Allergies and a blocked nose: practical guidance

Symptoms may appear after contact with pollen, dust mites, mould or animals and can affect one or both nostrils. A cold can produce similar congestion, while persistent facial pressure, reduced smell or thick discharge may point to another nasal or sinus problem.

Allergic rhinitis often presents with bouts of sneezing, an itchy nose or eyes and clear discharge. Timing provides useful clues: symptoms may follow cleaning, entering a dusty room, handling bedding, being near an animal or spending time outdoors during a pollen season. House dust mite allergy can cause congestion throughout the year.

Nasal blockage can disturb sleep, encourage mouth breathing and leave the throat dry. Snoring alone does not identify the cause, but loud habitual snoring with pauses, choking sounds or marked daytime sleepiness warrants assessment for obstructive sleep apnoea.

Reduce exposure where practical: keep windows closed when pollen is troublesome, shower after outdoor exposure, damp-dust surfaces and wash bedding regularly. A saline rinse can clear mucus and allergens; prepare it only with sterile, distilled, or previously boiled and cooled water, and keep the device clean.

A pharmacist or clinician can advise on allergy medication and correct nasal-spray technique. Aim the spray slightly outward, away from the centre wall of the nose, and use it as directed. Decongestant nasal sprays can cause rebound blockage when overused, so check the product instructions and do not extend treatment without professional advice.

Arrange a review if congestion persists, repeatedly disrupts sleep, affects breathing during exercise, or does not improve with appropriate self-care. Assessment is also sensible for one-sided blockage, recurrent nosebleeds, a reduced sense of smell, significant facial pain or thick discharge with fever.

Get urgent help for severe breathing difficulty, swelling of the lips, tongue or throat, faintness, or widespread hives with breathing symptoms. A child who is struggling to breathe, unusually drowsy or unable to drink also requires urgent attention.

Describe when the blockage began, whether sides alternate, which exposures make it worse and what you have already tried. Ask whether the pattern fits allergy, whether examination or allergy testing would change management, and which treatment is suitable with your other medicines or health conditions. Bring the nasal spray so technique can be checked.