Rhinitis: what forms are there and what helps?

Rhinitis – commonly called a cold – is harmless but can also lead to complications. Different forms of rhinitis have different triggers and should also be treated differently. From allergic rhinitis to vasomotor rhinitis to rhinitis sicca – this article shows you how to recognize the various forms of rhinitis, the different causes behind each, how best to treat the different forms, and when to see a doctor.

Rhinitis: what happens when you have a cold?

When you have a cold, you often get a runny nose. This is triggered by viruses that enter the respiratory tract via the air we breathe. If the pathogens settle there, the mucous membrane becomes inflamed. This swells, and nasal breathing is hindered as a result. This form of rhinitis is called infectious rhinitis.

At first, the nasal secretion is thin, and the nose runs. Later, there is increased production of viscous mucus, which significantly restricts nasal breathing – the nose is blocked. Inflammation of the paranasal sinuses (sinusitis) and the throat ( pharyngitis ) is also joint.

A cold usually lasts a week, and the symptoms are primarily limited to the nose.

 

How is rhinitis treated?

In the case of infectious rhinitis, in addition to classic home remedies such as steam baths, nasal douches or onions, the (temporary) use of nasal spray or expectorant preparations, such as acetic acid, can also help. You can find comprehensive tips for treating colds here.

What is chronic rhinitis?

If the nose runs for a more extended period or is constantly blocked up, it can be a question of chronic inflammation of the nasal mucous membranes. Chronic rhinitis is often accompanied by chronic sinusitis.

The paranasal sinuses are usually involved in the classic cold. But only when isolated symptoms such as severe headaches occur while the runny nose is absent does one speak of a sinus infection. Adults are primarily affected by sinusitis.

The causes of chronic rhinitis can be infections and allergic reactions. Depending on the cause, different remedies help against chronic rhinitis. Below, you can read about the types of rhinitis that can lead to permanent symptoms.

 

Allergische Rhinitis (Allergic Rhinitis)

As the name suggests, allergic rhinitis is caused by an allergic reaction. A misguided immune system reaction to certain substances (e.g. po, pollen in hay fever or the faeces of house dust mites ) leads to inflammation and swelling of the nasal mucous membranes. If the allergy-related symptoms occur all year round, this is called perennial rhinitis.

Symptoms of allergic rhinitis include:

  • stuffy nose
  • Niesreiz
  • itching in the nose
  • runny nose with clear nasal discharge

The allergic reaction can also lead to tiredness, itchy and watery eyes or a cough. Skin reactions are also possible.

If you suffer from allergic rhinitis, nasal sprays with corticosteroids and antihistamines can help. In the case of more extensive symptoms, antihistamines can also be taken in the form of tablets. Anyone suffering from severe symptoms should seek advice on possible hyposensitization.

Otherwise, it helps to avoid the allergen if possible or to use tips to alleviate allergic reactions. These include, for example, frequent showering and washing your hair to remove pollen from your skin and hair or removing carpets or curtains if you have a house dust allergy.

Dry Rhinitis (Trockene Rhinitis)

In rhinitis sicca, also called dry rhinitis, there is a reduced production of nasal secretions. This causes the nasal mucous membranes to become dry and inflamed.

In addition to dry nasal mucous membranes, the following symptoms can occur with rhinitis sicca:

  • Crust formation on the nasal mucosa
  • stuffy nose
  • Burning and pain in the nose
  • itching
  • nosebleeds (epistaxis)
  • Niesreiz

There are many causes of rhinitis sicca. Mechanical irritation (nose picking), dry, dusty air, irritating fumes, or cigarette smoke are common triggers. But specific clinical pictures, such as autoimmune diseases, as well as medication and operations, can also promote the development of rhinitis sicca.

If you want to treat dry rhinitis, you should first identify the trigger and avoid it if possible. In addition, the nasal mucous membranes should be moistened. For example, you can use nourishing seawater nasal sprays, special nasal ointments or a nasal douche. On the other hand, you should avoid using decongestant nasal sprays, as they further dry out the mucous membranes.

Rhinitis atrophicans

A rhinitis atrophicans (atrophic rhinitis) describes a regression of the nasal mucous membranes. A distinction is made between primary and secondary atrophic rhinitis. The latter is also known as “Empty Nose Syndrome”.

The nasal cavity enlarges as part of a rhinitis atrophicans, causing the inhaled air to be more swirled in the nose. As a result, the mucous membranes dry out severely.

While the triggers for the primary form are usually unknown (genetic causes are suspected), secondary atrophic rhinitis is caused by factors such as surgery or overuse of nasal decongestants.

The following symptoms can occur with a rhinitis atrophicans:

  • Regression of the nasal mucosa
  • dry nasal mucosa
  • Formation of crusts and scabs
  • disturbed transport of nasal secretions
  • Disorder of the sense of smell
  • headache

It is usually impossible to heal a rhinitis atrophicans because the damage that has already occurred can no longer be repaired.

However, the symptoms can be relieved by regularly moistening the nose, for example, with nourishing sprays, nasal oils or ointments. In the case of an additional bacterial infection, which can lead to reddening of the skin or the formation of pimples in the nostril, antibiotics are also a treatment option.

If the symptoms are very severe, an operation is also possible, during which the nasal cavity is artificially narrowed. The risks and benefits should be carefully weighed and discussed in a medical consultation.

 

Komplikation “Stinknase”

In the context of atrophic rhinitis, crusts and crusts can form in the nose, where pus and bacteria can collect. One then speaks of a rhinitis atrophicans cum foetore, also called ozaena. Because these scabs give off a foul odour, the disease is often referred to as a “stinky nose”.

Purulent or bacterially infected nasal discharge can also be caused by other diseases, such as sinusitis, or by a foreign object in the nose.

Medicinal rhinitis

As the name suggests, rhinitis medicamentosa (drug sniffles ) occurs as a side effect of medication. As a rule, these are decongestant nasal sprays or drops; antihypertensive drugs more rarely trigger this form of rhinitis.

If decongestant nasal sprays are used more than three times a day and for more than a week at a time, contrary to the package insert, the so-called rebound effect can occur. The hollow bodies expand through the decongestant nasal spray – if you stop the nasal spray, the nose swells all the more. It is also called a nasal spray addiction.

To treat rhinitis medicamentosa, the nose must be weaned from the nasal spray for extended periods. If other medications trigger the disease, these should be discontinued or changed. In both cases, the right course of action should be clarified by a doctor.

Vasomotorische Rhinitis

Vasomotor rhinitis (rhinitis vasomotor) occurs when the body can adequately regulate the swelling of the turbinates. The disease is probably based on a nervous system disorder, which is supposed to control swelling. For this reason, the name “nervous cold” is sometimes used for vasomotor colds.

What, in turn, triggers the malfunctioning of the nervous system itself has yet to be clarified. Conceivable causes are hormonal changes or excessive sensitivity of the nasal mucosa.

The swelling of the turbinates leads to obstruction of nasal breathing, which can worsen, especially at night. This can also lead to a disturbance in the sense of smell and sleep quality, including sleep apnea. The symptoms can be triggered or aggravated by various factors such as stress, fragrances, alcohol or hot spices.

Nasal sprays with different active ingredients are used for treatment. These include nasal sprays with antihistamines, glucocorticoids or seawater. Which nasal spray to use against the symptoms should be clarified by a doctor. The same applies here: decongestant nasal sprays should be avoided, as they can even worsen the symptoms if used for a long time.

In addition to drug treatment, the triggers, as far as they are known, should be avoided. Exercising can also help reduce nasal concha swelling.

 

Hyperplastische Rhinitis

In some cases (chronic) colds also lead to the formation of polyps. Then, one speaks of hyperplastic rhinitis. These benign growths can develop in the paranasal sinuses and nasal cavities. They often obstruct nasal breathing.

Cold: when to see a doctor?

Usually, a cold heals on its own. However, to avoid the development of chronic rhinitis or other complications, medical advice should be sought if:

  • the cold persists for more than a week or gets much worse
  • there is pain in the paranasal sinuses
  • a sore throat or earache occurs
  • the lower respiratory tract is affected, or there is fever, coughing and breathing difficulties

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