Sneezing, runny nose, itchy eyes: What to know about allergy relief

Advertorial Allergic rhinitis is often mistaken for a cold. Here’s how to tell the difference and why newer-generation antihistamines may help relieve symptoms with less risk of drowsiness. Many cases of allergic rhinitis remain undermanaged, even though antihistamines can help control symptoms. (Photos: Shutterstock) New: You can now listen to articles. This audio is generated by an AI tool. Sneezing, a blocked or runny nose, and itchy eyes and throat are common signs of allergic rhinitis. Also known as hay fever, the condition can affect sleep and concentration, with knock-on effects on school, work and mood. Some people see it as a minor nuisance that comes and goes. Others live with the symptoms, assuming little can be done.Ear, nose and throat (ENT) specialist Dr Soma Subramaniam, senior consultant and medical director of ENT Plus Specialist Centre, said the condition should not be dismissed as a passing inconvenience. “Allergic rhinitis is a chronic inflammatory condition that can usually be managed effectively with appropriate treatment to minimise symptoms in the long term,” said Dr Soma. MORE THAN THE COMMON COLD Allergic rhinitis is often confused with a cold or flu because they share similar symptoms. But there are key differences. A cold is a viral upper respiratory tract infection that may cause fever, body aches, sore throat and fatigue. Symptoms typically last one to two weeks. Patients are generally advised to rest, drink plenty of water and avoid close contact with others to reduce the spread of the virus. Allergic rhinitis, on the other hand, is not contagious. It is an immune overreaction to otherwise harmless substances in the environment. In Singapore’s tropical climate, where there are no distinct pollen seasons, house dust mites are a prevalent year-round trigger. House dust mites, commonly found in bedding, carpets and upholstered furniture, release allergen-containing particles that can trigger allergic reactions. The condition stems from a combination of genetic predisposition and environmental exposure. When someone with allergic rhinitis inhales dust mite allergens, such as while cleaning the house, the immune system mistakenly perceives them as a threat and releases histamine.Histamine is a natural chemical involved in the body’s immune and inflammatory responses. During an allergic reaction, excessive histamine release can set off symptoms such as sneezing, nasal congestion and itchy eyes. It is estimated that allergic rhinitis affects more than 30 per cent of people in Singapore, mostly children and young adults. Yet many cases remain undermanaged. In a 2024 local study of Chinese young adults, researchers found that about 85 per cent of those with the condition had not been diagnosed and 73 per cent were not receiving treatment, despite 68 per cent having moderate-to-severe disease. “Allergen avoidance measures, such as washing bedsheets and pillowcases regularly at 60°C, can make a meaningful difference. Medication is also important and not just when symptoms appear,” said Dr Soma. “For individuals with severe persistent allergic rhinitis, regular preventive treatment may be more effective than treating flare-ups after they occur and could lead to a better quality of life.” HOW ANTIHISTAMINES CAN HELP Most antihistamines are available over the counter, and pharmacists can advise on which types may be most suitable for each person. Antihistamines block histamine receptors, which prevents histamine from triggering allergy symptoms. Different types are available and individual responses to medication can vary. “Compared with first-generation antihistamines which were developed decades ago, second-generation versions are less likely to cross the blood-brain barrier and therefore carry a lower risk of drowsiness,” said Dr Soma. Fexofenadine is a second-generation antihistamine commonly used to treat allergic rhinitis. It may work relatively quickly, Dr Soma said, with some patients experiencing relief within 45 minutes to an hour.CHOOSING THE RIGHT TREATMENTThe right approach depends on the symptoms. Antihistamines usually help relieve sneezing, an itchy nose and eyes, and a runny nose. If nasal blockage is the main problem, a nasal decongestant spray or a combination antihistamine-decongestant medicine may help patients breathe more comfortably.Dr Soma advised caution when using nasal decongestant products. “Decongestants are not suitable for everyone and should generally be used for short-term symptom relief rather than as a long-term daily treatment,” he said. “Likewise, pseudoephedrine-containing medication should not be used for more than one week continuously.” Lifestyle needs should also be considered. People who need to stay alert, such as drivers, machine operators and students preparing for exams, should factor in the risk of drowsiness when choosing an antihistamine, Dr Soma said. Fexofenadine may be an option in such cases, he added. Fexofenadine may be used by both adults and children over a longer period after a doctor’s review. AIM FOR LONG-TERM CONTROL Some patients may continue to experience troublesome symptoms despite regular use of over-the-counter antihistamines. Dr Soma said they should seek medical assessment, as other conditions, such as chronic sinusitis or nasal polyps, could be contributing to their symptoms. “For patients with persistent allergic rhinitis, the most effective approach is usually a combination of allergen avoidance, appropriate medication and regular follow-up when symptoms remain,” he said. Individual responses to medication vary. For further information, seek medical advice from a doctor or pharmacist.MAT-SG-2600105 / Ver 2.0 / DA 07-2026 / DM 07-2026