Alergias

Question: I sneeze when I go outside on a sunny day. Am I allergic to sunlight? Answer: No. Some people have the tendency to sneeze and have a runny nose when exposed to bright sunlight. This isn't an allergy; rather, it's a form of non-allergic rhinitis called a naso-ocular reflex. When exposed to bright light, the eyes water as a response to the light, which then causes the nose to run. Sneezing may occur as a result of the runny nose. How do you know whether you're having a naso-ocular reflex or outdoor allergies? It may be difficult to tell for sure, but the naso-ocular reflex should occur almost immediately after stepping outside. Outdoor allergies, due to pollen and mold, may occur after a few minutes of being outside, and will also cause symptoms of itchy nose and eyes. Allergies will get better with a wide variety of allergy medications; the naso-ocular reflex may get better with a variety of prescription nasal sprays and a good pair of sunglasses. In my practice, I often encounter people who say that they are allergic to the sun. With exposure to sunlight, they experience symptoms such as itching, hives or burning. Some have visible rashes while others don't. Some have a medical condition which makes them more sensitive to sunlight; others are using various medications or topical agents that cause a reaction on the skin with sun exposure. It is possible that you can be allergic to the sunlight, with exposure causing hives. More commonly, people experience hives as a result of heat exposure - whether due to the warm of the sun, hot showers or exercise. Other reactions to sunlight occur as a result of contact dermatitis to topically applied products, such as cosmetics and sunblocks. What is Non-allergic Rhinitis? Non-allergic rhinitis is a medical condition of unknown cause, leading to symptoms very similar to allergic rhinitis, or hay-fever. Approximately half of people suffering from allergies also have a non-allergic component to their symptoms. Unlike allergies, which can be a seasonal problem, symptoms of non-allergic rhinitis are typically year-round. Non-allergic rhinitis also tends to be more common as people age, whereas allergic rhinitis tends to affect children and young adults. Non-allergic rhinitis has many different forms: • Vasomotor rhinitis is triggered by physical conditions such as strong odors, perfumes, changes in temperature and humidity, smoke, fumes and bright sunlight. Most patients experience a runny nose, post nasal drip and/or nasal congestion. Itching of the nose and eyes is typically not present. • Infectious rhinitis is typically related to a viral or bacterial infection, and symptoms can mimic a sinus infection, with facial pain and green nasal discharge. However, these patients do not have evidence of a sinus infection on x-rays. This disease process resolves on its own within a few days, and responds to oral antibiotics in severe or prolonged cases, just as a sinus infection would. • Hormonal rhinitis can occur during pregnancy and in patients with low thyroid function. Pregnant women usually have symptoms of severe nasal congestion occurring during their second month of pregnancy, and this can persist until the baby is born. Symptoms typically disappear shortly after delivery. • Medication-induced rhinitis can occur in many patients using high blood pressure medication, birth control pills and non-steroidal anti-inflammatory drugs (such as aspirin and ibuprofen). • Rhinitis medicamentosa is related to overuse of over the counter decongestant sprays, such as oxymetazoline, with symptoms of severe nasal congestion and runny nose. People who over-use these sprays essentially become "addicted" to the medication, needing more and more medication to control their symptoms. • Gustatory rhinitis can be related to food or alcohol intake, but is rarely due to an allergic cause. People suffering from this form of rhinitis experience a runny nose, usually of a clear, watery fluid, particularly after eating hot or spicy foods. • Rhinitis related to acid reflux disease is particularly common in young children, with symptoms of nasal congestion, runny nose and post-nasal drip. Symptoms may tend to occur after heavy meals, or in the morning after the person has been having acid-reflux while lying flat at night. How is Non-allergic Rhinitis Diagnosed? It can be very difficult to diagnose non-allergic rhinitis by a person's symptoms alone. A diagnosis is usually based on the history of symptoms, medication use, other known medical problems, and a physical examination. Allergy testing will be negative in patient with non-allergic rhinitis, and this testing is usually required to make sure that allergies are not playing a role in the person's symptoms. How is Non-allergic Rhinitis Treated? Avoiding the irritant triggers which cause the symptoms is the best way to treat non-allergic rhinitis, but not always possible. Typically, patients with non-allergic rhinitis do not respond to anti-histamine medications, since histamine is not causing their symptoms. Medications which are at least partially effective include prescription nasal steroid and antihistamine sprays, and oral decongestants. Patients with symptoms of constant "dripping" nose and post nasal drip may benefit from the drying effect of an anti-cholinergic nasal spray, and seem to be most helpful in vasomotor and gustatory rhinitis. Rhinitis during pregnancy can respond to saline nose sprays, and rhinitis medicamentosa requires stopping the over-the-counter topical decongestant and often replacing it with a prescription nasal spray. Treatment of other forms of non-allergic rhinitis may be patient-specific and require the care of a physician. Allergy shots, or immunotherapy, are ineffective in the treatment of non-allergic rhinitis. Symptoms of non-allergic rhinitis may also indicate a chronic sinus infection. Learn more about sinus infections. #######################################################################################################################################################################