Overview

Nonallergic rhinitis involves chronic sneezing or a congested, drippy nose with no apparent cause. Nonallergic rhinitis symptoms are similar to those of hay fever (allergic rhinitis), but with none of the usual evidence of an allergic reaction.

Nonallergic rhinitis can affect children and adults. But it's more common after age 20. Triggers of nonallergic rhinitis symptoms vary and can include certain odors or irritants in the air, weather changes, some medications, certain foods, and chronic health conditions.

A diagnosis of nonallergic rhinitis is made after an allergic cause is ruled out. This may require allergy skin or blood tests.

Symptoms

If you have nonallergic rhinitis, you probably have symptoms that come and go year-round. Signs and symptoms of nonallergic rhinitis might include:

  • Stuffy or runny nose
  • Sneezing
  • Mucus in the throat
  • Cough

Nonallergic rhinitis doesn't usually cause itchy nose, eyes or throat — symptoms associated with allergies such as hay fever.

When to see a doctor

See your doctor if:

  • Your symptoms are severe
  • You have signs and symptoms that aren't relieved by over-the-counter medications or self-care
  • You have bothersome side effects from over-the-counter or prescription medications for rhinitis

Causes

The exact cause of nonallergic rhinitis is unknown.

Experts do know that nonallergic rhinitis occurs when blood vessels in your nose expand and fill the nasal lining with blood and fluid. There are many possible causes, including the nerve endings in the nose being overly responsive, similar to the way the lungs react in asthma.

Whatever the trigger, the result is the same — swollen nasal membranes, congestion or excessive mucus.

There are many triggers of nonallergic rhinitis, including:

  • Environmental or occupational irritants. Dust, smog, secondhand smoke or strong odors, such as perfumes, can trigger nonallergic rhinitis. Chemical fumes, such as those you might be exposed to in certain occupations, also can be to blame.
  • Weather changes. Temperature or humidity changes can trigger the membranes inside your nose to swell and cause a runny or stuffy nose.
  • Infections. Viral infections such as a cold or the flu commonly cause nonallergic rhinitis.
  • Foods and beverages. Nonallergic rhinitis can occur when you eat, especially when eating hot or spicy foods. Drinking alcoholic beverages also can cause the membranes inside your nose to swell, leading to nasal congestion.
  • Certain medications. Medications that can cause nonallergic rhinitis include aspirin, ibuprofen (Advil, Motrin IB, others) and high blood pressure medications, such as beta blockers.

    Nonallergic rhinitis also can be triggered in some people by sedatives, antidepressants, oral contraceptives or drugs used to treat erectile dysfunction. Overuse of decongestant nasal sprays can cause a type of nonallergic rhinitis called rhinitis medicamentosa.

  • Hormone changes. Hormonal changes due to pregnancy, menstruation, oral contraceptive use or other hormonal conditions such as hypothyroidism may cause nonallergic rhinitis.
  • Sleeping on your back, sleep apnea and acid reflux. Lying on your back at night while you sleep can cause nonallergic rhinitis, as can obstructive sleep apnea or acid reflux.

Risk factors

Factors that can increase your risk of nonallergic rhinitis include:

  • Exposure to irritants. If you're exposed to irritants such as smog, exhaust fumes or tobacco smoke, you may be at increased risk of developing nonallergic rhinitis.
  • Being older than age 20. Unlike allergic rhinitis, which usually occurs before age 20, nonallergic rhinitis occurs after age 20 in most people.
  • Prolonged use of decongestant nasal drops or sprays. Using over-the-counter decongestant nasal drops or sprays (Afrin, Dristan, others) for more than a few days can actually cause more-severe nasal congestion when the decongestant wears off, often called rebound congestion.
  • Being female. Due to hormonal changes, nasal congestion often gets worse during menstruation and pregnancy.
  • Occupational exposure to fumes. In some cases, nonallergic rhinitis is triggered by exposure to an airborne irritant in the workplace (occupational rhinitis). Some common triggers include construction materials, solvents, or other chemicals and fumes from decomposing organic material such as compost.
  • Certain health problems. Several chronic health conditions can cause or worsen nonallergic rhinitis, such as hypothyroidism, chronic fatigue syndrome and diabetes.

Complications

Nonallergic rhinitis might be linked to:

  • Nasal polyps. These are soft, noncancerous (benign) growths that develop on the lining of your nose or sinuses due to chronic inflammation. Small polyps might not cause problems. But larger polyps can block the airflow through your nose, making it difficult to breathe.
  • Sinusitis. Prolonged nasal congestion due to nonallergic rhinitis can increase your chances of developing an infection or inflammation of the membrane that lines the sinuses (sinusitis).
  • Interrupted daily activities. Nonallergic rhinitis can be disruptive. You might be less productive at work or school. You also might need to take time off because of symptom flares or doctor visits.

Prevention

If you already have nonallergic rhinitis, you can take steps to reduce your symptoms and prevent flare-ups:

  • Avoid your triggers. If you can identify what causes or worsen your symptoms, avoiding your triggers can make a big difference.
  • Don't overuse nasal decongestants. Using these medications for more than a few days at a time can worsen your symptoms.
  • Get treatment that works. If treatment isn't working, see your doctor. Your doctor can make changes that do a better job preventing or reducing your symptoms.