent damage occurs to the intranasal tissues during the treatment, it can be used for extended periods without issues.
Especially in the early stages of Rhinolight treatment, temporary nasal dryness, crusting, and bleeding may occur. In such cases, vitamin A and oily nasal creams should be applied to the nose.
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