Nose Running? How to Tell If It’s Allergies, a Cold, COVID—or Something Else

It’s allergy time in Arizona, but not every runny nose is an allergy. Nor is it necessarily the common cold, or even COVID-19. It may be non-allergic rhinitis causing chronic sneezing, congestion, or a runny nose. Understanding the difference is important for treatment.

NON-ALLERGIC RHINITIS

Non-allergic rhinitis, sometimes called vasomotor rhinitis, doesn’t involve our immune system reacting to an allergen. Rather, non-allergic rhinitis is thought to result from environmental irritants—think smoke or smog in the air—or even just overusing nasal allergy medicine. In fact, in a lot of cases, the true cause can’t even be pinpointed with certainty.

Non-allergic rhinitis can cause chronic sneezing, congestion, or runny nose, symptoms similar to those of hay fever (otherwise known as allergic rhinitis), and other conditions, including the common cold, and even COVID-19, so it can be difficult to tell what condition you’re dealing with—and what treatment you should seek.

COLDS VS. COVID-19

Generally, colds cause comparatively mild symptoms, and typically don’t result in serious complications. A runny or stuffy nose is a prevalent sign of having a cold. Plus, with a cold, your symptoms usually reach their peak within three days. Worried it may be COVID-19? Sneezing is common for both non-allergic rhinitis and for an airborne allergic reaction, though much more rare in cases of COVID-19.

WHAT TO DO

Neither seasonal allergies nor nonallergic rhinitis can be cured, but many people find relief by avoiding triggers, using a saline rinse solution, or by taking over-the-counter or prescription medications. And because the symptoms are so similar between non-allergic rhinitis and allergic rhinitis, allergy testing is often recommended to rule out the latter.

As with all health concerns, seeking an accurate diagnosis is important to manage your condition appropriately. Talk to your doctor about your symptoms, and they will help you find the right course of treatment—whether that’s prescribed medication, recommending an over-the-counter nasal spray, or just plenty of rest.

Dr. Leo Odle is associate medical director and primary care physician with Optum – Arizona.