, Volume 5, Issue 2, pp 122-136
Date: 03 Nov 2012

Topical Corticosteroid Therapy of Rhinitis

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The introduction of nasal corticosteroids 20 years ago has been the most important therapeutic progress in rhinitis management since the introduction of the first generation of antihistamines. Our knowledge of the mode of action of corticosteroids is still incomplete, although a series of intranasal studies has now clarified this problem as the airway mucous membrane of the nose is easily accessible for investigation. Nasal corticosteroids are a highly effective therapeutic modality that can be used for long term therapy of allergic rhinitis, perennial nonallergic rhinitis and nasal polyposis. Experience for 20 years has shown that the adverse effects from this type of treatment are negligible, and far less serious than those occurring in the skin following long term use of corticosteroid ointment. Intranasal corticosteroids can therefore be considered as first-line treatment for allergic and nonallergic rhinitis.

The major disadvantage of this type of treatment is the slow onset of action and the lack of effect on itchy eyes. For that reason, the second generation antihistamines are the drugs of choice in patients having occasional symptoms. However, in our opinion, intranasal corticosteroids are preferable in patients who have symptoms on a regular basis, either in the pollen season or all year.