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Hay Fever (Allergic Rhinitis) or Cold: How to Tell The Difference

Not all runny noses are caused by a common cold. What feels like the beginning of a cold could potentially be a manifestation of hay fever (rhinitis/nasal allergies), which is the most common immune reaction to allergic seasonal disorders.

Unlike a cold, hay fever isn't triggered by a viral infection and can’t spread from one person to the other. Hay fever is caused by an allergic reaction to outdoor or indoor allergens. Most common causes include pollen, mold, dust, pets, cockroaches and cow’s milk.

While these two conditions share some similarities (sneezing, runny or stuffy nose and coughing), there are some notable differences – a persistently itchy nose and recurrent sneezing.

Facial itchiness - especially above the tip of the nose, around eyes, ears or throat - is a dead giveaway and normally only seen with hay fever. Symptoms that last longer than you would expect for a cold (a few weeks) or suddenly occur during certain seasons without advancing into in illness are also a clue.

When it’s not so obvious, look for these subtler signs:

  • Clear nasal discharge (it’s yellowish/green color in a cold)

  • Plugged ears and sinuses without feeling ill

  • Itchy throat or cough

  • Site of symptoms (outside but not at home)

  • Fatigue and headache

  • Cold symptoms that seem chronic (persisting for weeks or months)

When in doubt, the simplest way is to try an over-the-counter allergy medicine - nasal spray such as Fluticasone or any generic equivalent and antihistamine tablets for a couple of days.

Long-acting antihistamines such as Cetirizine “Zyrtec” or Fexofenadine “Allegra” are preferred compared to the short-acting and sedating “Benadryl” due to their safety profile and association of Benadryl with Parkinson’s Disease and Dementia due to Benadryl’s effects on dopamine and acetylcholine.

If symptoms improve, it’s most likely allergies. However, there are some other causes for a runny nose (sinus infection, adenoids or nasal polyps) that only a specialist can rule out in person.

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