Why your nose keeps running, and what stops it
Has your nose been running for 12 weeks or more?
If your nose has been running, dripping or blocking for 12 weeks or more, and you are not sick, that has a name: chronic rhinitis. The lining of your nose is irritated and making too much mucus for too long. Sometimes it is allergies. Very often it is not.
This is not a cold that never ended. It is a chronic condition, and it is treatable. But it is not one disease. There are several kinds. They have different triggers, and they need different treatments. That is why it is so hard to sort out on your own.
happens when your immune system reacts to something harmless. Common triggers are pollen, dust mites, mold and pet dander. Your nose runs, itches and sneezes, and your eyes water. Signs it is allergic: itching in your nose or eyes, sneezing fits, a seasonal pattern, or symptoms tied to one place or one animal. Allergy testing shows what you actually react to.
causes the same symptoms with no allergy behind them. The nerves and blood vessels in your nose over-react to ordinary things: cold air, humidity, strong smells, cleaning products, smoke, alcohol and stress. The most common type is called vasomotor rhinitis. There is usually no itching and no sneezing fits. Your nose just runs and blocks, and it often switches sides. Allergy testing comes back negative. That is why many people spend years being treated for allergies they do not have.
is the kind that makes your nose run while you eat. Hot and spicy food are the classic triggers, but for some people any meal does it. It starts within minutes of the first bite and stops soon after you finish. It is a nerve reflex, not a food allergy. It is harmless, but embarrassing. An ipratropium spray shortly before meals helps many people. It needs a prescription.
is often called “hay fever,” though hay is rarely the cause. In Georgia the pattern usually looks like this:
- Tree pollen drives symptoms in late winter and spring.
- Ragweed drives symptoms in the fall.
- Mold spores from damp leaves and grass can set it off, most often in wet weather.
Not sure how to handle your Chronic Rhinitis symptoms?
Treatment works in steps. Almost everyone starts at the top. You move down only after a fair trial of the step above: the right medicine, used correctly, for four weeks or more.
There is no cure for chronic rhinitis. It is a chronic condition. The realistic goal is that it stops running your day. Getting there starts with knowing which kind you have, because the treatments are different.
Saline rinses, avoiding your triggers, dust-mite covers and a HEPA filter help both kinds of rhinitis, and they are safe every day. At the same time, stop what makes it worse. Decongestant sprays like oxymetazoline work for about three days. After that your nose rebounds and blocks worse without them. Bring your medication list too. Some blood pressure, anti-inflammatory and antidepressant medicines cause a runny nose. On their own, these steps are rarely enough for severe symptoms.
A steroid spray such as fluticasone is the usual first prescription for both kinds. It takes one to two weeks to build up, and it only works if you use it every day. An ipratropium spray targets the running nose, including the kind set off by food, but it does little for stuffiness. An antihistamine spray helps allergic itching and sneezing, and it often does little for the non-allergic kind.
RhinAer becomes an option when the drip and the run have lasted 12 weeks or more, are moderate to severe, and at least two classes of medicine have been tried properly and have failed. It is not for stuffiness-dominant symptoms, not for mild symptoms, and not a first step. Expect some temporary congestion and crusting afterward. It is not permanent, and it is not a cure.
Office visits, nasal endoscopy and allergy testing are generally covered like any other specialist care, subject to your deductible and copay. In-office procedures are plan-specific. Anthem currently denies RhinAer under CPT 31242. Medicare and Cigna generally cover posterior nasal nerve treatment when their criteria are met. We verify your benefits before you commit and give you your number in writing. Call (678) 689-1100, Monday to Friday, 8:00 AM to 5:00 PM. We see patients in Lawrenceville and in Watkinsville, near Athens.
RhinAer, for a runny nose that medicine did not fix
RhinAer is an in-office treatment for chronic rhinitis, and it is FDA cleared. Of the procedures we offer for a runny nose and post-nasal drip, it has the most published evidence behind it: a randomized trial that compared RhinAer against a fake version of the treatment, plus a position statement from the American Academy of Otolaryngology (AAO-HNS) supporting treatment of the posterior nasal nerve.
It is not surgery, and it does not need general anesthesia. You are numbed in the exam chair and you go home the same day. It is also not a cure. Chronic rhinitis is a chronic condition, symptoms can come back, and Anthem currently denies this procedure under CPT 31242. We check your coverage first and tell you your cost in writing.
How does the Rhinaer procedure work?
RhinAer works on the posterior nasal nerve. That nerve tells your nose to make mucus. Your provider passes a small flexible wand into your nose and uses low-level radiofrequency energy to interrupt the nerve. Less signal means less mucus. You are awake, and you are numbed first.
What the research measured
In studies, people treated with RhinAer reported changes like these. Results vary from person to person, this is not a cure, and some people need treatment again later.
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