The first line treatment is avoidance of the particular allergen. However, this can be difficult if you are not sure what it is you are allergic to or you are allergic to trees and pollen. (Unless you are planning on staying inside for the entire spring..) If you are having severe symptoms it can be helpful to know what you are allergic to and this is where allergists come in handy.
Nasal saline irrigation can help with congestion. You can buy a commercially prepared saline irrigation or make a salt water solution yourself. This can be done as often as necessary.
The most effective treatment for nasal symptoms are nasal steroids. There are many different types available and some are available over the counter. Some examples are nasacort, and flonase. These are very effective to decrease the inflammation in the nose and open the nasal passages. The downside is they can take days to work. They are best started in the beginning of someone's allergy season and continued while symptoms persist.
Oral antihistamines can help with symptoms other than nasal congestion. These tend to work faster than the nasal steroids. They are very effective in combination with the nasal steroids and very safe. Some people may experience sleepiness but this can be overcome by taking the medication at night. Some examples are benadryl, zyrtec, claritin and allegra.
Another option is a nasal antihistamine such as astelin. These are not as commonly used but are another option for someone who is not helped by the oral antihistamines.
Decongestants are not effective in the treatment of allergic rhinitis alone. They are combined in with antihistamines in some medications such as zytrec D and claritin D. These can be effective for some people but need to be used with caution in patients with high blood pressure and some heart problems.
Decongestant nasal sprays are available over the counter. These should not be used for more than 3 days to avoid a rebound congestion which is very difficult to treat.
These are the most commonly prescribed options. There are other treatments, such as allergy shots, which can be prescribed by an allergist. It is important to have someone to followup with to help determine the best treatment for you.
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