Stopexposure to known allergens is the first step in antiallergic treatment. Eliminating the allergen is not always possible, as in the case of pollen allergies.

pharmaceuticals

Different pharmaceuticals may alleviate the symptoms of rhinitis. Some are taken by mouth, others are nasal sprays or eye drops (eye drops). If the over-the-counter products don’t work, your doctor may prescribe others that work differently.

• The antihistamines work by blocking the production of histamine, a substance that causes allergy symptoms. They relieve sneezing, runny nose, and itchy eyes and throat. The first generation antihistamines caused drowsiness (Benadryl®). Antihistamines that do not have this side effect are now available over the counter in pharmacies (Claritin®, Allegra®, Zyrtec®).
• The decongestants rapidly decrease swelling of nasal tissue. They are often used in combination with antihistamines. They are found in the form of syrups, tablets (Sudafed®, Actifed®) and nasal sprays (Neo-Synephrine®). They contain pseudoephedrine. The topical decongestants (in the form of sprays) should not be used for more than 3 consecutive days, as they may cause rebound rhinitis. It is therefore a temporary measure which should not be abused.
• Rinsing the nasal passages. Rinsing the nasal passages withsalt water is a simple, inexpensive and effective method of relieving nasal congestion. A good rinse flushes out mucus and allergens nasal passages. Obtain a saline solution available in pharmacies or prepare your homemade solution with ¼ tsp. salt in 2 cups (500 mL) lukewarm water. Use a nasal spray or syringe.
• The nasal corticosteroids are anti-inflammatory drugs that block the allergic reaction (Flonase®, Nasacort®, Nasonex®). They are usually prescribed when antihistamines do not provide relief, more often in people with persistent rhinitis. They are administered directly into the nose, using a spray bottle. However, they can cause irritation to the mucous membranes of the nose.
• The oral corticosteroids are sometimes used to relieve severe allergic symptoms. However, they are prescribed for a short time, as long-term use can cause serious side effects.
• The anti-granulants (sodium cromoglycate) work by preventing the release of histamine and other chemical mediators that initiate allergic reactions. Products like Cromolyn®, Opticrom® and Nasalcrom® can be used as a nasal spray or as eye drops. Particularly effective in children and well tolerated, they seem to play a preventive role against allergic reactions when taken. before symptoms appear. However, they must be administered several times a day.
• The antileucotriènes, prescription drugs (Singulair®, Accolate®) block the effects of leukotrienes. These are produced by the immune system during an allergic reaction and contribute to the onset of symptoms. Antileukotrienes are often used when a nasal spray is not well tolerated.

Progressive desensitization treatment

When the cause of allergy is well defined and drug treatments are not effective, it is possible to consider treatment of desensitization or immunotherapy. It consists of injecting, over a period of 3 to 5 years, increasing doses of allergenic substance. This treatment is only available for common allergens, such as pollen, cat and dog dander, dust mites and mold. It is particularly effective in cases of allergies to pollen and dust mites. According to a meta-analysis of data from 16 clinical studies, 1 in 2 people get improvement in their symptoms with desensitization treatment, compared to 1 in 4 with placebo treatment³⁰.

Desensitization can also be done by taking daily drops or tablets that are allowed to melt under the tongue. This technique is called sublingual desensitization or SLIT (sublingual immunotherapy). Several studies and meta-analyzes have found a decrease in symptoms compared to taking a placebo^33-39 . However, no study has compared this technique to immunotherapy using injections. Sublingual desensitization is commonly used in Europe, but is not authorized in Canada.

surgery

If the drug treatment is insufficient or in the event of anatomical abnormalities of the nasal cavities, a surgical treatment can be considered. Surgery is indicated for deviated nasal septum, for nasal polyps, or to drain infected sinuses. The main purpose of surgery is to make breathing easier, but in no case will it prevent an allergy from developing.