Can sinus congestion be caused by allergic (hypersensitivity) reactions?

From the Guidelines

Yes, sinus congestion can definitely be caused by allergic reactions, as evidenced by the clinical practice guideline for allergic rhinitis, which lists nasal congestion as a symptom consistent with an allergic cause 1. When allergens like pollen, dust mites, pet dander, or mold spores enter the body, the immune system may overreact in sensitive individuals, releasing chemicals like histamine that cause inflammation of the nasal passages and sinuses. This inflammation leads to increased mucus production and swelling of the sinus tissues, resulting in congestion. To treat allergy-related sinus congestion, antihistamines like cetirizine (Zyrtec), loratadine (Claritin), or fexofenadine (Allegra) can help block the histamine response, as recommended for patients with allergic rhinitis and primary complaints of sneezing and itching 1. Nasal corticosteroids such as fluticasone (Flonase) or mometasone (Nasonex) reduce inflammation when used daily, typically one or two sprays per nostril, and are recommended for patients with a clinical diagnosis of allergic rhinitis whose symptoms affect their quality of life (QOL) 1. Nasal saline rinses using a neti pot or squeeze bottle can physically flush out allergens and thin mucus. Decongestants like pseudoephedrine may provide temporary relief but shouldn't be used for more than 3-5 days to avoid rebound congestion. For long-term management, identifying and avoiding specific allergens is crucial, and in severe cases, immunotherapy (allergy shots) might be recommended by an allergist to gradually desensitize the immune system to specific allergens, as suggested by the guideline 1. Some key points to consider in the management of allergic rhinitis include:

• Assessing patients for associated conditions such as asthma, atopic dermatitis, sleep-disordered breathing, conjunctivitis, rhinosinusitis, and otitis media 1
• Considering environmental controls, such as removal of pets, use of air filtration systems, bed covers, and acaricides, to reduce exposure to allergens 1
• Offering combination pharmacologic therapy for patients with inadequate response to monotherapy 1
• Referring patients to a surgeon for inferior turbinate reduction or to a clinician for acupuncture or immunotherapy as needed 1

From the FDA Drug Label

Fluticasone Propionate Nasal Spray, USP relieves allergy symptoms caused by pollen, mold, dust and pets. Fluticasone Propionate Nasal Spray, USP not only relieves sneezing, itchy nose, runny nose and itchy, watery eyes, but also relieves nasal congestion. Allergies can cause uncomfortable symptoms like congestion and itchy eyes. These symptoms can be triggered by allergens like pollen, mold, dust or pet dander

Yes, sinus congestion can be caused by allergic (hypersensitivity) reactions 2.

• Key points:
  • Allergic reactions can trigger sinus congestion
  • Fluticasone Propionate Nasal Spray, USP is used to relieve allergy symptoms, including nasal congestion
  • The drug works by blocking allergic reactions in the nose
  • It is effective against a broad range of allergens, including pollen, mold, dust, and pet dander

From the Research

Sinus Congestion and Allergic Reactions

• Sinus congestion can be caused by allergic (hypersensitivity) reactions, as evidenced by the association between allergic rhinitis and nasal congestion 3, 4, 5, 6, 7
• Allergic rhinitis is a common condition that affects an estimated 15% of the US population and is associated with symptoms such as nasal congestion, rhinorrhea, postnasal drainage, sneezing, and itching of the eyes, nose, and throat 4
• Nasal congestion is considered the most bothersome symptom of allergic rhinitis and can significantly impair daily functioning 3, 6

Treatment of Allergic Rhinitis and Nasal Congestion

• Combination therapy with an antihistamine and a decongestant, such as desloratadine and pseudoephedrine, can be an effective treatment for allergic rhinitis and nasal congestion 3
• Intranasal corticosteroids are recommended as first-line therapy for patients with moderate-to-severe allergic rhinitis and nasal congestion 4, 6, 7
• Second-generation antihistamines, such as cetirizine, fexofenadine, desloratadine, and loratadine, can also be used to treat allergic rhinitis and nasal congestion 4

Efficacy of Treatments

• Studies have shown that combination therapy with desloratadine and pseudoephedrine can improve nasal congestion scores and quality of life in patients with allergic rhinitis 3
• Intranasal corticosteroids, such as mometasone furoate nasal spray, have been shown to be effective in relieving moderate-to-severe nasal congestion in patients with seasonal allergic rhinitis 7
• Patient adherence to treatment and individual preferences for treatment can affect outcomes 6