Chronic runny nose, also known as chronic rhinitis, is a frequent issue that affects many people and can significantly impact daily life. While most are familiar with a runny nose as a symptom of illnesses like the common cold, flu, COVID-19, or allergies, some individuals experience persistent symptoms without an obvious cause.
Dr. Mas Takashima, an ENT specialist at Houston Methodist who focuses on nasal and sinus conditions, explains that chronic rhinitis involves more than just a runny nose. “Many other symptoms are associated with chronic rhinitis, including sneezing, congestion, coughing and itchiness of the nose,” he says.
Rhinitis occurs when the nose becomes irritated or inflamed and produces extra mucus to clear out irritants. Typically this is temporary—known as acute rhinitis—and resolves once inflammation subsides. Chronic rhinitis is different in that it lasts for months or even years despite using medications for at least a month.
“Chronic rhinitis is when these symptoms persist for months to even years, despite at least a month of using medications to treat the issue,” Dr. Takashima explains. “It’s the people who keep facial tissue in their pockets all the time and are constantly blowing their nose. Sometimes they’re even embarrassed to go out in public because of it — especially nowadays since, due to COVID-19, people are self-conscious about coughing, clearing their throat and blowing their nose around people.”
Common causes of chronic rhinitis include allergic reactions (allergic rhinitis), acid reflux irritating nasal linings, and vasomotor rhinitis—a nonallergic condition where everyday triggers such as air pollution or spicy foods lead to excess mucus production. According to Dr. Takashima: “Allergic rhinitis is probably the most common cause of a persistent runny nose, especially here in Houston. The humidity is so high most of the year here, so mold spores are everywhere. Dust mites are too.”
Vasomotor rhinitis tends to become more common with age but its exact cause remains unclear. Other less frequent causes include certain medications—such as overuse of nasal decongestant sprays—and lingering effects from viral infections like COVID-19.
“Viral illness can also sometimes cause a persistent runny nose or cough, as these are usually the last two symptoms to resolve after the infection is cleared,” says Dr. Takashima. “We’re actually seeing a lot more of this these days due to COVID-19 — where people are dealing with a runny nose or cough for quite a while after recovery.”
Identifying what causes chronic rhinitis is essential before starting treatment options tailored for each individual case.
“Once the etiology of the rhinitis is defined, treatments vary depending on the cause,” adds Dr. Takashima.
Initial treatment often starts with basic therapies such as nasal sprays, oral antihistamines and sinus irrigation under guidance from primary-care doctors. “For instance, these basic medications can help treat allergic rhinitis,” Dr. Takashima notes. “Sinus irrigation, or sinus rinse, is another great option since it clears the nose of irritants , such as allergens or environmental pollutants.”
If first-line treatments do not work patients may be referred to ENT specialists who investigate further by reviewing medical history and specific triggers—like eating or exercising—which could indicate nonallergic forms.
“In a case like that we may try an ipratropium nasal spray which reduces the amount of mucus your nose produces right away and see if symptoms improve,” says Dr.Takashima.
Allergy testing may be recommended if allergic origins are suspected; otherwise treatments targeting acid reflux might be prescribed if relevant.
“We try these options and see if the symptoms improve,and from there,we continue to manage the issue.Sometimes though,we try all these things and patient still has persistent runny nose.This is when we start consider procedures,” states Dr.Takashima
Procedures available include cryotherapy or radiofrequency therapy performed in-office.”In either case,a small device placed up into nostril along nerve controlling mucus production.Either very cold temperature or radiofrequency energy applied.Treatment helps prevent brain from inappropriately triggering excess mucus,” he explains.Both methods involve minimal discomfort,safety,and take little time.Dr.Takashima reports both have similar efficacy: “around 65% patients notice about 70% decrease in drainage.”
“Our team has spent a lot of time researching and publishing about why chronic rhinitis happens—as well as effectiveness of these procedures to treat it.What we’ve found is that these in-office procedures aren’t just beneficial for nonallergic rhinitis.They can also help reduce symptoms of allergic rhinitis,” he says.This provides alternatives for those seeking relief beyond long-term allergy shots
Surgery may be considered only after exhausting other measures.”If our in-office procedures fail,we do talk about surgery in some cases.We prefer exhaust all other treatment options prior recommending any kind surgical options.But surgery can be effective form treatment,” concludes Dr.Takashima
