How to Distinguish a Cold from an Allergy

Allergic and cold-related rhinitis (nasal congestion) differ, which means their treatments also vary. Understanding the causes and features of each condition is essential.

Key Symptoms and Causes of Rhinitis

A runny nose often indicates inflammation of the nasal mucosa, usually caused by allergens or respiratory viruses.

Cold or Allergy?
A doctor typically diagnoses rhinitis based on symptoms, patient history, blood tests, and examination of the nasal mucosa (including rhinoscopy or endoscopic evaluation).

Allergic and Cold Rhinitis: Main Differences

1. Triggers:
   • Allergic rhinitis is often triggered by allergens in the air (pollen, pet dander, dust), while cold rhinitis is caused by viruses.
   • Symptoms of allergic rhinitis can worsen in hot, dry weather due to increased airborne allergens, unlike cold rhinitis, which is not affected by weather.
2. Symptoms:
   • Allergy Symptoms: Runny nose and sneezing intensify with exposure to allergens, such as pollen or pet dander. Red eyes, tearing, and itching often accompany allergies but are absent with colds.
   • Cold Symptoms: Mucus changes consistency and color during a cold, unlike with allergies where it remains thin and clear. Fever, body aches, and fatigue are common with viral infections.
   • Response to Treatment: Antihistamines reduce allergic reactions but have no effect on cold symptoms, while antiviral medications help relieve colds but are ineffective for allergies.
3. Genetic Factors: Allergies often run in families, so if close relatives have allergies, there is a higher likelihood of developing them as well.

Allergy Symptoms

Allergic rhinitis can manifest in two main patterns:

• Intermittent: Occurs less than 4 days a week or less than 4 weeks a year.
• Persistent: Occurs more than 4 days a week or for more than 4 weeks a year.

During an allergic reaction, patients may experience:

• Tingling and burning sensations in the nasal passages
• Redness and itchiness around the nose
• Sneezing as the body tries to expel irritants
• Nasal congestion due to mucosal swelling
• Reduced sense of smell (hyposmia)
• Distraction, fatigue, and, in some cases, ear congestion from frequent blowing of the nose

Common Triggers for Allergic Rhinitis

Allergic rhinitis may be caused by perfumes, cigarette smoke, household chemicals, pet dander, and dust mites. Seasonal allergies (pollinosis) occur due to plant pollen and cause additional symptoms such as red, itchy eyes and eyelid swelling.

Cold Symptoms and Stages of Development

Cold-related rhinitis progresses through three stages, each with distinct symptoms:

1. Initial Stage: Itching in the nose, sneezing, and a runny nose as the nasal mucosa reacts to external irritants or viruses. Fever, headaches, fatigue, and weakness are common.
2. Second Stage: Nasal mucosa swells, breathing becomes difficult, and the voice may sound nasal. Sense of smell decreases, sometimes temporarily disappearing. Persistent fever, drowsiness, and lethargy are also common.
3. Third Stage: Nighttime nasal congestion worsens, disrupting sleep. Nasal discharge thickens and turns yellow-green. Attempting to clear thick mucus can lead to ear congestion and mild headaches.

Proper treatment can resolve a cold within 7-10 days, but without it, inflammation can spread to the sinuses, bronchi, or eustachian tube, leading to complications such as otitis, rhinosinusitis, or bronchitis.

Treatment of Cold-Related Rhinitis

Viral or acute catarrhal rhinitis, often due to hypothermia, is treated with localized medications, including drops and sprays:

• Antibacterial and Antiviral Medications: Help eliminate pathogens and prevent the infection from spreading to the ears or lower respiratory tract.
• Decongestants: Relieve nasal congestion and reduce mucosal swelling.
• Mucolytics: Thin mucus and facilitate drainage. Nasal passages can be rinsed with saline solutions before sprays to enhance effectiveness.

Popular Treatments for Allergic Rhinitis

Preventing allergic rhinitis involves:

• Elimination strategies: Avoiding contact with allergens.
• Medication: Various pharmacological groups help manage symptoms.
• Allergen-Specific Immunotherapy (ASIT): Provides targeted treatment against specific allergens.

To ease symptoms, patients may use:

• Antihistamines: Available in systemic (tablet) or local (nasal spray) forms, these block histamine production, reducing mucosal swelling and nasal discharge.
• Intranasal Corticosteroids: Reduce inflammation in the nasal passages.
• Leukotriene Modifiers: Prevent severe complications, such as significant swelling and bronchial spasms.
• Decongestants: Used 5 minutes before other nasal medications to reduce congestion but should not be used for more than 5 days.

Removing allergens can significantly improve symptoms. However, it is crucial to consult a doctor before starting any allergy medication. Proper treatment helps relieve rhinitis symptoms, regardless of the cause.