4 Myths (and the Facts) About Nasal Allergies

If you regularly sniffle, sneeze, and cough, you may be one of the 50 million people in this country, including one in five children, who suffer from allergies.

There’s a lot of information swirling around about allergies—and some of it isn’t correct. Here, we sort the myths from the facts:

Myth #1: Allergies and sinusitis are the same thing. Allergies are a hypersensitivity to certain substances that cause a reaction from the immune system, while sinusitis in an inflammation of the sinus passages. But because both conditions can cause sneezing and sniffling (and allergies are a well known condition), many people assume they have allergies. But they may not be right: A 2011 online survey conducted by the Asthma and Allergy Foundation of America found that 51 percent of respondents mistakenly believed they had allergies rather than sinusitis. The correct diagnosis is important, since the treatments for these two conditions are not necessarily the same. Here are some ways to figure out if you’re dealing with a true nasal allergy:

  • You have specific triggers. If you regularly get itchy, watery eyes, and nasal symptoms such as congestion and sneezing after visiting your friend who has a cat, that’s a pretty good clue that you’re allergic to cat dander (small particles of Fluffy’s hair or skin). Similar symptoms after gardening or walking outside may also point to an allergy to some sort of seasonal pollen or mold.
  • You have physical manifestations. One obvious sign that a patient has a nasal allergy is a transverse nasal crease, a horizontal line or a crease on the lower part of the nose. This can develop after prolonged rubbing or touching of the nose, which is what someone with persistent allergies might do, explains Clifford Bassett, MD, an assistant clinical professor of medicine and founder and director of New York City’s Allergy and Asthma Care of NY. Puffy eyes and "allergic shiners," or discoloration beneath the lower eyelids are also common in patients with allergies; some people may even have dental irregularities from years of breathing through the mouth due to nasal congestion.
  • You have a parent with allergies. While children of people with allergies aren’t guaranteed to have the same problems, the chance of someone having allergies is 35% if one parent has them, and up to 75% if both parents do, according to Bassett.

There are several other ways to tell if your symptoms indicate allergies rather than sinusitis:

  • Skin testing. Done under supervision in an allergist’s office, these virtually painless tests can quickly pinpoint patients’ exact allergy triggers. One version involves a patient’s skin being either pricked or punctured with a diluted allergen and watching for a reaction. Another version involves the allergen being injected directly below the skin’s surface. If a red, itchy bump develops after either test, that’s an indication of allergic sensitization and possible allergy to the substance.
  • Blood tests. Blood tests may reveal evidence of possible allergy. But in many cases, a patient history and a physical exam are also needed for optimal interpretation and diagnosis, says Bassett. He notes that there is often a lag time between the blood draw and the test results, possibly necessitating a follow-up visit.

It’s important to note that no single test or symptom is a definitive indicator of allergies. A skilled clinician will make a diagnosis based on skin or blood testing, the results of a physical exam, and a patient’s history. Then a course of treatment will be decided upon. "We really put together a whole individualized regimen," Bassett says, adding that only immunotherapy (allergy shots) or self-administered sublingual (under the tongue) allergy tablets have been shown to reduce and/or eliminate allergy symptoms over time.

Myth #2: Decongestant sprays can treat nasal allergies. Over-the-counter nasal decongestant sprays may offer temporary relief from symptoms, but after a few days of use you’ll experience a "rebound effect" and find that your nose is more clogged than before. And these sprays do nothing to treat the allergies themselves. A more effective alterative for short-term relief is an over-the-counter nasal corticosteroid spray, which helps reduce inflammation.

Myth # 3: Local honey can help. Some people believe that consuming locally produced honey will help them fight pollen allergies. The idea is that regular exposure to the pollen in local honey will de-sensitize them. The problem is that honey contains mostly flowering-plant pollen, which doesn’t tend to be allergenic, and very little airborne tree pollen, which is highly allergenic. Although it may be tasty, local honey is not an effective allergy cure.

Myth #4: Switching to organic foods can relieve symptoms. If sensitivity to a certain food is causing your nose to run and eyes to water, buying it at the health food store won’t provide relief. The allergens are present in the food itself (either in the pulp or skin), not the soil in which its grown, or the pesticides with which it may be sprayed.

Clifford Bassett, MD, reviewed this article.

Sources

Clifford Bassett, MD. Interview on April 8, 2015.

"Allergies." Centers for Disease Control and Prevention. Page last updated February 2, 2011.

"Allergy Facts and Figures." Asthma and Allergy Foundation of America. Page accessed April 15, 2015.

"Playing Doctor and Paying a Price? Survey Finds Patients are Confused Between Allergy and Sinusitis Symptoms." Asthma and Allergy Foundation of America. Page accessed April 15, 2015.

"Sinusitis." American Academy of Otolaryngology—Head and Neck Surgery. Accessed April 10, 2015.