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Allergic rhinitis and rhinoconjunctivitis
Understanding what triggers nasal and eye symptoms and improving control
In this sheet
The essentials
The typical picture
Repeated sneezing, an itchy nose, clear discharge and nasal blockage. If the eyes also itch, become red and water, this is called rhinoconjunctivitis.
Positive test ≠ responsible allergen
A positive skin prick test or IgE result shows sensitisation. To conclude that the allergen explains your symptoms, the clinical history, timing and exposure must match.
Do not forget the airways
Cough, wheeze, shortness of breath, night waking or exercise symptoms should also raise the possibility of asthma. Treating the nose does not replace assessment or treatment of the airways.
Rhinitis, rhinoconjunctivitis and ‘hay fever’
Allergic rhinitis mainly affects the nose. Rhinoconjunctivitis combines nasal and eye symptoms. ‘Hay fever’ is a common term used mainly for seasonal pollen-related forms.
Not every allergic rhinitis is therefore ‘hay fever’: dust mites, animals or some moulds may cause much more prolonged symptoms.
What does allergic rhinitis look like?
- repeated sneezing;
- itchy nose;
- clear nasal discharge;
- blocked nose;
- itchy, red or watery eyes when the conjunctiva is also involved.
What is the impact?
- Tiredness, poorer sleep and difficulty concentrating may accompany persistent symptoms.
- Significant rhinitis can therefore have a real effect on school, work and quality of life.
Seasonal or all year round?
Mainly during certain seasons
Pollens are a common cause. Periods vary by species, region and weather. A pollen season provides clues but is not enough on its own to identify the allergen.
All year round or very often
Dust mites, animals and some indoor or occupational exposures may be involved. Several factors may coexist.
My test is positive: have I found the cause?
Not necessarily. A positive skin prick test or positive specific IgE means your immune system recognises an allergen: this is sensitisation.
To determine whether this allergen actually explains your rhinitis, the doctor compares symptoms, dates, places, exposures and test results.
Food tests are not routinely used to investigate the cause of rhinitis.
Not every blocked nose is allergic
Other causes may produce similar symptoms: viral infection, non-allergic rhinitis, smoke or pollution irritation, some medicines, rhinosinusitis or an anatomical problem.
Reducing exposure: useful when the allergen is genuinely involved
The goal is not to transform your entire environment after a single positive test. Measures should be targeted and realistic.
Pollens / outdoor environment
Adapt measures to periods of exposure. See ‘Pollens: understanding seasons and reducing exposure’.
Dust mites / animals / moulds
See the dedicated sheets for bedrooms, bedding, animals, humidity and measures that are genuinely useful.
Nasal rinses
Saline solutions may help remove secretions, improve comfort and complement treatment. They do not replace prescribed treatment when rhinitis is significant.
See also ‘Nasal sprays & rinses’ for practical technique.
Antihistamines
Antihistamines may be particularly helpful for sneezing, itching, nasal discharge and some eye symptoms. Some may cause more drowsiness than others.
See also ‘Using H1 antihistamines correctly’.
Nasal corticosteroids: an important role
Intranasal corticosteroids are among the most effective treatments for allergic rhinitis, especially when nasal obstruction or persistent symptoms predominate. Depending on the situation, a combination with a nasal antihistamine may also be offered.
Effectiveness also depends on correct use and the prescribed schedule. Poor technique may reduce effectiveness and promote irritation or bleeding.
See ‘Nasal sprays & rinses’ to learn the technique.
‘My treatment only works while I take it’
This may be normal: rhinitis linked to repeated exposure may require regular treatment during the specified period. Do not start, stop or change prescribed treatment on your own.
What about the eyes?
When both eyes itch, become red and water at the same time as nasal symptoms, this may be rhinoconjunctivitis. Significant pain, true loss of vision or marked photophobia are not usual signs of a simple allergy and require medical advice.
See ‘Eye allergy’.
Do not forget the airways
If you also have recurrent cough, wheezing, shortness of breath, night-time or exercise symptoms, mention them. Rhinitis and asthma may coexist; treating the nose does not replace management of possible asthma.
What about pollen-food allergy syndrome (PFAS)?
Some people with pollen allergy experience itching or swelling in the mouth after certain fruits, vegetables or tree nuts, especially when raw. This is a separate condition called pollen-food allergy syndrome.
A dedicated SOS Allergo PFAS sheet complements this page.
When should allergen immunotherapy be discussed?
Allergen immunotherapy (desensitisation) may be discussed when the responsible allergen is clearly identified and the condition remains sufficiently troublesome despite appropriate management, depending on your circumstances and preferences.
See ‘Allergen immunotherapy: monitoring desensitisation’.
Common misconceptions
‘My nose is blocked, so it must be allergy.’
No. Several causes are possible.
‘My skin prick test is positive, so I have found the cause.’
Not necessarily. The result must match the symptoms and exposure.
‘Hay fever means every allergic rhinitis.’
No. The term mainly refers to seasonal pollen-related forms.
‘A nasal spray does not work: I tried it twice.’
Some treatments need correct and regular use according to the prescription.
‘A corticosteroid spray and a decongestant spray are the same.’
No. Their mechanisms, use and risks differ.
‘Pollen allergy means I must avoid some fruits.’
No. Do not avoid food preventively because of pollen sensitisation alone.
| Misconception | What you need to know |
|---|---|
| ‘My nose is blocked, so it must be allergy.’ | No. Several causes are possible. |
| ‘My skin prick test is positive, so I have found the cause.’ | Not necessarily. The result must match the symptoms and exposure. |
| ‘Hay fever means every allergic rhinitis.’ | No. The term mainly refers to seasonal pollen-related forms. |
| ‘A nasal spray does not work: I tried it twice.’ | Some treatments need correct and regular use according to the prescription. |
| ‘A corticosteroid spray and a decongestant spray are the same.’ | No. Their mechanisms, use and risks differ. |
| ‘Pollen allergy means I must avoid some fruits.’ | No. Do not avoid food preventively because of pollen sensitisation alone. |
What helps your allergist
Before the consultation, try to identify:
- when symptoms occur and during which seasons;
- where they occur: home, work, school, outdoors or at someone else’s home;
- possible exposures: pollens, animals, dust, humidity or irritants;
- whether the eyes or airways are also involved;
- treatments already tried, how they were used and their effect.
You may also want to read
Key points
- Symptoms + timing + exposure matter as much as tests.
- Positive test ≠ necessarily the responsible allergen.
- Good nasal technique matters greatly.
- Do not forget the eyes and airways.
- Avoidance measures and treatments should remain appropriate to your situation.
Scientific references
- Sousa-Pinto B, Bousquet J, et al. Allergic Rhinitis and Its Impact on Asthma (ARIA)-EAACI Guidelines - 2024-2025 Revision: Part I - Guidelines on Intranasal Treatments. Allergy. 2026;81(4):954-976. doi:10.1111/all.70131. PMID: 41324154.
- Vieira RJ, Sousa-Pinto B, Bousquet J, et al. ARIA-EAACI Guidelines - 2024-2025 Revision: Part II - Guidelines on Oral and Ocular Treatments. Allergy. 2026;81(6):1947-1970. doi:10.1111/all.70305. PMID: 41877472.
- Dykewicz MS, Wallace DV, Amrol DJ, et al. Rhinitis 2020: A practice parameter update. J Allergy Clin Immunol. 2020;146(4):721-767. doi:10.1016/j.jaci.2020.07.007. PMID: 32707227.
- Roberts G, Pfaar O, Akdis CA, et al. EAACI Guidelines on Allergen Immunotherapy: Allergic rhinoconjunctivitis. Allergy. 2018;73(4):765-798. doi:10.1111/all.13317.
- Assurance Maladie. Rhinite allergique et rhume des foins : symptômes et causes. Ressource patient consultée en septembre 2026.
This sheet provides general information. It does not make a diagnosis or replace medical consultation, a prescription or personalised instructions from your healthcare professional.
Scientific review: September 2026 · sosallergo.fr