Dr. Zachary Rubin

Allergies in general, whether we talk about allergic rhinitis, eczema, food allergies, asthma, medication reactions, it's one of the most common chronic diseases that affect millions of people, and it's just not talked about enough.

Well, it may be or maybe not.

So the reality is, is that when you experience nasal symptoms like a runny, stuffy or itchy nose chronically, that's rhinitis.

That's inflammation of the nasal passages.

And the underlying trigger of that could be allergic rhinitis or non-allergic rhinitis.

In other words, you could have the immune system responding in a way that creates protein tags known as IgE

antibodies that when you have subsequent exposure to something like pollen, cats, dogs or mold, it can create histamine release and other chemicals released from the immune system to cause those symptoms that we talk about.

If you have non-allergic rhinitis, that means there's a different

pathway that your body is abnormally responding to non-specific triggers like changes in weather, cigarette smoke, air pollution, getting sick.

And so the actual treatment is different and you technically don't have allergies when you have non-allergic rhinitis, but the symptoms are essentially the same.

Right, so actually that's not the case.

So if you have allergic rhinitis, yes, something like Claritin or an antihistamine helps because one of the main chemicals released from your immune system is histamine.

So you take an antihistamine to block those effects.

But if you have non-allergic rhinitis, there's a lot less histamine being released.

So taking an antihistamine is not quite as effective.

So we have to rely on other treatments like nasal sprays that contain steroids that can help just decrease the overall immune response locally in that area to treat those symptoms.

Antihistamines are great for sneezing and runny nose and even potentially some coughing or post-nasal drip.

But if your nose is really stuffy and there's a ton of mucus production, then a steroid is going to be more effective when you take that topically like Aflonase or Nasacort.

And so can I tell the difference or do I have to go to the doctor to tell the difference?

You would need to go to an allergist to get formal testing to be able to tell the difference.