Allergic Rhinitis Treatment in Singapore

If you’re experiencing a runny nose, sneezing, and itchy eyes, you’re not alone. Allergic rhinitis is a common condition in Singapore, impacting daily activities and sleep quality. This condition occurs when your immune system reacts to airborne allergens, causing nasal and eye symptoms.

While allergic rhinitis cannot be cured, modern treatment approaches can help control symptoms and may improve your quality of life. Our ENT specialist can provide comprehensive treatment for allergic rhinitis in Singapore, helping patients identify triggers and develop personalised management strategies.

*Individual results and timelines may vary.*

doctor img
Dr Gan Eng Cern

MBBS

MRCS (Edin)

mmed (orl)

FAMS

Image Whisk_c06c26baf0d8f7b84df4e2cc43854cf2dr Image Whisk_c06c26baf0d8f7b84df4e2cc43854cf2dr

What is Allergic Rhinitis?

Allergic rhinitis, commonly known as hay fever, is an inflammatory condition of the nasal passages triggered by exposure to specific allergens. When you breathe in these normally harmless substances, your immune system mistakenly identifies them as threats and releases chemicals like histamine, causing inflammation and irritation of the nasal lining.

In Singapore’s tropical climate, allergic rhinitis tends to be perennial (year-round) rather than seasonal, with house dust mites being a common trigger. The condition affects people of all ages but often begins in childhood or early adulthood.

Allergic rhinitis may affect work productivity and sleep quality in some patients.

Types of Allergic Rhinitis

Perennial Allergic Rhinitis

This form occurs year-round and is common in Singapore. Symptoms may persist daily or most days, triggered by indoor allergens. House dust mites can thrive in Singapore’s humid climate. Patients with perennial allergic rhinitis may experience symptoms that can worsen at night or early morning when dust mite exposure in bedding may be higher.

Seasonal Allergic Rhinitis

Less common in Singapore due to our consistent tropical climate, seasonal allergic rhinitis may still affect some individuals during specific periods. This can occur during haze seasons when air quality deteriorates, or when certain plants release pollen. Some patients may also experience seasonal patterns when travelling to temperate countries.

Episodic Allergic Rhinitis

This type involves intermittent symptoms occurring with sporadic exposure to allergens, not generally in the patient’s environment. Examples include visiting homes with pets, exposure to cigarette smoke, or encountering strong perfumes. Symptoms may develop quickly upon exposure and can resolve once the allergen is removed.

Causes & Risk Factors

Causes

The primary cause of allergic rhinitis is an overactive immune response to airborne particles. In Singapore, common triggers include:

  • House dust mites (Dermatophagoides species)
  • Cockroach allergens
  • Pet dander from cats and dogs
  • Mould spores thrive in humid conditions
  • Grass and weed pollen from nearby green spaces
  • Air pollutants and haze particles

Risk Factors

Several factors may increase the likelihood of developing allergic rhinitis:

  • Family history of allergies, asthma, or eczema
  • Personal history of other allergic conditions
  • Early childhood exposure to cigarette smoke
  • Being firstborn or from smaller families (hygiene hypothesis)
  • Living in urban areas with higher pollution levels
  • Occupational exposure to irritants or allergens
  • Gender may play a role in the childhood development of the condition

Signs & Symptoms

Mild Symptoms

  • Clear, watery nasal discharge
  • Occasional sneezing (2-3 times in succession)
  • Mild nasal congestion
  • Slight itching in the nose or throat
  • Minor eye watering
  • Mild postnasal drip
  • Occasional throat clearing

Moderate Symptoms

  • Frequent sneezing fits
  • Persistent nasal blockage affecting breathing
  • Constant runny nose requiring frequent tissue use
  • Itchy, red, watery eyes
  • Dark circles under eyes (allergic shiners)
  • Mouth breathing due to nasal obstruction
  • Disrupted sleep from nasal congestion
  • Reduced sense of smell and taste

Severe Symptoms

  • Complete nasal obstruction
  • Severe facial pain or pressure
  • Persistent headaches
  • Significant sleep disturbance and daytime fatigue
  • Difficulty concentrating at work or school
  • Recurrent sinus infections
  • Ear fullness or popping
  • Chronic cough from postnasal drip

Symptoms typically appear within minutes of allergen exposure and can persist for hours or days, depending on continued exposure. Some patients may notice symptoms worsen during sleep or upon waking, when dust mite exposure from bedding is highest.

Experiencing these symptoms?

Consult with an ENT specialist for an accurate diagnosis and treatment plan.

Human head sinus structure

When To See an ENT Specialist

Consult an ENT specialist if your symptoms persist beyond two weeks despite over-the-counter medications, or if they significantly impact your daily activities. Seek immediate medical attention if you experience severe facial pain, bloody nasal discharge, or signs of infection such as fever with thick, coloured mucus.

During your consultation, the ENT specialist may conduct a thorough nasal examination and may recommend allergy testing to identify specific triggers. Early intervention may help prevent complications and support the establishment of an effective long-term management strategy. The consultation typically involves discussing your symptom patterns, environmental exposures, and prior treatments.

Don’t wait until symptoms become unbearable – addressing allergic rhinitis early can improve outcomes and help reduce the risk of related conditions like sinusitis or asthma.

Diagnosis & Testing Methods

Accurate diagnosis begins with a detailed medical history and physical examination. Your ENT specialist may examine your nasal passages using a nasal endoscope, a thin, flexible tube with a camera that provides visualisation of the nasal cavity and any structural abnormalities or inflammation.

Skin Prick Testing

Skin prick testing is a recognised method for identifying specific allergens. Small amounts of allergens are applied to your forearm, and any resulting wheals indicate sensitivity. This test covers allergens including various dust mite species, cockroach, cat and dog dander, moulds, and regional pollens.

Blood Tests

Blood tests measuring specific IgE antibodies offer an alternative for patients unable to undergo skin testing due to severe eczema or certain medications. These tests can provide information about allergen sensitivities.

Nasal Smear Examination

Nasal smear examination may reveal increased eosinophils, which can indicate allergic inflammation. Some patients may benefit from nasal provocation testing, where suspected allergens are directly applied to the nasal passages under controlled conditions.

Imaging Studies

Imaging studies, such as CT scans, are reserved for cases with suspected complications or when considering surgery.

Treatment Options Overview

Intranasal Corticosteroid Sprays

These medications form the cornerstone of treatment for allergic rhinitis in Singapore. They reduce inflammation in the nasal passages, controlling all significant symptoms, including congestion, runny nose, sneezing, and itching. Modern formulations have minimal systemic absorption, making them safe for long-term use. Patients may notice improvement within several days, with benefit developing over weeks of consistent use. Your ENT specialist may demonstrate proper spray technique for optimal medication delivery.

Oral Antihistamines

Second-generation antihistamines provide relief from sneezing, itching, and a runny nose without causing significant drowsiness. These medications block histamine receptors, preventing the allergic cascade. While effective for many symptoms, they offer limited relief for nasal congestion. Antihistamines work well for episodic symptoms or as adjunct therapy with nasal sprays. Options include once-daily formulations for convenience and improved compliance.

Intranasal Antihistamines

These sprays offer symptom relief, often working more quickly than oral antihistamines. They control sneezing, runny nose, and nasal itching while providing modest congestion relief. Some patients prefer them to oral medications because they have fewer systemic effects. Combination with intranasal corticosteroids may provide symptom control in moderate-to-severe cases.

Leukotriene Receptor Antagonists

These oral medications block inflammatory mediators called leukotrienes, which are particularly beneficial for patients with concurrent asthma. They reduce nasal congestion, runny nose, and sneezing while potentially improving asthma control. Montelukast, commonly prescribed in Singapore, offers once-daily dosing and is well-tolerated. This treatment is particularly suited to patients who prefer oral medications or those with aspirin sensitivity.

Allergen Immunotherapy

Sublingual immunotherapy (SLIT) offers a disease-modifying treatment approach that gradually desensitises patients to specific allergens. Daily tablets dissolved under the tongue contain standardised allergen extracts, primarily for dust mite allergy in Singapore. Treatment continues for several years, with benefits that may persist after completion. This option suits motivated patients with proven allergen sensitivity who desire long-term symptom reduction beyond symptomatic medications.

Saline Nasal Irrigation

Regular nasal washing with isotonic or hypertonic saline solution physically removes allergens and inflammatory mediators from the nasal passages. This simple, drug-free approach may reduce symptoms and medication requirements. Proper technique using squeeze bottles or neti pots for effective cleansing. Many patients perform irrigation twice daily, which is particularly beneficial during haze periods or high allergen exposure.

Nasal Decongestants

These medications provide relief from severe nasal congestion but require careful use. Topical decongestants may not be used for more than several days due to the risk of rebound congestion. Oral decongestants offer longer use potential but may cause insomnia or elevated blood pressure. Your ENT specialist may advise appropriate use during severe symptom flares while maintaining long-term control with other medications.

Turbinate Reduction Procedures

When medical management fails to control symptoms adequately, surgical options may help. Radiofrequency turbinate reduction uses controlled heating to shrink swollen turbinates, thereby improving nasal airflow. This minimally invasive procedure, performed under local anaesthesia, requires no packing and allows recovery. Patients with structural abnormalities like a deviated septum may benefit from concurrent septoplasty.

Every patient’s condition is unique.

Our ENT specialist will assess your specific situation and recommend the appropriate treatment.

Human head sinus structure

Complications if Left Untreated

Untreated allergic rhinitis extends beyond nasal symptoms, potentially leading to various health issues. Chronic nasal inflammation may increase susceptibility to recurrent sinus infections, and some patients may develop chronic sinusitis. Postnasal drip can irritate throat tissues, potentially leading to a chronic cough and increasing the risk of respiratory infections.

Sleep quality may be affected, with nasal obstruction potentially leading to frequent awakenings, snoring, and, in some cases, sleep apnoea. This sleep disruption may lead to daytime fatigue, difficulty concentrating, and reduced work or school performance. Children with untreated allergic rhinitis may experience learning difficulties and behavioural problems.

The allergic march phenomenon means that untreated allergic rhinitis may increase the risk. Existing asthma can become harder to control when allergic rhinitis remains untreated. Chronic mouth breathing due to nasal obstruction can cause dental malocclusion in children and can lead to dry mouth, which may in turn lead to dental decay. Quality-of-life impacts can be significant, with patients potentially experiencing limitations in daily activities, social interactions, and emotional well-being.

Prevention

While you cannot entirely prevent allergic rhinitis if you’re predisposed, several strategies may help reduce symptom frequency and severity. Environmental control forms the foundation of prevention in Singapore’s tropical climate.

Dust mite reduction requires comprehensive bedroom management. Use dust-mite-proof covers on mattresses and pillows, wash bedding weekly in hot water above 60°C, and maintain bedroom humidity below 50% using dehumidifiers. Replace carpets with hard flooring and minimise soft furnishings that harbour mites. Regular vacuuming with HEPA-filtered cleaners may reduce allergen levels.

Improving indoor air quality with HEPA air purifiers may help, particularly in bedrooms. Keep windows closed during haze periods and high pollen days. Regular air conditioner maintenance can help prevent mould growth in filters and vents. Avoid indoor smoking and minimise the use of strong fragrances or cleaning products.

Personal measures include showering before bed to remove allergens from hair and skin, changing clothes after outdoor activities, and using wraparound sunglasses outdoors to protect eyes from allergens. Consider wearing a mask during high-pollution periods or when doing dusty activities. Starting preventive medications before known trigger exposures, such as antihistamines before visiting homes with pets, may help reduce symptom development.

*Individual results and effectiveness of prevention strategies may vary.*

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Frequently Asked Questions (FAQ)

Can allergic rhinitis be permanently cured?

Allergic rhinitis cannot be permanently cured, but it can be effectively managed with proper treatment. Allergen immunotherapy offers an approach that may provide long-lasting symptom relief. Patients can achieve symptom control through combinations of environmental measures and medications. Your ENT specialist may develop a personalised management plan targeting your specific triggers and symptoms. With consistent treatment, patients may experience reduced symptoms and maintain normal daily activities.

How do I differentiate between allergic rhinitis and a common cold?

Allergic rhinitis produces clear, watery nasal discharge, while colds typically cause thicker, coloured mucus after a few days. Allergic symptoms persist as long as allergen exposure continues, whereas colds resolve within 7-10 days. Itchy eyes and nose strongly suggest allergies rather than infection. Allergic rhinitis doesn’t cause fever, body aches, or a sore throat unless a secondary infection complicates it. Symptom patterns also differ – allergies often worsen at specific times or locations, while cold symptoms remain relatively constant.

Is allergic rhinitis hereditary?

Allergic rhinitis has a genetic component. Children of parents with allergic rhinitis may be at increased risk of developing the condition. Genetics isn’t the only factor – environmental factors significantly influence whether allergic tendencies manifest as clinical disease. Early-life exposures, pollution levels, and lifestyle factors all play a role. Even with genetic predisposition, proper environmental control and early treatment can help minimise symptom development and severity.

What triggers should I avoid in Singapore?

House dust mites are a common trigger in Singapore, present in homes due to our humid climate. Focus on reducing bedroom allergens, since you spend considerable time there. Avoid carpet, heavy curtains, and stuffed toys that trap dust. Be cautious during haze periods when air quality deteriorates. Common indoor triggers include cigarette smoke, incense, strong perfumes, and cleaning products. Pet dander can persist in homes for extended periods even after pet removal. Mould thrives in bathrooms and kitchens, so they require good ventilation and regular cleaning.

How long does allergic rhinitis treatment take to work?

Treatment response varies by medication type. Antihistamines may provide relief within hours for acute symptoms. Intranasal corticosteroid sprays may require several days for initial improvement, with full effectiveness achieved after weeks of regular use. Consistent use of sprays helps prevent symptom return. Allergen immunotherapy requires patience, with improvement typically developing over months and benefits developing over years. Environmental modifications show gradual improvement over time as allergen levels decrease.

Can children undergo allergic rhinitis treatment?

Yes, children can receive allergic rhinitis treatment with age-appropriate medications and dosing. Intranasal corticosteroids can be used in children aged 2 years or older, with specific formulations designed for paediatric use. Second-generation antihistamines have paediatric syrups and chewable tablets. Early treatment in children may help prevent progression to asthma and reduce school absence. Allergen immunotherapy can begin from age 5 in suitable candidates. Your ENT specialist may consider your child’s age, symptom severity, and ability to cooperate with treatment when recommending options.

Will I need treatment forever?

Treatment duration depends on symptom severity and chosen management approach. Patients may require long-term medication during high allergen exposure periods, but can reduce or stop treatment during better periods. Allergen immunotherapy offers potential for lasting remission, with benefits that may persist after completing the treatment course. Some patients achieve adequate control through environmental measures alone after initial symptom stabilisation. Your treatment needs may change with age, lifestyle modifications, or relocation. Regular follow-ups with your ENT specialist help with optimal treatment adjustment.

Are there any side effects from long-term nasal spray use?

Modern intranasal corticosteroid sprays have established safety profiles for long-term use. Local side effects, such as nasal dryness or minor nosebleeds, may occur and usually resolve with proper technique or a dosage adjustment. Systemic absorption is minimal. Avoid prolonged use of decongestant sprays beyond 1 week due to rebound congestion risk. Regular ENT follow-ups monitor for any concerns. Intranasal corticosteroids can be used safely for extended periods.

Conclusion

Living with allergic rhinitis in Singapore’s tropical climate presents unique challenges, but effective management is achievable. Understanding your specific triggers and implementing appropriate environmental controls forms the foundation of treatment. Modern medications can provide symptom control when used correctly. Whether through intranasal corticosteroids, antihistamines, or allergen immunotherapy, our ENT specialist may identify an appropriate approach for your situation. Don’t let allergic rhinitis diminish your quality of life – with proper diagnosis and personalised treatment, you may experience improved comfort.

*Individual results and timelines may vary.*

Take the First Step Towards Better Health

Living with allergic rhinitis can be challenging, but you don’t have to face it alone. Our ENT specialist has experience diagnosing and treating allergic rhinitis using evidence-based approaches.

Human head sinus structure
ENT Specialist in Singapore | Dr Gan Eng Cern

Dr Gan Eng Cern

MBBS

MRCS (Edin)

mmed (orl)

FAMS

With over 15 years of experience, Dr Gan specialises in the comprehensive management of a broad range of conditions related to the ear, nose and throat (ENT), and head and neck.

Dr. Gan has contributed to the academic field as a Senior Clinical Lecturer at the Yong Loo Lin School of Medicine, National University of Singapore. He is recognised for his extensive research work, with numerous contributions to reputable international ENT journals. Dr Gan is also highly sought after as a speaker and has shared his surgical knowledge as a surgical dissection teacher at various prominent ENT conferences and courses.

  • 2020 – Reader’s Choice Gold Award for Best ENT Specialist (Expat Living Singapore)
  • 2016 – Best Educator Award (Eastern Health Alliance)
  • 2016 – “Wow” Award (Patient Compliment)
  • 2014 – Eastern Health Alliance Caring Award – Silver
  • 2014 – 19th Yahya Cohen Memorial Lectureship (awarded by the College of Surgeons, Academy of Medicine Singapore for best scientific surgical paper)
  • 2012 – Human Manpower Development Award (Ministry of Health, Singapore)
  • 2007 – Singhealth Best Doctor Award

Qualifications

  • MBBS – Bachelor of Science, Bachelor of Medicine, Bachelor of Surgery (University of New South Wales, Sydney, Australia)
  • MRCS (Edin) – Member of the Royal College of Surgeons Edinburgh, United Kingdom
  • MMed (ORL) – Master of Medicine in ENT (National University of Singapore)
  • FAMS – Fellow of the Academy of Medicine Singapore
Singapore ENT specialist performing a procedure

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