Runny nose: causes, symptoms, treatment and prevention

A runny nose, known medically as rhinitis, is one of the most common health problems. It affects millions of people every year, causing discomfort, disrupting daily life and reducing the ability to work. Although it is often seen as a minor complaint, it can be a symptom of various conditions, from the common cold to allergies and sinus inflammation.

This article covers the causes, symptoms and types of rhinitis, its diagnosis, treatment and prevention, and when you should see a doctor.

What is a runny nose and how does it develop?

Rhinitis is inflammation of the lining of the nose. The inflammation increases mucus production, which may drain from the nose or build up in the nasal passages and cause congestion. The nasal lining plays an important role in protecting the respiratory system: it filters inhaled air and traps dust, allergens and microorganisms. When the lining is irritated or infected, its blood vessels widen, mucus production increases and the tissue swells.

Causes of a runny nose

The causes can be divided into three main groups:

• Infectious causes – most commonly viral infections such as the common cold (rhinoviruses, coronaviruses, adenoviruses) and flu. Less often, a bacterial infection such as bacterial sinusitis is involved.
• Allergic causes – allergic rhinitis, or hay fever, is an immune reaction to harmless substances called allergens. The most common allergens are pollen, house dust mites, pet dander and mould. Allergic rhinitis can be seasonal (for example in spring or summer) or year-round.
• Non-allergic causes – factors unrelated to infection or allergy.

Non-allergic causes include:

• Irritants – tobacco smoke, air pollution, strong fragrances and chemicals.
• Hormonal changes – pregnancy and puberty.
• Medicines – some blood pressure medicines, non-steroidal anti-inflammatory drugs (NSAIDs) and decongestant nasal sprays used for too long.
• Structural problems – a deviated nasal septum or nasal polyps.
• Weather – cold or dry air.
• Food – spicy food can cause a short-lived runny nose.

Symptoms

Symptoms vary with the cause, but the most common are:

• Nasal discharge – mucus may be watery, thick, yellow or green. Its colour alone does not indicate a bacterial infection.
• Nasal congestion – difficulty breathing through the nose.
• Sneezing
• Itching in the nose, throat, eyes and ears (typical of allergic rhinitis).
• Watery and red eyes.
• Postnasal drip – mucus running down the back of the throat, which can cause coughing and throat irritation.
• Facial pain and pressure – around the forehead, cheeks and eyes (typical of sinusitis).
• Reduced sense of smell and taste
• Headache and tiredness

Types of rhinitis

Rhinitis can be classified by its cause and duration:

Acute rhinitis

The most common type, usually caused by a viral infection. Symptoms develop quickly and usually improve within 7–10 days, although a cough and blocked nose can sometimes last longer.

Chronic rhinitis

Rhinitis is considered chronic when symptoms last more than 12 weeks. It may be linked to allergies, chronic sinusitis, nasal polyps or non-allergic factors.

Allergic rhinitis

Caused by an immune reaction to allergens. Typical symptoms are sneezing, itching, watery discharge and watery eyes.

Non-allergic rhinitis

Not related to allergy or infection; it can be triggered by irritants, temperature changes, hormones or medicines.

Sinusitis

Inflammation of the sinuses, which often develops together with acute rhinitis. Most cases are viral and clear up without antibiotics.

Diagnosis

The doctor will ask about your symptoms, how long they have lasted and your medical history, and will examine your nose and throat. Further tests are sometimes needed:

• Allergy tests – to find out whether an allergy is the cause.
• Nasal endoscopy – to examine the nasal passages and sinuses (performed by an ENT specialist).
• Imaging (CT scan) – for chronic or complicated sinus disease.
• Microbiological testing of discharge – in selected cases, to identify a bacterial infection.

Treatment

Treatment aims to relieve symptoms and address the underlying cause.

Symptom relief

• Saline nasal rinsing helps clear mucus, allergens and irritants. It is a safe way to reduce congestion and discharge.
• Decongestants narrow the blood vessels in the nasal lining and ease congestion. Decongestant nasal sprays or drops should not be used for more than 3–5 days, as they can cause a rebound effect that makes congestion worse. Children should only use products intended for their age, following the label or a doctor’s advice.
• Antihistamines block the action of histamine during an allergic reaction and reduce sneezing, itching and a runny nose.
• Steroid nasal sprays reduce inflammation in the nasal lining. They are effective for allergic and chronic rhinitis and are usually used regularly over a longer period, as advised by a doctor.
• Pain and fever relief, such as paracetamol and ibuprofen, can ease headaches, facial pain and fever.
• Humidifying the air indoors can help keep the nasal lining moist and make breathing easier.

Treatment by cause

• Viral infections – there is no specific treatment. Drinking enough fluids and resting are important. Antibiotics do not help viral infections.
• Allergic rhinitis – avoiding allergens is key. A doctor may prescribe antihistamines, steroid nasal sprays, leukotriene receptor antagonists or allergen immunotherapy.
• Sinusitis – viral sinusitis is treated for symptoms. If bacterial sinusitis is suspected, the doctor will decide whether antibiotics are needed. Severe or chronic cases may require an ENT consultation.
• Non-allergic rhinitis – treatment focuses on avoiding irritants and relieving symptoms. A doctor may recommend a steroid or ipratropium bromide nasal spray.
• Hormonal changes – hormonal rhinitis, for example during pregnancy, usually settles on its own. During pregnancy, take medicines only after consulting a doctor or pharmacist.
• Medicine-induced rhinitis – the doctor may adjust the dose or switch the medicine.
• Structural problems – a deviated septum or polyps may need treatment by an ENT specialist, including surgery.

Runny nose in children

Children get runny noses very often, especially at nursery age. Babies breathe mainly through the nose, so a blocked nose can interfere with feeding and sleep.

• Use saline drops or spray to clear the nose, and a nasal aspirator for babies.
• Without advice from a doctor or pharmacist, do not give combination cold remedies to children under 6, and do not use nasal sprays intended for adults.
• Make sure your child is drinking enough and watch for breathing difficulty or a persistent cough.

If the runny nose comes with a cough, read our article Cough in children: when should you see a paediatrician?. At Republikas laukuma klīnika, children are seen by paediatrician Dr Jeļena Liepa.

Prevention

Not every cold can be prevented, but you can reduce the risk:

• Wash your hands often with soap and water.
• Avoid close contact with people who have cold or flu symptoms.
• Avoid allergens if you have allergic rhinitis.
• Avoid irritants such as tobacco smoke, air pollution and strong fragrances.
• Humidify indoor air, as dry air can irritate the nasal lining.
• Keep a healthy lifestyle – a balanced diet, enough sleep and physical activity.
• Get vaccinated against flu – the annual flu vaccine helps protect against flu and its complications.

When to see a doctor

Most runny noses clear up on their own, but see a family doctor or paediatrician if:

• symptoms do not improve within 10 days, or get worse again after initially improving;
• there is a high or prolonged fever;
• there is severe facial pain, swelling around the eyes or a severe headache;
• the discharge is bloody, or a runny nose persists on one side only;
• the runny nose keeps coming back or lasts for weeks, especially with sneezing, itching and watery eyes – to check for an allergy;
• a baby has difficulty feeding because of a blocked nose, or a baby under 3 months has a temperature of 38°C or above.

If breathing is severely difficult, call 113.

Dr. Jeļena Liepa

Paediatrician, neonatologist

Book online

Dr. Ruslans Mihailovskis

Family doctor, sleep specialist

Book online

A runny nose is common and bothersome, and it can have many causes. Most viral colds clear up on their own, and saline rinsing, rest and enough fluids can ease the symptoms. If a runny nose lingers, keeps returning or causes severe symptoms, see a doctor to find the cause and get the right treatment.

Related information:

• Family doctor in Riga
• Paediatrician in Riga
• Cough in children: when should you see a paediatrician?
• Flu vaccine in Riga

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