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Nose Allergy
(Allergic Rhinitis in Singapore)
What is Allergic Rhinitis (Sensitive Nose)?
Allergic rhinitis, also known as a sensitive nose, refers to inflammation of the nasal passages caused by exposure to airborne allergens such as dust mites, pollen, pet dander, mould spores, and other environmental irritants, including chemical fumes and air pollution.
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In Singapore’s humid climate, these allergens are common in homes and workplaces, often triggering symptoms throughout the year.
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According to HealthHub, allergic rhinitis is not infectious but may recur, particularly in individuals with a family history of allergies or asthma. Early evaluation and consistent treatment for sensitive nose symptoms can help reduce the impact on sleep, productivity, and quality of life.
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Commonly managed by a nasal specialist in Singapore, this condition may present as a nose allergy or a sensitive nose and requires proper assessment to identify triggers and suitable management options.
What are the Symptoms of Nose Allergy?
Frequent Morning Sneezing
Sneezing fits, particularly in the morning, are a common sign of a sensitive or allergic nose reacting to environmental allergens.
Blocked or Runny Nose
Chronic nasal congestion or watery discharge occurs due to swelling of the nasal lining and increased mucus production.
Itchy Nose, Eyes, or Throat
Persistent itchiness in these areas may occur as the immune system releases histamine in response to allergens.
Watery Eyes
Allergic rhinitis often appears alongside conjunctival irritation, causing watery or red eyes.
Post-Nasal Drip or Cough
Excess mucus draining down the throat may cause coughing or throat clearing, especially at night.
Facial Pressure or Headaches
Swelling within the nasal passages and sinuses may result in facial pressure or mild headaches.
Fatigue Due to Disturbed Sleep
Blocked nasal passages can disrupt rest, leading to tiredness and reduced concentration during the day.
What Causes Nose Allergy and Who is at Risk in Singapore?
Dust Mites
Thriving in warm, humid environments, dust mites are found in bedding, carpets, and upholstered furniture. Their microscopic droppings are common allergens.
Pet Dander
Proteins in pet skin, saliva, and urine can trigger allergic reactions in sensitive individuals.
Pollen
Certain plants release pollen that can cause nasal inflammation, even in Singapore’s tropical climate, where imported plants or seasonal exposure may occur.
Mould Spores
Mould thrives in damp indoor areas such as bathrooms and poorly ventilated rooms. Inhaled spores can aggravate nasal symptoms.
Air Pollution
Smog, cigarette smoke, and industrial pollutants can worsen nasal irritation or act as triggers for allergic rhinitis.
Carpets
Thick carpets trap dust and allergens, increasing the risk of persistent nasal inflammation.
Soft Toys
Soft toys may harbour dust mites and contribute to ongoing symptoms, especially in children.
Family History of Allergies
Individuals with a family history of asthma, eczema, or hay fever are more likely to develop allergic rhinitis.
How Nasal Allergy Doctors Diagnose Allergic Rhinitis in Singapore
Diagnosis typically involves a structured evaluation by a nasal specialist or nose allergy specialist, guided by the ENT diagnosis in Singapore’s practices.
Clinical History and Nasal Examination
The doctor reviews symptom patterns, possible triggers, and family history, followed by a detailed nasal examination.
Nasal Endoscopy
A thin, flexible endoscope allows direct visual assessment of the nasal passages to identify inflammation, swelling, or structural issues.
Allergy Tests
These help determine the allergens responsible for the symptoms:
Skin Prick Test
A small amount of suspected allergen is introduced to the skin; results appear within minutes.
Blood IgE Test
Measures antibodies linked to allergic response.
Food Elimination and Challenge Tests
Used when food allergies are suspected, conducted under medical supervision.
Imaging (if sinus issues are suspected)
If chronic congestion or facial pain is present, sinus imaging such as a CT scan may be recommended to assess for sinusitis or related conditions.
What Complications Can Nose Allergy Cause?
Sinusitis (Chronic or Acute)
Persistent nasal inflammation may block sinus drainage, leading to sinus infections.
Ear Infections or Blocked Ears
Allergic swelling can affect the Eustachian tubes, causing fluid buildup or temporary hearing discomfort.
Snoring / Sleep Disturbance
Nasal obstruction may contribute to snoring or mild sleep disruption.
Reduced Concentration and Daytime Tiredness
Ongoing nasal congestion and poor sleep quality can reduce focus and alertness during the day.
What are the Treatment Options for Sensitive Nose Allergy?
Environment Control: Get Rid of Dust Mites
Although killing mites is initially very desirable, if dust is left in place, the mites will soon return. It is thus important to clean regularly and thoroughly to minimize dust.
- Floors: Carpets are an ideal place for dust to settle and mites to hide. The ideal situation would be to minimize carpets in the house; but if this is not possible, a short pile carpet and regular vacuuming with a HEPA-filter vacuum cleaner would be the next best alternative.
- Curtains: Wooden blinds or plastic curtains are preferred over heavy fabric curtains.
- Bedding / Mattresses: All bedding should be washed at least weekly in temperatures above 60 degrees centigrade and above to kill dust mites. Mattresses harbor a lot of dust and dead skin cells, and should be vacuumed regularly. Anti-dust mite covers for mattresses and pillows are available and can be used to stop the mites from getting out. These covers also need to be washed regularly at a similar temperature to bedding.
- Furniture: Upholstered furniture traps dust. Better alternatives would be plastic, wood or leather furniture.
- Soft toys: These, like bedding, can harbor a large amount of dust mites. The best thing would be to get rid of them completely, but an alternative would be to regularly wash them at 60°C to kill the dust mites.
Dust mites and their droppings generally cling to bedding / carpet / heavy fabrics and are not circulating in the air. Air purifiers clean circulating air and thus in general, are not useful in patients with dust mite allergies and allergic rhinitis.
Over-The-Counter (OTC) Medications For Nose Allergy​
Medications for allergic rhinitis, sinus congestion, runny nose and the common cold make up the largest section of OTC medication in pharmacies. When used appropriately, most of them provide significant relief of symptoms from allergies and common colds. These medications do not cure the allergies or the common cold, but help relieve the symptoms making the patient more comfortable.
Antihistamines
Antihistamines are one of the most widely used medications on the market, due to their high efficacy and ease of administration. Histamine is a chemical in the body that is responsible for the majority of the congestion, sneezing and runny nose that a patient suffers with an allergic attack. Antihistamines block the action of histamine and thus reduce the allergic symptoms. For best results, antihistamines should be taken before histamine has been released in the body; i.e. before allergic symptoms are well established.
There are numerous antihistamines available over the counter, such as Telfast, Clarityn, Clarinase, and Zyrtec.Â
The majority of antihistamines are non-drowsy, but some older antihistamines may result in drowsiness. Caution has to be taken when driving or operating heavy machinery.
Decongestants
Nasal congestion or obstruction is typically due to swollen or expanded blood vessels in the nose and air passages. The nose has an abundance of these blood vessels with a great capacity for expansion. Histamine can stimulate these blood vessels to expand.
Decongestants are useful in this case as they case shrinkage of these blood vessels, which forces the blood out and open up the air passages. Decongestants usually come in two forms, an oral formulation and a nasal spray. Examples of oral decongestants include Phenylephrine and Pseudoephedrine, and examples of nasal spray decongestants include Afrin and Oxy-nase. These are chemically related to adrenaline, which is a form of stimulant. Hence, decongestants have side effects such as agitation and nervousness, and can also elevate blood pressure and pulse rate. In patients who are elderly, they may also cause urinary retention. These side effects are more pronounced in patients who take the oral formulation. Decongestants should not be used by patients with irregular heart rhythms, high blood pressure, heart disease or glaucoma.
Combination Antihistamine-Decongestant
Numerous combinations of antihistamines with decongestants such as Zyrtec-D, Telfast-D, Claritin-D and FEDAC are available. These medications are convenient, and are most useful in patients with symptoms of runny nose and nasal congestion.
Nasal Sprays
Nasal steroid sprays are now available over the counter, and are used for chronic nasal inflammation and congestion from allergies and other causes. There has been some evidence that starting a nasal steroid spray, even in cases of the common cold, may be effective in reducing the duration and severity of symptoms. Examples of such nasal steroid sprays include Flixonase, Nasonex, Avamys and Nasacort.
Subcutaneous Immunotherapy (SCIT)
SCIT involves a series of small injections containing specific allergens to help the immune system become less reactive over time. According to the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines, this approach can provide lasting symptom improvement in selected patients when conducted under medical supervision.
Sublingual Immunotherapy (SLIT)
SLIT uses allergen extracts administered under the tongue, allowing gradual desensitisation without injections. Endorsed by the World Health Organization and supported by Cochrane systematic reviews, SLIT is considered a safe option for individuals with allergic rhinitis who prefer non-injection therapy.
FAQs about Nasal Allergies (Allergic Rhinitis)
1. Can allergic rhinitis be completely cured?
Allergic rhinitis is a chronic condition, but its symptoms can be managed effectively with the right treatment plan. Long-term control is possible through environmental changes, medication, or immunotherapy.
2. What’s the difference between sinusitis and allergic rhinitis?
Sinusitis is usually caused by infection and may present with facial pain, fever, and thick nasal discharge. Allergic rhinitis is caused by an allergic reaction and typically involves sneezing and itching without fever.
3. Is allergic rhinitis common in Singapore?
Yes, due to the warm and humid climate, allergic rhinitis is relatively common in Singapore. Dust mites, mould, and pollution are frequent triggers in both homes and workplaces.
4. Are nose allergy treatments safe for children?
Many treatments, such as saline sprays and certain antihistamines, are suitable for children. However, it is important to consult a qualified paediatric ENT specialist for an age-appropriate diagnosis and treatment plan tailored to your child’s needs.
5. Do I need an allergy test for nose sensitivity?
Allergy tests may be considered if symptoms are persistent or if the exact cause is unclear. Your doctor will advise if testing is necessary based on your history and symptoms.
Getting Help for Nose Allergies in Singapore
If you are experiencing persistent symptoms of a sensitive nose or allergic rhinitis, seeking medical advice is the first step toward relief. A consultation with a qualified nasal allergy specialist can help you understand your condition and explore suitable management options.
To schedule an appointment, please contact our clinic or use the online booking form.
Nasal Allergy Specialist Doctor in Singapore
If your symptoms persist beyond a few weeks, disturb sleep, or affect school/work performance, it may be helpful to consult a nasal specialist for an evaluation. Dr Leslie Koh sees patients at Mount Alvernia Hospital.