6 Things You Should Know About Chronic Runny Nose

Hitting the sales to stock up on tissues? Constant sniffing and wiping? Wondering if you're going to need to leave a meeting or social event because your nose is running? A chronic runny nose is more than an annoyance. It can significantly affect your quality of life.

"People with a chronic runny nose are often forced to keep tissues on themselves at all times to prevent mucus from running down their face," says John Craig, M.D., an ear, nose and throat (ENT) surgeon who specializes in rhinology (the care and treatment of the sinuses and nasal cavities) at Henry Ford Health.

Dr. Craig notes that there are six key takeaways about a persistent runny nose:

1. Mucus is beneficial. The inner lining of the nose, known as the mucosa, contains different types of mucus glands. Mucus often gets a bad rap, but it actually has several important roles in your health. Mucus lubricates your nasal and sinus passages, protecting this important tissue from drying out. It also helps trap bacteria and other contaminants before they can reach your lungs and other parts of your body. And it contains antibodies, enzymes and proteins to help fight these invaders.
2. But too much mucus is not beneficial. "While some mucus is good, when the nerves that supply the mucus glands become overactive, these glands can create more than your body needs," Dr. Craig says. "This excess mucus can then run out of your nose, or down the back of your throat. Or both."
3. Runny nose may only be part of the problem. For some people with rhinitis, runny nose is the only symptom. For others, a runny nose may be accompanied by nasal itching, sneezing or nasal airflow blockage due to inflammation in the nasal tissue lining.
4. It's important to get the diagnosis right. Rhinitis also may occur with allergies (allergic rhinitis) or without (nonallergic rhinitis). To make matters more confusing, some people get a mixed form of both conditions, or they could have conditions besides rhinitis, too. "For example, if you have chronic sinusitis or if your nasal septum (the piece of bone and cartilage that makes up the dividing wall between your nasal passages) is deviated or crooked, these can also cause a runny nose or nasal obstruction, and we have to figure out which condition needs treatment to alleviate the right symptoms," Dr. Craig says.
5. There may be specific triggers. For some with allergic rhinitis, these symptoms can be related to seasonal changes, while others are triggered by pets or dust. People with non-allergic rhinitis may be triggered by food, temperature change, exercise, alcohol, emotional or hormonal changes (such as those associated with pregnancy), or environmental irritants like perfumes or cigarette smoke. And yet for others, symptoms are constant or sporadic with no clear triggers.
6. In rare cases, a runny nose may be a sign of a more serious condition. While most runny noses will be due to rhinitis or sinusitis, runny noses that do not respond to medical therapy after a few weeks should be evaluated by an ENT specialist both to mange your condition and rule out more serious conditions like nasal polyps, tumors or even nasal cerebrospinal fluid leaks (fluid from brain cavity leaking through the nose, putting one at risk for brain infections). "People need to know that if they have a one-sided runny nose with clear, watery mucus, they should get assessed by an ENT surgeon for a potential cerebrospinal fluid leak," Dr. Craig says.

How Do You Treat Runny Noses?

"Some people think it's a part of life, but you don't have to live with a chronic runny nose," Dr. Craig says.

There are steps you can take yourself. Here's what to do:

• Identify your triggers: If you can identify specific triggers that cause your nose to run, you can work to avoid these. Knowing these also can help when providing a history to your doctor as well.
• For allergic rhinitis, try over-the-counter treatments: Nasal steroid sprays are low-risk first-line treatments that help relieve the swelling and congestion in your nasal passages by reducing inflammation and fluid in your mucosa. If sprays alone do not control the nasal allergies, you can try oral antihistamines. These products help to address runny nose generally caused by allergies by blocking a chemical known as histamine, which makes your mucosa swell up and get itchy. People may also find topical nasal saline via sprays or rinses to be helpful for moisturizing the nose or flushing out allergens. These safe over-the-counter measures may provide enough temporary relief to avoid a trip to the doctor.
• Consider allergy testing for allergic rhinitis: If you suspect you may have allergies, you can undergo allergy testing. Once a diagnosis has been made, there are several potential treatments, which may include one or more nasal sprays, antihistamines, medications, or even allergy shots (a form of immunotherapy).
• Nonallergic rhinitis treatments: If you are not allergic, another type of nasal spray known as an anticholinergic spray is highly effective in controlling a watery, runny nose, but this must be prescribed by a physician.
• Intranasal cryotherapy or radiofrequency: This is a newer treatment that freezes the nasal nerves in the back of the nose and is less invasive than surgery. "Anyone who has a watery, runny nose and is not responding adequately to sprays is a potential candidate," says Dr. Craig. "This includes people with both allergic and nonallergic rhinitis." While the response durations differ between patients, these treatments are extremely low risk.
• Surgery: In severe cases where other treatment do not provide adequate relief, there are other low-risk surgical options, including a procedure that severs the nerves that are causing the glands to produce too much mucus. While it is usually successful, a long discussion should be had with your surgeon about potential risks as well.