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All about pulmonary devices (nebulizers and inhalers) and how they're used in the proper treatment of allergic rhinitis.

Treatment for allergic rhinitis is always evolving, with new options available all the time. While traditionally, the best options were antihistamines, nasal spray corticosteroids, and immunotherapy via allergy shots, the use of other devices – often employed to reduce or control symptoms of asthma – are also now viable choices for treatment.

Pulmonary devices (nebulizers and inhalers) in the treatment of allergic rhinitis isn’t a novel idea, but it has just become a frequently considered option. While these have long been employed for patients with asthma, emphysema, and other harsh lung ailments. What are the prospects for using a pulmonary device used for treating seasonal allergies (hay fever)?

What is a Nebulizer?

A nebulizer, sometimes called a breathing machine, is used to take a liquid medication and turn it into a fine mist that can be inhaled. While there are several medications available for use in this way, the most commonly prescribed in Albuterol, which has been a very popular treatment for asthma in the form of an inhaler as well.

Also referred to as “breathing treatments,” nebulizers are easy to use. Insert the medication into the machine, place the mouthpiece in the mouth, and flip the switch to turn the nebulizer on. Breathe in and out normally, and the machine will typically shut off in about ten minutes, when the medicine has been used up.

Nebulizers are commonly used to treat wheezing and tightness in the chest for those with asthma, and it can be easily regulated, giving it an advantage over inhalers. Regular treatments at regulated times, with specific doses, go a long way in reducing allergic reactions as well as asthma symptoms.

One of the negative things about nebulizers is that they can have some difficult side effects to cope with.

Some of those include:

  • Increased heart rate
  • Tremors
  • Increased blood pressure

While all of these tend to be temporary, lasting a few minutes to a couple of hours after the treatment, they can be harsh enough to make it more appealing to use an inhaler, which doesn’t affect patients so badly.


Inhalers and nebulizers are not the same thing, though the strength of the treatment is equal. There isn’t a difference in the intended dosing, but it’s harder to coordinate due to slightly inconsistent dosing. However, using an inhaler with a spacer device helps negate this problem, which makes an inhaler more convenient.

An inhaler is easily portable, and the small size means it easily fits in a purse or pocket, unlike a nebulizer. And for emergency use, this is vital so that there is never a concern with not having a treatment available when an asthma attack or serious allergies strike.

Also, unlike a nebulizer, inhalers take far less time to use. As opposed to dedicating at least ten minutes to treatment, an inhaler (also known as an MDI) takes only about thirty seconds. They tend to be a lot less expensive than nebulizers, cause fewer side effects, and create an easier way to treat symptoms of allergic rhinitis, similar to their use for asthma.

Allergic Rhinitis

For those who aren’t familiar with the term “allergic rhinitis,” the terms “hay fever” and “seasonal allergies” might ring a bell. Hay fever, as it is commonly called, can cause a lot of allergy symptoms similar to asthma, and in some instances, can be just as debilitating.


Seasonal allergies are most commonly caused by a variety of pollens, with grasses being at the top of the list, followed by trees and weeds. An allergic reaction occurs when the histamine produced by the body to control and remove the allergen from the nose, nasal passages, and lungs is seen as an attacker by the immune system. In this case, antibodies are produced to fight the histamine, leading to the production of excess mucus, inflammation, and excess fluid.


The symptoms of allergic rhinitis usually come in bundles that can include several or all of these:

  • Runny nose, sneezing, and postnasal drip
  • Itching and irritated nose, throat, sinuses, and lungs
  • Coughing and, in asthmatics, wheezing
  • Skin itching and irritation
  • Inflammation and congestion

Standard treatments

When it comes to treating seasonal allergies, there are several typical options that are employed, whether over the counter or by prescription. Doctors tend to recommend starting with:

  • Antihistamines (available as tablets, liquids, or nasal sprays)
  • Decongestants (for short term use only)
  • Nasal corticosteroids (usually the most effective method)
  • Oral corticosteroids (for those who can’t tolerate nasal sprays)
  • Allergy shots (a form of immunotherapy)
  • Clearing the nasal passages with a saline solution

However, these options don’t always work as well as necessary, or symptoms are severe and bordering on life threatening, pulmonary devices are an excellent alternative. They have shown great promise with asthma, and sometimes, the symptoms of allergic rhinitis are very similar and just as severe. Therefore, doctors have turned to treating patients suffering more than a mild seasonal allergy the same way they would treat an asthmatic, which has given patients new hope and great relief.


Pulmonary devices have been a standby, tried and true, for a very long time in the treatment of asthma, but moving into the allergic rhinitis realm is a relatively new purpose for these treatments. However, they have been quite promising in improving the quality of life for people with severe hay fever reactions and, especially, those who have seasonal allergies coupled with asthma.

It might make sense to try the more common medicines, both over the counter and by prescription, prior to expecting a doctor to prescribe an inhaler or nebulizer. Both devices can help control symptoms of allergic rhinitis, and the choice depends on whether a more structured treatment is needed or if the convenience of an inhaler, as well as the lower cost, is preferable. Either way, life can get better, even if the patient has extreme reactions to specific allergens.

Talking to a physician can help with understanding how inhalers and nebulizers work and whether or not they are the best options in your situation.

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