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I have a chronic runny nose. What's going on?

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The question

I have a constantly runny nose. Even if I am not sick or do not have any cold/flu symptoms, my nose will be running. What's causing this - and how can I cure it?

The answer

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Having a constantly runny nose - especially when you're not ill - can be bothersome and embarrassing. There are a variety of potential causes for a runny nose, also known as rhinistis, but for the vast majority of sufferers, it's not dangerous - just annoying.

First, let's understand why your nose runs. In addition to the function of smell, the nose serves to protect our body from potentially harmful substances such as viruses or bacteria as well as foreign objects such as particles of dust or smoke. A runny nose starts when the tissue and blood vessels in the nose react to something in the environment and produces fluid or mucous for protection.

The steps I suggest to patients who suffer from a persistent runny nose include:

1. Identify and avoid triggers and irritants: Common triggers include environmental allergens (pollen, dust, pet dander), odours (perfumes), irritants (cigarette smoke) and other causes including spicy food, temperature change and for some, strong emotions.

2. Clean and dust regularly: Dust and pet dander can accumulate in the home and can trigger symptoms. Specifically, dust mites are tiny insects that live on the fibre of carpeting, furniture, mattresses and bedding. While they do not cause pain or bite humans, dust mites are a very potent allergic trigger for many people.

In addition to regular cleaning, consider washing your bedding in hot water weekly and use dust mite covers on your mattresses and pillows. An air filter may also be helpful to improve the air quality in your home as well as regularly changing your heating and air conditioning filters.

3. Take care of your nose: It may seem counterintuitive, but a dry nose can reactively overproduce mucous and continuously run. To help with this, there are options such as nasal saline rinses or nasal lubrication which can both be bought over-the-counter. Keeping well hydrated can also thin mucous and help moisturize the nasal passages.

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If these changes don't do the trick, a trial of medications may be considered for symptomatic relief after discussion and evaluation with your doctor.

1. Inhaled therapies: There are many potential medicated nasal sprays, including inhaled corticosteroids and inhaled antihistamines. The choice of topical therapy depends on your symptoms, other medical conditions and medications. In general, these medications are safe but potential side effects include nasal dryness and irritation, and if used for extended periods of time can cause a paradoxical rebound increase in mucous production.

2. Oral medications: Not many oral therapies are recommended for an isolated runny nose, but if related to allergies, antihistamines such as Reactine, Claritin or Benadryl can be considered. These can be bought over-the-counter and come in drowsy and non-drowsy formulations. If runny nose is related to inflammation or congestion, anti-inflammatories or decongestants can be helpful.

If your runny nose is persistently unilateral (from one nostril only), there is blood in the mucous, or occurs following a head injury - see your doctor immediately to rule out a more serious cause.

Send family doctor Sheila Wijayasinghe your questions at doctor@globeandmail.com. She will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

Read more Q&As from Dr. Wijayasinghe.

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The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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