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Duke Medicine: Why do I have a runny nose?

Posted April 15, 2013

Unfortunately, beautiful flowers and warm weather can also mean itchy, watery eyes, sneezing fits and nasal congestion. These days, pollen from plants and flowers typically are released earlier in the year than in the past, causing longer allergy seasons according to the American College of Allergy, Asthma and Immunology, which noted that 2012 was one of the worst such seasons on record.

Allergies got you down? Wondering how to get relief? Namrata Shidhaye, MD, a family physician at Duke Primary Care Waverly Place, helps sort out the causes and cures for your annoying runny nose.

The older I get, the more my nose runs. Can you develop seasonal allergies as an adult that you didn’t have as a child?


Yes, adults can develop environmental allergies at any age. Asthma can develop during adulthood as well. A runny nose isn’t always a sign of allergies, though. Older individuals may experience runny nose due to age-related physical changes — some people, as they age, develop overactive tear ducts and nasal secretions (it’s called cholinergic hyperactivity). Also, some medications taken for other conditions such as high blood pressure, prostate enlargement, or erectile dysfunction can cause a runny nose as a side effect.

How do I know when it’s just a cold? When should I consider seeing an allergy specialist?


A common cold is usually associated with a variety of symptoms in addition to a runny nose: cough, body aches, fatigue, and occasional yellow nasal discharge. All of these symptoms usually resolve in one to two weeks. Allergies occur immediately after contact with the allergens that provoke them. They’re associated with clear discharge from the nose, nasal congestion, and itchy eyes, and the symptoms persist as long as contact with the allergens continues. Body aches are unlikely, but fatigue may occasionally occur with allergies. Your primary care physician can usually help treat your allergies, but if specific testing is required to identify the cause for your allergies — or if symptoms are not adequately controlled with medicines prescribed by your doctor — then a consultation with an allergist is probably needed.

Is it safe to take an over-the-counter allergy medication every day?


I strongly recommend consulting with your physician. There are several types of over-the-counter allergy medications. Some of them, such as Benadryl (diphenhydramine) and Zyrtec (cetirizine), can cause sedation and performance impairment, so I don’t recommend them for everyday use. Claritin (loratadine) and Allegra (fexofenadine) usually don’t have that side effect. Over-the-counter decongestants such as pseudoephedrine (found in Sudafed) and phenylephrine should be used very carefully — they can cause elevated blood pressure, heart palpitations, difficulty falling asleep, and irritability. I don’t recommend them for patients who have heart conditions, high blood pressure or hyperthyroidism.

Dr. Shidhaye answers more commonly asked questions about runny noses in the full post at DukeHealth.org. Duke Medicine, Go Ask Mom's sponsor, offers health information and tips every Tuesday.

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