Vasomotor Rhinitis

Overview

What is vasomotor rhinitis?

Vasomotor rhinitis happens when the tissues inside of your nose become inflamed (swollen). The inflammation causes unpleasant symptoms most people associate with allergies, like a stuffy or runny nose.

However, unlike allergies (allergic rhinitis), vasomotor rhinitis doesn’t result from exposure to allergens, like pollen, mold, pet dander, etc. It’s not caused by viruses or bacteria either. Instead, you may experience symptoms because of weather changes, certain smells, eating, exercise, medications or other triggers that irritate your nose.

Vasomotor is also called idiopathic rhinitis. It’s a type of nonallergic rhinitis.

Who is likely to have vasomotor rhinitis?

Anyone can develop vasomotor rhinitis, but most people get diagnosed after age 20. The majority of diagnoses occur between ages 30 and 60. It’s more common in women and people assigned female at birth.

How common is vasomotor rhinitis?

Allergic and nonallergic rhinitis (including vasomotor rhinitis) affects up to half of the population in industrialized countries. Vasomotor rhinitis accounts for anywhere from 15% to half of these cases.

Symptoms and Causes

What causes vasomotor rhinitis?

Vasomotor rhinitis, unlike allergic rhinitis, doesn’t happen because you’re sensitive to a specific allergen, like tree pollen, dust mites or mold. Instead, various triggers may cause symptoms. It’s likely people with vasomotor rhinitis have heightened sensitivity to various substances and environmental changes that would trigger a response in most people — just in higher amounts.

If you have nasal inflammation and related symptoms resulting from an unknown cause, you might receive this diagnosis.

What triggers vasomotor rhinitis?

Triggers related to your environment, medicines you’re taking and even hormone changes can cause a reaction.

Environmental triggers

Your surroundings can trigger your senses and cause a reaction. Common environmental triggers include:

  • A drop in temperature.
  • Air pollution or smog.
  • Cold or dry air.
  • Perfume or cologne.
  • Cigarette smoke.
  • Paint fumes.
  • Spicy food.
  • Stress.
Medication triggers

Certain medications can trigger nasal inflammation and swelling or make it worse. Triggers include:

Hormone imbalances

Hormone changes can trigger a reaction. You may experience symptoms during times when hormones are in flux, including:

Nonallergic rhinitis may also result from using nonprescription drugs, like cocaine.

What are the symptoms of vasomotor rhinitis?

Unlike allergic rhinitis, symptoms of vasomotor rhinitis usually occur year-round. Instead of being seasonal — as is the case with seasonal allergies — symptoms flare up whenever you’re exposed to a trigger.

Symptoms of vasomotor rhinitis include:

  • Stuffy nose.
  • Runny nose.
  • Postnasal drip.
  • Sneezing.
  • Diminished sense of smell.

Rarely, vasomotor rhinitis causes a foul-smelling crust to form inside your nose. The interior nasal tissues may bleed when you attempt to remove the crust.

Is vasomotor rhinitis contagious?

No. It’s unrelated to germs that cause infections, like viruses and bacteria, which means you can’t catch it or spread it to someone else.

Diagnosis and Tests

How is nonallergic rhinitis diagnosed?

A healthcare provider can diagnose vasomotor rhinitis with a physical exam of your nose and throat and a review of your medical history. In some cases, further testing helps confirm your diagnosis.

  • Allergy testing: Your provider may recommend allergy testing to rule out the possibility that allergies are causing your symptoms. Allergy tests use a blood sample or a skin prick, which exposes your body to small amounts of specific allergens. Then, it tests for antibodies in your blood made in response to those allergens. You may need a referral to an allergy expert for this test.
  • Nasal endoscopy: In rare cases, providers examine the inside of your nose and nasal passages with a long, flexible tube called an endoscope. During the exam, a provider can identify other problems that may cause your symptoms, such as nasal polyps. Nasal polyps are noncancerous growths of tissue occurring in your sinuses or nasal passages.
  • Computed tomography (CT) scan: Your provider may recommend a CT scan. This test uses X-rays to create detailed pictures of the inside of your nose. They can show if structural irregularities, like nasal polyps or a deviated septum, are causing your symptoms.
  • Nasal inspiratory flow test: Your provider may order a nasal inspiratory flow test to measure how much air enters your lungs when you inhale. It can detect blockages in your nasal passages that may be causing your symptoms.

Management and Treatment

Is vasomotor rhinitis curable?

There isn’t a cure for nonallergic rhinitis. Most people manage symptoms with self-care measures, changes to their environment and medicine.

How is vasomotor rhinitis treated?

If your condition results from exposure to triggers like perfumes, treatment may be as simple as avoiding the trigger. In those cases where avoiding the trigger is impossible, you can put measures in place to ease symptoms, try over-the-counter medications or get a prescription from a healthcare provider.

Using a humidifier at home or at work may ease symptoms. It may be helpful to rinse your nasal passages with a saline (salt water) solution to clean out your nose and nasal cavities (nasal irrigation).

Prescribed medications can decrease nasal inflammation and manage your symptoms. These medications may include:

  • Decongestant nasal sprays to relieve nasal congestion.
  • Antihistamine nasal sprays that reduce nasal inflammation.
  • Corticosteroid nasal sprays (like fluticasone) to reduce nasal inflammation (first-line treatment for nasal congestion).
  • Anticholinergic nasal sprays (like ipratropium bromide) to help with a runny nose.

Surgery may be an option if the medications aren’t helping or if another condition is intensifying the problem, like a deviated septum or nasal polyps.

What complications are associated with vasomotor rhinitis?

Left untreated, vasomotor rhinitis may cause persistently blocked nasal passages or a constantly runny nose. These conditions can cause complications, including:

  • Middle ear infections.
  • Nasal polyps.
  • Sinusitis, inflammation of your sinus cavities.
  • Difficulty sleeping and a tired feeling during the day.
  • Difficulty concentrating.
  • Irritability.

Prevention

Can vasomotor rhinitis be prevented?

There’s no way to prevent vasomotor rhinitis. You can lower your risk by avoiding triggers known to cause rhinitis.

Outlook / Prognosis

What is the prognosis (outlook) for people with vasomotor rhinitis?

For many people, vasomotor rhinitis is a chronic, or long-term, condition. It may come and go over time.

Living With

When should I contact my doctor?

If you have a runny nose, stuffy nose or postnasal drip that won’t go away, talk to a healthcare provider. They can help determine what’s triggering your symptoms. They can recommend treatments that can help.

A note from Cleveland Clinic

The symptoms associated with vasomotor rhinitis — runny nose, nasal congestion and postnasal drip — are unpleasant, regardless of the cause. If you’re experiencing these symptoms, and they don’t improve, see a healthcare provider. They can determine whether the cause is related to allergies, an infection or something else (as is the case with vasomotor rhinitis). They can recommend or prescribe medicines that can help.

Last reviewed by a Cleveland Clinic medical professional on 10/27/2022.

References

  • Dykewicz MS, Wallace DV, Amrol DJ, et al. Rhinitis 2020: A practice parameter update. (https://pubmed.ncbi.nlm.nih.gov/32707227/) J Allergy Clin Immunol. 2020;146(4):721-767. Accessed 10/27/2022.
  • Leader P, Geiger Z. Vasomotor Rhinitis. (https://www.ncbi.nlm.nih.gov/books/NBK547704/) In: StatPearls. Treasure Island (FL): StatPearls Publishing; July 11, 2022. Accessed 10/27/2022.
  • Merck Manual Professional Version. Nonallergic Rhinitis. (https://www.merckmanuals.com/professional/ear,-nose,-and-throat-disorders/nose-and-paranasal-sinus-disorders/nonallergic-rhinitis) Accessed 10/27/2022.
  • National Health Services. Non-allergic rhinitis. (https://www.nhs.uk/conditions/non-allergic-rhinitis/) Accessed 10/27/2022.
  • Rutter P. Respiratory system. In: Community Pharmacy: Symptoms, Diagnosis and Treatment. 5th ed. Elsevier, 2021.

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