Vasomotor (Idiopathic) Rhinitis

What is vasomotor rhinitis?

Vasomotor rhinitis is a runny nose that is not caused by an allergy or cold. Other names for this problem are idiopathic rhinitis and nonallergic rhinitis.

How does it occur?

Vasomotor rhinitis is caused by tissue in the nose that is sensitive to changes in environmental conditions such as temperature, humidity, and the presence of irritants. Examples of irritants are smoke, dryness, smog, and perfume. In response to these conditions or irritants, the nose makes more mucous.

What are the symptoms?

The common symptom is a runny nose. Unlike allergic rhinitis, there is usually no itching or sneezing. You may have a stuffy nose (nasal congestion).

How is it diagnosed?

There is no specific test for the diagnosis of vasomotor rhinitis. Your healthcare provider reviews your medical and family history. The diagnosis is suspected from your history and when other possible causes of symptoms have been eliminated.

Your healthcare provider may swab the lining of your nose to obtain a sample of mucus. The mucus will be examined for the presence of allergy cells (eosinophils). These cells are rarely present in people who have vasomotor rhinitis. However, they are not always present in people whose rhinitis is caused by allergies, so the test is not always helpful.

How is it treated?

If treatment is necessary, it is often helpful to base it on the main symptom.

• If a runny nose is the only symptom, then a nasal spray containing the medicine ipratropium is the first choice.
• If nasal congestion is the only symptom, nasal steroid sprays usually work best.

If you have more than 1 symptom or if the medicines mentioned above are not working, then the first choice may be a prescription antihistamine (azelastine) that you can spray into your nose. Antihistamine tablets are for allergies and do not usually help vasomotor rhinitis, but spraying the prescription antihistamine directly into the nose is helpful for most people with this problem.

Getting some exercise may help your nose become less congested.

How long will the effects last?

The condition is usually lifelong. However, you may reduce the symptoms by avoiding the irritants in your environment that seem to cause problems for you.

What can be done to help prevent vasomotor rhinitis?

There is no known prevention.