Sensitive Nose & Allergic Rhinitis Treatment in Singapore

What is Allergic Rhinitis?

Allergic rhinitis — often called "sensitive nose" or "nose allergy" in Singapore — is an inflammation of the nasal passages triggered when your immune system over-reacts to airborne allergens. It is one of the most common chronic conditions in Singapore: published epidemiological studies put the adult prevalence at around 24% and the prevalence in children and adolescents closer to 40%.

Unlike temperate countries where "hay fever" is seasonal, Singapore's tropical climate means there is no off-season. House dust mite (Dermatophagoides pteronyssinus) thrives all year round in our 80–90% humidity, so symptoms tend to be daily and persistent rather than coming in seasonal flares.

Symptoms of Allergic Rhinitis

• Persistent sneezing — particularly first thing in the morning
• Clear, watery runny nose
• Nasal congestion or blocked nose, often alternating between nostrils
• Itchy nose, eyes, throat, and ears
• Post-nasal drip and a feeling of mucus at the back of the throat
• Reduced sense of smell or taste
• Dark circles under the eyes (sometimes called "allergic shiners")
• Mouth breathing, snoring, and disturbed sleep — particularly in children

Symptoms that affect sleep, school attendance, work performance, or that lead to recurrent sinus infections are not "just allergies" — they need formal assessment.

What Causes Allergic Rhinitis in Singapore?

The Singapore allergen profile is unusual. House dust mite is by far the dominant trigger; pollen plays a much smaller role than in Europe or North America. Common triggers we see in clinic include:

• House dust mites — present in bedding, mattresses, pillows, carpets, curtains, and soft toys
• Haze and PM2.5 — symptoms typically spike during the July–September haze season
• Pet dander — cats, dogs, and even hamsters
• Mould spores — high humidity in HDB bathrooms and aircon units encourages growth
• Cockroach allergens — under-recognised but significant in tropical Asia
• Cigarette smoke and strong perfumes — irritants that worsen baseline allergic symptoms

When Should You See an ENT Doctor for Allergic Rhinitis?

Most patients in Singapore self-treat with over-the-counter antihistamines for years before seeking specialist help. You should see an ENT doctor if:

• Symptoms have lasted more than 4 weeks
• Over-the-counter antihistamines are no longer giving relief
• Sleep, work, or school performance is affected
• You have recurrent sinus infections
• You suspect, but have never confirmed, what you are allergic to
• There are wheezing or chest symptoms (allergy and asthma share triggers)
• Your child is mouth-breathing, snoring, or showing signs of poor sleep

How is Allergic Rhinitis Diagnosed?

Diagnosis at CENTAS is usually completed within a single appointment:

• Detailed history and examination — pattern of triggers, severity, sleep impact, family history
• Nasoendoscopy — a thin flexible camera takes about a minute and shows nasal swelling, polyps, deviated septum, and post-nasal drip directly
• Skin prick test — small drops of common Singapore allergens are placed on the forearm; results are read in 15 minutes
• Blood test (specific IgE / RAST) — useful when skin testing is not possible (e.g. severe eczema, antihistamine use)

Treatment Options for Allergic Rhinitis in Singapore

Non-Surgical Treatment

• Allergen avoidance — dust mite-proof mattress and pillow encasings, hot wash bedding weekly, HEPA filters, dehumidifiers, regular aircon servicing
• Oral antihistamines — non-drowsy options such as cetirizine, loratadine, bilastine
• Intranasal antihistamines — azelastine spray for fast on-demand relief
• Intranasal corticosteroid sprays — fluticasone and mometasone are first-line for moderate-to-severe symptoms; safe for long-term daily use
• Nasal saline irrigation — physically washes out allergen and mucus

Immunotherapy — the Long-Term Solution

Antihistamines and steroid sprays manage symptoms but do not change the underlying immune response. Immunotherapy is the only treatment that can durably modify the allergy itself.

• Sublingual Immunotherapy (SLIT) — daily allergen drops or tablets taken under the tongue at home. Dr Pang pioneered SLIT for allergic rhinitis at the National University Hospital and was the first to introduce this therapy into mainstream practice in Singapore.
• Subcutaneous Immunotherapy (SCIT) — small allergen injections, given monthly at the clinic during maintenance
• Both treatment courses run 3 to 5 years
• Published clinical evidence reports symptom improvement in around 80–90% of suitable patients

Read more about Allergy Immunotherapy and SLIT.

Why Choose Dr Pang for Allergic Rhinitis Treatment?

• Pioneered Sublingual Immunotherapy (SLIT) for allergic rhinitis at the National University Hospital
• Over 20 years of ENT practice across the United Kingdom, United States, and Singapore
• Comprehensive allergy testing performed in-clinic — diagnosis and management plan in one visit
• Treats both adults and children, including those who have failed long courses of antihistamines
• Convenient Mt Elizabeth Medical Centre location off Orchard Road

Frequently Asked Questions