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Hear Well, Breathe Well, Sleep Well, Live Well.

Whether you are seeking care for yourself or your child, at ENTcare Clinic, we provide experienced assessment and treatment for a wide range of ear, nose and throat concerns.

Get in touch

Allergy and Sensitive Nose Treatment in Singapore

Dr Annabelle Leong 梁翠娟

Senior Consultant ENT SurgeonMBBS (Hons) (London), BSc (Hons); DOHNS, MRCS (England), FRCS ORL-HNS (England)

Understanding Nasal Allergies

Allergy problems of the nose, also known as allergic rhinitis or “hay fever”, are very common. They can cause persistent or recurring symptoms such as:

Sneezing
An itchy nose
Watery eyes that may become itchy and red
A persistently runny nose
A blocked nose

These symptoms can interfere with everyday life, making it difficult to sleep, study or work comfortably.

Nasal allergies are also commonly mistaken for “sinus” problems. While some symptoms may be similar, allergy and sinus conditions are different and may require different treatment, making it important to identify what is actually causing your symptoms.

What Causes Nasal Allergies?

Nasal allergies develop when the lining of the nose becomes over-sensitive to certain substances, or allergens, such as pollen and dust. The immune system overreacts to these allergens, causing a buildup of immune cells called mast cells.

These mast cells release chemicals that can:

Cause the soft tissue inside the nose, known as the turbinates, to swell
Stimulate the mucus glands to produce more secretions
Trigger symptoms such as an itchy nose and watery eyes

The swelling and increased mucus production can then contribute to the blocked or runny nose commonly experienced with nasal allergies.

Enlarged turbinate tissue inside the nose may sometimes be mistaken for a nasal polyp.

Dealing with persistent allergy symptoms?

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Dizziness and balance problems assessment

How Are Nasal Allergies Treated?

Treatment for nasal allergies aims to control symptoms, reduce exposure to allergy triggers and address persistent nasal blockage where needed.

Depending on your symptoms and allergy triggers, treatment may involve:

Identifying the allergens causing flare-ups
Medication to help control allergy symptoms

Treatment to relieve persistent nasal blockage or congestion
Desensitisation therapy to provide longer-term control of the allergic response

Identifying Your Allergy Triggers

Allergy testing can help identify the substances that may be triggering your symptoms. Testing may be performed using a skin prick test or blood test.

Both can be useful for identifying allergies, although the range of allergens tested may differ:

Skin prick test: Usually tests for around 8–10 potential allergens.
Blood test: Can screen for up to 46 different allergens, including allergens found in food.

Identifying your triggers can help guide how your allergies are managed and which allergens you may need to avoid where possible.

Medication for Nasal Allergies

A combination of saline nasal wash (douche), nasal steroid spray and an antihistamine tablet or syrup can help control many cases of nasal allergy.

There are different medications available within each category, so Dr Annabelle can advise on which may be appropriate for you. Some nasal sprays combine a steroid and antihistamine in a single spray, which may reduce the need to take an antihistamine by mouth.

Treating Persistent Nasal Blockage

Sometimes, nasal congestion can persist despite medication, making it difficult or uncomfortable to breathe through the nose. This may happen when the turbinates, the long structures of soft tissue inside each nasal passage, remain enlarged and swollen.

Reducing the size of the turbinates can help improve airflow through the nose. Two techniques that may be considered are radiofrequency ablation of inferior turbinates (RFIT) and turbinoplasty.

Radiofrequency Ablation of Inferior Turbinates (RFIT)

RFIT is a short procedure that can be performed as day surgery under local anaesthesia. A special instrument is inserted into the nose and a low electrical current is passed through the swollen turbinate tissue to shrink it.

Following RFIT:

First week: Temporary swelling may occur, so your nose may continue to feel congested while the tissue begins to heal.
Around weeks 3–4: The turbinate tissue gradually reduces in size, with optimal results usually noticed around this time.
First month: Crusting or dry scabs may sometimes form inside the nose. Dr Annabelle usually advises a daily saline nasal douche during this period.
Around 18–24 months: The turbinate tissue may occasionally regrow. If this happens, some patients may return for RFIT a second time.

Radiofrequency Ablation of Inferior Turbinates (RFIT)

Radiofrequency ablation of the soft tissue inside the nose helps you to breathe clearly through the nose.

Turbinoplasty

Turbinoplasty differs from RFIT in that it aims to provide a more definitive, long-term reduction in swollen turbinate tissue. During the procedure, part of the inner core of turbinate bone is carefully removed while preserving the delicate nasal lining.

As the area heals, the nasal lining scars and remains reduced in size without the underlying bone adding volume. Turbinoplasty is also commonly performed together with a septoplasty, which straightens a deviated or crooked nasal septum. Unlike RFIT, turbinoplasty is performed under general anaesthesia and carries a slightly higher risk of bleeding.

Patients therefore typically:

Stay overnight in hospital
Have special nasal sponge packing placed inside the nose
Have the packing removed the following day before being discharged home

Enlarged inferior turbinate blocking the left nasal passage, making it difficult to breathe through the nose.

Two months after turbinate reduction procedure

2 months after my patient underwent his Turbinoplasty procedure, he was very happy as he could now breathe clearly through his nose. The turbinate tissue is now much smaller than before, allowing easy airflow through the nose.

Desensitisation Therapy (Sublingual Immunotherapy)

Desensitisation therapy, also known as sublingual immunotherapy (SLIT), aims to gradually reduce the immune system’s sensitivity to specific allergens so that it becomes less reactive to them over time.

Three species of house dust mite are major allergy triggers in Singapore. For house dust mite-related allergic rhinitis, sublingual immunotherapy may be administered in two forms:

Spray (SLIM): Two puffs are sprayed under the tongue each day..
Tablet (Acarizax): One tablet is placed under the tongue each day.

The area beneath the tongue is used for absorption. Rather than containing conventional allergy medication, SLIT contains proteins associated with the allergen, in this case house dust mite proteins, which are introduced regularly to help the immune system become less sensitive to them. It is sometimes described by patients as an allergy “vaccine”, although it is not technically a vaccine. Sublingual immunotherapy can be effective in treating house dust mite-related allergies, although individual responses to treatment may vary.

SLIT is a long-term treatment and may need to continue for up to three years to achieve longer-term control of house dust mite allergy and potentially reduce the need for nasal sprays and antihistamines. Many patients may begin to notice an improvement in their symptoms at around one year after starting treatment.

The occasional missed dose may not necessarily affect the overall treatment outcome, although SLIT should be taken according to Dr Annabelle’s instructions.

Frequently Asked Questions About Nasal Allergies

Yes. Nasal allergies can develop at different stages of life, even if you did not experience allergy symptoms as a child. New or recurring symptoms may warrant assessment to determine whether an allergy or another nasal condition is responsible.

No. Allergic rhinitis is caused by the immune system reacting to allergens and cannot be passed from one person to another. However, symptoms such as a runny or blocked nose and sneezing can sometimes resemble those of a cold.

Air-conditioning itself is not necessarily an allergen. However, cold or dry air may aggravate nasal symptoms in some people, while air-conditioned environments may also contain allergens such as house dust mites that can trigger symptoms in those who are sensitive to them.

Yes. Allergic rhinitis can affect children as well as adults. Persistent sneezing, an itchy or runny nose, nasal blockage or other recurring symptoms may warrant assessment, particularly if they are affecting a child’s sleep or everyday activities.

Our Allergy & Sensitive Nose Specialist

Dr Annabelle Leong 梁翠娟

Senior Consultant ENT Surgeon

MBBS (Hons) (London), BSc (Hons);

DOHNS, MRCS (England), FRCS ORL-HNS (England)

Dr Annabelle Leong is a senior consultant ENT surgeon with more than 25 years of experience across the United Kingdom, Canada and Singapore. She assesses and treats nasal allergies in both adults and children, including persistent symptoms such as sneezing, nasal blockage and a runny or itchy nose.

Where appropriate, Dr Annabelle can also arrange allergy testing to identify possible triggers and advise on treatment ranging from medication and desensitisation therapy to procedures for persistent nasal blockage.

More about Dr Annabelle