Does your nose drip like a leaky faucet 365 days a year? Do you constantly sniffle away, while the rest of your office casts judgemental stares at you?
From date nights, to friend gatherings and important work meetings, a runny nose that never seems to go away can be hugely debilitating to your everyday life.
Good news? There's hope for you. Stop using up 2 whole boxes of tissue paper each week. I'm here to teach you how to get rid of your runny or sensitive nose, permanently.
Why is your nose constantly runny?
The likely cause for your constantly runny nose is Rhinitis, also know as "sensitive nose" in Singapore.
Rhinitis is due to inflammation of the lining of your nose. It also happens to be one of the most common problems that patients come to my ENT clinic for.
You're not alone in your suffering - Rhinitis affects 10% to 30% of the population worldwide (scant consolation, I know).
Doctors don't fully know the reason for Rhinitis, but it's been shown that Rhinitis tends to run within your family.
What are the symptoms of Rhinitis?
The most common symptoms that my patients complain about are:
- Runny nose with clear, watery mucous
- Post-nasal drip (mucous dripping down the back of your throat)
- Itchy nose and eyes
- Watery eyes
- Blocked nose
How can you tell if you've got Rhinitis, or a cold?
I often have patients mix up the two conditions. Symptoms from Allergic Rhinitis can be very similar to a cold.
To help you distinguish between the two, a cold tends to cause more of the following symptoms:
- Fever and sore throat
- Thick, coloured mucous (yellow, green or brown)
- Thick phlegm
- Body ache
Importantly, a cold also usually resolves within a week, unlike Rhinitis which can pretty much be a daily affair. A cold also causes less itching of your nose and eyes.
How many types of Rhinitis are there?
Rhinitis can be broadly divided into 3 types:
1. Allergic Rhinitis (AR)
This is the most common form of Rhinitis, and is caused by exposure to allergens (proteins that trigger an allergic reaction).
Common allergen culprits in Singapore include:
- House dust mites
- Grass or tree pollen
- Dog/cat fur and hair
2. Non-Allergic Rhinitis
As the name implies, this type of rhinitis is NOT due to allergen exposure. Symptoms of non-allergic Rhinitis are similar to that of Allergic Rhinitis.
Common causes in Singapore include:
- Change of weather conditions or temperature (ie aircon to non-aircon, humid to non-humid environment)
- Cigarette smoke
- Traffic fumes
- Strong odours
3. Infectious Rhinitis
Rhinitis that's due to a viral infection. The flu bug is a common trigger for Infectious Rhinitis.
Do you have Allergic or Non-Allergic Rhinitis?
An Allergy Test may be performed to help you distinguish between Allergic and Non-Allergic Rhinitis.
The two most common Allergy Tests are:
- Skin Prick Tests
- Blood tests to look for antibodies to the allergen
A skin prick test involves dipping a multi-prong needle into a tray of common allergens. The multi-prong needle is then applied firmly onto your forearm.
There should be no blood encountered as it only pricks the outer layer of your skin. After about 20 minutes, the size of your skin rash reaction to the allergen is measured.
How is Rhinitis diagnosed?
I'll typically diagnose Rhinitis based on the findings from your clinical history, and physical examination.
Part of the examination usually includes a nasoendoscopy test to look into your nose. Patients with Rhinitis often have enlarged inferior turbinates, which is a sausage-like bony structure at the side of the nose.
How do you get rid of Rhinitis?
Finally, we get to the million dollar question! You can get rid off your annoying runny nose through a combination of lifestyle changes, medications, and very rarely, surgery.
1. Lifestyle changes
It doesn't take a rocket scientist to tell you that you should avoid exposure to your known trigger (in Non-Allergic Rhinitis), or allergen (in Allergic Rhinitis).
A local study showed that approximately 80% of Singaporeans are allergic to house dust mites. Hence, it's of paramount importance that you wash your bedsheets and pillow cases with hot water at least once a week. The temperature of the water has to be at least 60 degrees celsius.
This temperature is required to remove and kill common allergens such as house dust mites, dog hair/fur and pollens.
Oral antihistamines are very useful to keep your symptoms under control, and have minimal side effects.
The most effective treatment method for long-lasting relief of your runny nose however, is through the use of a nasal steroid spray.
Nasal steroid sprays work by reducing inflammation in your nasal cavity. Although it's a steroid spray, studies have shown that very little gets absorbed into the blood system. Hence, it's safe for long-term usage, and you shouldn't worry about nasty side effects that may result from taking oral steroids.
For the steroid spray to be effective, you should use it on a daily basis, and ensure that the correct application technique for the spray is used.
Don't give up halfway - it often takes about 2 weeks for nasal steroid sprays to work their magic!
SLIT (Sublingual Immunotherapy) involves spraying the known allergen under your tongue daily to desensitise you, and is very effective.
The flipside? You need to be committed to the treatment for at least 3 YEARS. Things usually start getting better at the 3 - 6 months mark.
This option is reserved for those who've failed to respond to all the above treatments. In most cases, surgery is used to relieve a blocked nose, which involves reducing the size of the inferior turbinates.
The two most commonly used methods for this include:
- Radiofrequency or coblation of the inferior turbinate (“burning” of the turbinate to shrink it)
- Inferior turbinoplasty (removal of the turbinate bone)
Your ENT Specialist will discuss with you on the surgical option that suits you best.
I hope you found the post helpful! The next time you notice someone at your office having a runny nose EVERY DAY, instead of passing him the Vitamin C and Kleenex, feel free to point him to this article :-)
Dr Gan Eng Cern is an ENT Specialist at Mount Elizabeth Novena Specialist Centre (A Specialist Centre for Sinus, Snoring & ENT), and is also a Senior Clinical Lecturer at the National University of Singapore. He obtained Subspecialty training in Nose and Sinuses, and has a passion for the treatment of snoring and Obstructive Sleep Apnoea (OSA). Dr Eng Cern enjoys jogging regularly to keep his spare tyres under control.