From the Guidelines
The most effective method for preventing sneezing is the use of intranasal corticosteroids, as they are typically the most effective medication class for controlling sneezing, itching, rhinorrhea, and nasal congestion, the 4 major symptoms of allergic rhinitis 1.
Methods for Preventing Sneezing
- Oral antihistamines: Oral second-generation/less sedating antihistamines, such as loratadine, are recommended for patients with allergic rhinitis and primary complaints of sneezing and itching 1.
- Intranasal antihistamines: May be useful alternatives to oral antihistamines, but may cause sedation in some patients and/or may be perceived to have a bitter taste 1.
- Oral anti-LT agents: May be useful in the treatment of allergic rhinitis, alone or in combination with antihistamines, but are generally less efficacious than intranasal corticosteroids 1.
- Avoidance measures: Initial treatment of nonsevere rhinitis may include avoidance measures, such as avoiding allergens that trigger sneezing 1.
- Nasal cromolyn: Less effective than intranasal corticosteroids, but can reduce symptoms of allergic rhinitis in some patients if initiated before symptoms become severe 1.
- Intranasal anticholinergics: May effectively reduce rhinorrhea, but have minimal effects on nasal congestion or other nasal symptoms 1.
From the Research
Methods for Preventing Sneezing
There are several methods that can be used to prevent sneezing, including:
- Applying firm pressure on the nose or lip to abort an attack of sneezing 2
- Avoiding triggers such as allergens, bright light, and physical stimulants of the trigeminal nerve 3
- Treating underlying conditions such as allergic rhinitis, which is the most common cause of persistent or frequent sneezing 2
- Using psychotherapy to treat psychogenic intractable sneezing, which is a diagnosis of exclusion and is mostly psychogenic 4
Important Considerations
It is important to note that active intervention to limit a sneeze can be deleterious, and closure of the airway during a sneeze can result in over 20 times the airway pressures, leading to a variety of untoward events 5. Therefore, when triggered, a sneeze should be allowed to proceed without intervention to prevent associated injuries 5.
Treatment Approaches
Treatment of persistent or recurring sneezing should be directed at the cause whenever possible 2. A multidisciplinary team effort, especially with a child psychiatrist, is important for the treatment and follow-up of patients with intractable sneezing 4. Imaging should also be routinely performed as some patients may have underlying organic causes that present as intractable sneezing 4.