Topical treatment of allergic rhinitis

Topical medications have dramatically changed the treatment of rhinitis. While systemic treatment is often more potent, topical treatment has fewer side effects. However, topical preparations also have side effects which should be considered when treating rhinitis. Topical steroids are potent anti-inflammatories but may cause nasal bleeding; sodium cromoglycate improves allergic and general inflammation but is less potent than steroids. Topical decongestants are beneficial for short-term use when there is nasal obstruction or copious discharge, but can cause damage to nasal epithelium or atrophy and dryness of the nasal mucous membrane after years of use. Anticholinergic spray is effective when watery discharge predominates, and saline is helpful when there is nasal dryness. Treatment of associated conjunctivitis is also discussed.