Intranasal corticosteroids are the most effective treatment and should be first-line therapy for mild to moderate disease.Moderate to severe disease not responsive to intranasal corticosteroids should be treated with second-line therapies, including antihistamines, decongestants, cromolyn, leukotriene receptor antagonists, and nonpharmacologic therapies (e.g., nasal irrigation).First, it takes an hour or so for the antihistamines to get in your system after you swallow them. Second, you may have to take a larger than recommended dose.
They are both effective, low- or non-sedating, and last all day.
Be aware that cetirizine makes about 15% of people sleepy.
Symptoms include rhinorrhea, nasal congestion, obstruction, and pruritus.1 Optimal treatment includes allergen avoidance, targeted symptom control, immunotherapy, and asthma evaluation, when appropriate.2 In 2001, Allergic Rhinitis and Its Impact on Asthma guidelines were published in cooperation with the World Health Organization, suggesting that the treatment of allergic rhinitis make use of a combination of patient education, allergen avoidance, pharmacotherapy, and immunotherapy.3 In contrast with previous guidelines, these recommendations are based on symptom severity and age, rather than the type or frequency of seasonal, perennial, or occupational exposures.
The adverse effects and higher cost of intranasal antihistamines, as well as their decreased effectiveness compared with intranasal corticosteroids, limit their use as first- or second-line therapy for allergic rhinitis.
Although allergic reactions can cause hives, most hives are non-allergic.
If you have a true food allergy, medication allergy, or bee sting allergy and you have an obvious exposure to your trigger, then you need to follow your own doctor’s advice on immediate treatment and seeking medical care.
If you break out in hives and experience symptoms such as difficulty breathing or swallowing, tongue swelling, or lightheadedness and dizziness, then you need to seek immediate medical help as these can be signs of anaphylaxis.
If, however, you experience strictly skin symptoms, you can usually treat yourself with simple antihistamines.
I see lots of cases of hives and I’m often struck by how many have been previously seen in an emergency department for control of their outbreaks.
I also frequently see patients for evaluation of hives when their rash is something altogether different.
Histamine is the most studied mediator in early allergic response.