Intermittent versus persistent
Intermittent: symptoms < 4 days
per week or < 4 weeks at a time
Persistent: symptoms >4 days per
week or >4 weeks at a time |
Even in intermittent allergic rhinitis, a
course of continuous INCS is likely to be
more effective than partial treatment with
inadequate doses, which may allow the nasal
passages to remain inflamed and
hypersensitive to irritants.
These classifications may overlap (e.g.
frequent short bouts throughout the year). |
Severity
Moderate–severe: any of impairment
of sleep, daily activities, leisure or
sport, school or work.
Mild: doesn’t impair any of these |
Individuals’ symptom severity fluctuates.
Categorising allergic rhinitis as moderate
or severe is mainly useful when recommending
treatment, e.g. a person who has been in the
habit of using insufficient doses of
over-the-counter medication intermittently
may consider adopting a more rational
self-management regimen after it is
explained that any impairment of activities
indicates that allergic rhinitis warrants
adequate medication. |
Seasonal versus perennial
Seasonal (hay fever):
triggered by wind-borne pollen from grasses,
weeds sometimes trees. Symptoms most common
in Spring and Summer but depends on
individual allergen exposure, geography,
rainfall, time of day (e.g. pollen exposure
is highest in morning, outside, windy days,
after thunderstorms)
Perennial: triggered by exposure
to allergens present all year round (e.g.
house dust mite, animal dander, moulds). |
People who predictably experience
symptoms only part of the year may benefit
from pre-emptive INCS course timed for usual
onset,44
and can usually discontinue
treatment afterwards. Generally at least 6
weeks’ treatment is needed during a pollen
season.
A mixed pattern of seasonal and perennial
features is common. |
