What are sinus allergies?

Sinus allergies are a type of allergic reaction in the sinuses, which are the passageways that run behind the cheeks, nose and forehead, shown in light pink in the image to the right. Seasonal or constant environmental factors can be the cause of allergy symptoms, many of which mimic those of other conditions. In fact, many people confuse sinus allergies with a cold, sinus infection, or the flu. True prevention is usually difficult, but there are ways to minimize exposure to allergens, the materials that cause allergic reactions. Additionally, there are natural, drug-based, and surgical treatments for sinus allergies.

Causes of sinus allergies
Sinus allergies are caused by allergens that enter the nose and sinus cavities. Allergens that commonly lead to sinus allergies include the following:
Pollen — both from plants and trees
Pet hair and dander
Mold
Smell
Dust
Some chemicals
Dust mites and dust mite excretions

Inhaling these allergens leads to two results: increased mucus production and the release of a compound called histamine. Although nasal mucus usually drains easily from the nose, increased mucus makes it difficult for the nose to drain properly. The release of histamine, which causes the nasal and sinus passages to swell, further inhibits drainage.

Unable to drain, mucus will start backing up into the nose, which leads to two common symptoms: a stuffy feeling and a runny nose. Histamine also causes an itchy sensation, which is why many people with sinus allergies have itchy nose and eyes and a tickling throat. The amount of allergen required to initiate this process varies from person to person.

This video describes how the immune system interacts with allergens.

While some allergens are always present, others are seasonal. The most common spring allergen is tree pollen, while the most common summer and fall allergens are grass pollen, ragweed and mould. Allergens like dust and pet dander are usually in the air year-round, but sometimes allergies can be seasonal because of how different people behave throughout the year. For example, someone with a pet who spends most of their time outdoors during the summer may begin to experience pet dander allergies in the winter if they start keeping their pet indoors.

Sinus allergy symptoms
The most common sinus allergy symptoms are:

A runny nose
A stuffy nose
Itchy eyes, nose and throat

All result from increased mucus production and narrowed nasal passages caused by inhaling allergens. They can also lead to many secondary symptoms:
Sore throat: This is caused by all the excess mucus coming out and irritating the throat
A reduced sense of smell
Heachache
Dizziness
A low fever
Slight pain

Not everyone will experience all of these symptoms, but clusters of these symptoms are usually a pretty good indication that you have these allergies. On the other hand, many of these symptoms mirror symptoms of other common diseases, so it’s important to know which condition is causing them to get the proper treatment:

Breast allergies
Cold
Influenza
Sinusitis/sinus infection Yes
Period of time?
As long as exposed to allergens.
From one week to ten days.
About four to ten days.
From less than a month up to three months.
Fever
Sometimes — low-grade.
Sometimes, but usually in children.
Often
Often
Heachache
Sometimes
Sometimes
Often
Often
a runny nose
Often
Often
Sometimes
Sometimes
sneezing
Often
Sometimes
Sometimes
Sometimes
Itchy eyes
Often
Rarely
Rarely
Rarely
Aches and pains
Often — mild.
Often — mild.
Often — severe.
Sometimes.
Cough
Sometimes
Often
Often
Rarely
Dizziness
Sometimes
Often
Rarely
Sometimes
Sore throat/hoarseness
Often
Often
Often
Often
Seasonal symptoms?
Often
Sometimes
Sometimes
Rarely

Unlike a cold, flu or sinusitis, sinus allergies aren’t caused by viruses or bacteria. Antibiotics and antiviral drugs are therefore generally ineffective. However, if sinus allergies are left untreated, bacteria can develop in the back-up mucus.
Prevention/treatment of sinus allergies
Often, the best way to avoid sinus allergies is to stay away from the trigger allergen. This can be challenging, however, especially for those who aren’t clear about what their trigger allergens are, who are allergic to many different things, or who are allergic to things that are essentially unavoidable. If you know the allergens, the best thing to do is avoid being around them; for example, someone who is allergic to grass pollen may want to try changing their exercise routine to stay indoors, or someone who is allergic to mold may want to hire a professional cleaning service to get rid of any mold in their home. If it is impossible to avoid allergens, an allergy sufferer may want to proactively take certain allergy medications before being exposed to a particular allergen.

Drug treatments
There are five main categories of drugs to prevent and treat allergies:
Antihistamines: These medications work to reduce the levels of histamine released by the body, which keeps the nasal passages from swelling as much. Over-the-counter (OTC) antihistamines include Benadryl®, Claritin® and Zyrtec®, among others. Prescription antihistamines include Clarinex® and Xyzal®, among others. Corticosteroids: These drugs also work to reduce swelling in the nasal passages. Commonly used corticosteroid medications include Flonase®, Nasonex® and Advair®, which is an inhaled medication. Leukotriene modifiers: These block the release of leukotrin, another chemical released in response to allergens. Zyflo® and Singulair® are two commonly used leukotriene modifiers. Mast cell stabilizers: work by preventing certain cells called mast cells from releasing histamine. They are usually given to asthma sufferers, but can also be taken to prevent allergies. Common mast cell stabilizers include Opticrom® and Nasalcrom®. Decongestants: These narrow blood vessels in the nasal passages to reduce swelling. Common over-the-counter decongestants include Allegra-D® and Benadryl Allergy and Sinus®, while Alwaysx-D® is a common prescription decongestant.

Another option for allergy treatment is immunotherapy or allergy shots. This is usually not a preferred treatment, as it requires regular injections and doesn’t work for everyone. It may, however, be helpful for those who can’t avoid their allergenic triggers or for those who can’t take other types of medications.
It’s important to discuss all medications with a doctor before taking them, even over-the-counter medications. Each type of allergy medication has the potential to cause side effects and should not be taken without the advice of a healthcare professional.
Alternative treatments
There are also a number of non-drug treatments for sinus allergies. Two of the most common are steam inhalation and saline irrigation.
Inhaling steam, especially steam infused with things like mint, eucalyptus, or tea tree oil, can help soothe your nasal passages and encourage mucus drainage. Saline irrigation serves the same purpose, although it can be difficult for some people to adjust to. To do a saline irrigation, a person takes room-temperature water with a little salt dissolved in it and sprays it or pours it into the nostrils to flush out excess mucus. This method can be effective, but it’s not good for people with sinus infections, since it can spread bacteria around. The diet is touted by some as effective in treating or preventing sinus allergies, although this is not widely accepted in the medical field. Foods that are associated with exacerbation of sinus allergies include dairy products; grain products; and sugar, especially refined sugars. Reducing or eliminating these foods, particularly during a sinus allergy attack, can be helpful, but allergy sufferers should consult a healthcare professional for personalized advice. Herbal and plant products are also said to be good for sinus allergies, including eucalyptus, mint, camphor, garlic, echinacea, bromelain, and horseradish or wasabi, among others. Those interested in herbal treatments for sinus allergies should consult a doctor, herbalist, or naturopathic doctor.

Surgical treatments

Surgery is usually the last option when it comes to treating allergy problems because it is more invasive than other treatments and carries a higher risk of complications. However, this type of treatment may be beneficial for those who have exhausted all other options. Most surgeries for sinus allergies involve widening the nasal passages slightly or opening passages that have closed up swollen or are abnormally small. Sinus surgery is typically done endoscopically, which means that a small instrument with an attached camera is inserted into the nasal passage to perform the surgery with as little trauma as possible.

The two main types of sinus surgery used to treat allergies are Balloon Sinuplasty® and laser sinus surgery. In Balloon Sinuplasty®, an instrument with a small, deflated balloon is threaded into the swollen or small nasal passages, where the balloon is then inflated. This widens the nasal passages and any backup pus or mucus can be expelled. Having wider nasal passages also helps prevent mucus from backing up in the future.

Laser sinus surgery is also done endoscopically, but works differently than balloon surgeries. In this surgery, a doctor inserts a small instrument into the nose that burns part of the nasal passages and also shrinks some of the underlying blood vessels which can cause inflammation if they become swollen. While this type of surgery can be effective, it sometimes has to be done multiple times before it works, and can cause nosebleeds and congestion. As with all surgery, people should consult their doctor before deciding to have the surgery, and should strictly follow aftercare instructions.
Video
A video illustration of the body reacting to allergies in more technical terminology:

A silent video with a good illustration of a blocked breast and a demonstration of one type of breast surgery:

A video on how to do a nasal irrigation with a neti pot:

Additional Resources
Allergy Action Plan — Detailed strategies for preventing allergies.
eMedTV — More Strategies to Prevent Allergies.
National Institutes of Health – Information on treatments for sinus allergies.
WebMD— Information on allergy treatments with the drugs and side effects listed.
LarianMD — Information on allergy surgeries, including balloon sinuplasty.

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