Non-allergic rhinitis

Non-allergic rhinitis is inflammation of the inside of the nose that isn't caused by an allergy.

Rhinitis caused by an allergen, such as pollen, is a separate condition known as allergic rhinitis.

Symptoms of non-allergic rhinitis can include:

• a blocked nose
• a runny nose – this may be through the nostrils or down the back of the nose (catarrh)
• sneezing – although this is generally less severe than in allergic rhinitis
• mild irritation or discomfort in and around your nose
• reduced sense of smell

In rare cases, non-allergic rhinitis can also cause a crust to develop inside the nose, which may:

• produce a foul-smelling odour
• cause bleeding if you try to remove it

When to see your GP

You should see your GP if you have symptoms of non-allergic rhinitis and the condition is affecting your quality of life.

Non-allergic rhinitis can be difficult to diagnose, as there is no test to confirm the condition. Your GP will first ask about your symptoms and medical history.

They may then carry out a blood test to check if you have an allergy, or they may refer you to a hospital clinic for more specific tests for allergies, including a "skin prick test".

If the test results suggest you don't have an allergy, you may be diagnosed with non-allergic rhinitis.

Read more about diagnosing non-allergic rhinitis.

What causes non-allergic rhinitis?

In non-allergic rhinitis, the inflammation is usually the result of swollen blood vessels and a build-up of fluid in the tissues of the nose.

This swelling blocks the nasal passages and stimulates the mucus glands in the nose, resulting in the typical symptoms of a blocked or runny nose.

There are several possible causes of non-allergic rhinitis, which can be divided into external or internal factors.

External factors include:

• viral infections, such as a cold – these attack the lining of the nose and throat
• environmental factors – such as extreme temperatures, humidity or exposure to noxious fumes, such as smoke

Internal factors include:

• hormone imbalances – such as those that occur during pregnancy or puberty
• hormone replacement therapy (HRT) or hormonal contraception

Read more about the causes of non-allergic rhinitis.

Treating non-allergic rhinitis

Although non-allergic rhinitis isn't usually harmful, it can be irritating and affect your quality of life. The best treatment option depends on how severe the condition is and what's causing it.

In some cases, avoiding certain triggers and undertaking self care measures, like rinsing your nasal passages, may relieve your symptoms. This can be done using either a homemade solution or a solution made with sachets of ingredients bought from a pharmacy. 

In other cases, medication may be needed, such as a nasal spray containing corticosteroids. These will help to relieve the congestion, but usually need to be used over a number of weeks to be fully effective.

Before taking any medication for non-allergic rhinitis, always check the leaflet that comes with it, as these treatments aren't suitable for everyone. If you're at all uncertain whether you should be using one of these medications, check with your GP or pharmacist.

Read more about treating non-allergic rhinitis.

Further problems

In some cases, non-allergic rhinitis can lead to complications. These include:

• nasal polyps – abnormal, but non-cancerous (benign) sacs of fluid that grow inside the nasal passages and sinuses
• sinusitis – an infection caused by nasal inflammation and swelling that prevents mucus draining from the sinuses
• middle ear infections – infection of part of the ear located directly behind the eardrum

These problems can often be treated with medication, although surgery is sometimes needed in severe or long-term cases.

Read more about the complications of non-allergic rhinitis.