Allergies are our immune system’s way of trying to protect us, but sometimes that protection goes into overdrive. Instead of saving us from harm, the immune system can misinterpret harmless particles in the environment as dangerous invaders. The result is allergic rhinitis, a condition marked by nasal inflammation, sneezing, congestion, and watery eyes.1
When these symptoms appear only during certain times of the year, like spring or fall, we call it seasonal allergic rhinitis, or “hay fever”. But when the symptoms never truly go away, persisting month after month, it’s known as perennial allergic rhinitis.1
The Immune System’s Overreaction
At the root of perennial allergic rhinitis is an immune system that reacts too strongly to everyday substances. Dust mites hidden in bedding, mold spores lingering in damp corners, pet dander floating through the air, and even cockroach droppings in crowded housing can all trigger this response.2
When the immune system mistakes these particles for dangerous threats, it releases histamine and other chemicals. These cause the familiar symptoms: swollen nasal passages, constant sneezing, runny nose, itchy eyes, and pressure in the face. For many, these symptoms are not just occasional irritations, they are a daily struggle that can disrupt sleep, work, school, and overall quality of life.2
Symptoms and Daily Impact
Unlike seasonal allergies, perennial allergic rhinitis doesn’t give the body a break. Symptoms may flare daily, making it hard to find relief. The most common include:1
- Nasal congestion – persistent stuffiness that makes breathing through the nose difficult.
- Runny nose (rhinorrhea) – clear, watery discharge that can feel constant.
- Sneezing fits – often triggered by sudden exposure to allergens like dust or pet dander.
- Itchy, watery, or red eyes – inflammation around the eyes that resembles conjunctivitis (pink eye).
- Itchy nose, throat, or ears – irritation that can make focusing or sleeping difficult.
- Facial pressure or sinus pain – caused by swelling of nasal passages and blocked airflow.
- Postnasal drip – mucus drainage leading to sore throat or chronic cough.
- Fatigue and poor sleep – congestion and irritation often disturb rest, leaving people exhausted during the day.
The impact of these symptoms extends beyond discomfort. Interrupted sleep lowers energy and productivity, leading to difficulty concentrating at school or work. Children may struggle academically due to fatigue or frequent absences. Adults may find their daily routines disrupted, relying on over-the-counter medicines that only provide partial relief. Over time, the emotional weight of chronic, untreated symptoms can contribute to stress, irritability, and reduced quality of life.2
Risk Factors in Underserved Communities
Perennial allergic rhinitis affects people across all backgrounds, but underserved communities often face greater risks. Densely populated housing increases exposure to indoor allergens like mold or pests. Older buildings may lack proper ventilation or insulation, worsening indoor air quality. At the same time, limited access to allergy specialists means many live undiagnosed or undertreated, normalizing symptoms as “just part of life”.3
Systemic inequities in healthcare amplify the problem. Misdiagnosis is common, with symptoms sometimes brushed off as recurring colds. Cultural stigmas around seeking care for “everyday” discomforts further silence those affected. These barriers make it harder for people to access the relief and treatment they deserve.3
Diagnosis and Treatment
A proper diagnosis begins with awareness, recognizing that ongoing congestion, itchy eyes, or sneezing might not be “just allergies,” but a chronic condition worth medical attention. Doctors may ask about symptom history, conduct a physical exam, or order allergy testing.4
Treatment can take many forms:
- Medications: antihistamines, nasal corticosteroids, and decongestants to control symptoms.4
- Immunotherapy: allergy shots or tablets that retrain the immune system over time.4
- Environmental changes: using HEPA air filters, washing bedding in hot water, controlling moisture to prevent mold, and addressing pest issues.4
With consistent management, many people see dramatic improvement in both symptoms and quality of life.
Taking Allergic Rhinitis Seriously
Perennial allergic rhinitis is more than a nuisance, it is a chronic condition with real impact. Left untreated, it can lead to sinus infections, worsen asthma, and lower daily functioning.
For communities already facing health disparities, it represents another silent burden on well-being.2 But it doesn’t have to stay that way. By breaking the stigma, advocating for proper diagnosis, and addressing environmental health factors, we can ensure that our communities have access to better breathing, relief and whole-person care.
References
- Hayes, K. (2024, September 12). What to Know About Perennial Allergic Rhinitis. Retrieved from VeryWell Health: https://www.verywellhealth.com/perennial-allergic-rhinitis-4159785
- Akhouri, S., & House, S. A. (2023, July 16). Allergic Rhinitis. Retrieved from StatPearls [Internet]: https://www.ncbi.nlm.nih.gov/books/NBK538186/
- Perry, T. T., Grant, T. L., Dantzer, J. A., Udemgba, C., & Jefferson, A. A. (2023). Impact of socioeconomic factors on allergic diseases. The Journal of Allergy and Clinical Immunology. doi:10.1016/j.jaci.2023.10.025
- WEAVER-AGOSTONI, J., KOSAK, Z., & BARTLETT, S. (2023). Allergic Rhinitis: Rapid Evidence Review. Retrieved from American Family Physician: https://www.aafp.org/pubs/afp/issues/2023/0500/allergic-rhinitis.html
