How allergic rhinitis is diagnosed
A proper diagnosis is mostly a good conversation plus, when needed, a simple allergy test. Here is what to expect — and how to prepare.
When should you see someone?
- Symptoms interfere with sleep, work, school or daily life
- Over-the-counter medicines are not controlling your symptoms
- You also have wheezing, cough, chest tightness or frequent asthma flare-ups
- You get repeated sinus infections or facial pain
- Symptoms last for several weeks, or come back at the same time each year
What happens at the appointment
- Your storyYour clinician asks about symptoms, when they started, timing and seasons, exposures at home and work, medicines you have tried, and your family history.
- Look in the noseAn examination with a light (or a small endoscope) checks for pale, swollen nasal linings, polyps and other blockages.
- Allergy testing if neededSkin prick tests or a specific IgE blood test identify exactly which allergens you react to.
- A planBased on the pattern, you leave with a stepwise treatment plan and clear follow-up.
The two main allergy tests
Skin prick test
Tiny drops of allergen extracts are placed on your forearm and pricked through the surface. If you are allergic, a small itchy bump appears within about 15 minutes. Quick, done in the clinic, results immediately.
Specific IgE blood test
A blood sample is measured for antibodies against specific allergens. Useful when skin testing is not possible — for example because of skin conditions or certain medicines. Results take a day or two.
Don't test the whole universe. Good allergy testing is guided by your history — testing for dozens of irrelevant allergens creates confusion, not clarity.
Allergy, cold, or something else?
| Feature | Allergic rhinitis | Common cold | Non-allergic rhinitis |
|---|---|---|---|
| Duration | Weeks, months, or recurring seasons | 7–10 days | Weeks to years, unpredictable |
| Sneezing & itching | Bursts of sneezing, itchy nose, eyes, throat | Mild sneezing, no itching | Variable, little itching |
| Discharge | Clear, watery | Clear then thick, often coloured | Clear or thick |
| Other signs | Watery, itchy eyes | Sore throat, fever, aches | Congestion dominant |
| Triggers | Pollen, dust, pets, seasons | Virus exposure | Weather, smoke, odours, stress |
| Allergy test | Positive | Negative | Negative |
Other conditions to rule out: chronic sinusitis, nasal polyps, a deviated septum, and rhinitis caused by medications. An ENT or allergist can help when the picture is unclear.
How to prepare for your visit
- Keep a 2-week symptom diary — date, symptoms, exposures, medicines taken
- List every medicine you use, including doses and how often
- Note what helps and what does not — that is clinical data
- Write down your questions: cause? tests needed? treatment options? when to review?
Not sure if it's allergies?
A quick self-assessment with a personalised next-step plan.