Table of ContentsView AllTable of ContentsOverviewAllergic RhinitisIrritantsSinusitisFood AllergiesNasal PolypsCPAP MachinesNasal TumorsBrain TumorsDiagnosing Pruritus
Table of ContentsView All
View All
Table of Contents
Overview
Allergic Rhinitis
Irritants
Sinusitis
Food Allergies
Nasal Polyps
CPAP Machines
Nasal Tumors
Brain Tumors
Diagnosing Pruritus
Nasalpruritusis the medical term for an itchy nose. There are many possible causes of nasal itchiness, including hay fever (allergic rhinitis),food allergies, a sinus infection (sinusitis), andnasal polyps. It may also be due to nasal irritation, dry air, and the use ofCPAP machines. On rare occasions, nasal pruritus may even be a sign of abrain tumor.
Although most cases of an itchy nose are relatively harmless, it is important to seek medical care if your symptoms are severe, interfere with sleep, or are not responsive toantihistaminesor other commonly used medications.
champja / Getty Images
What Causes Nasal Pruritus?
Pruritusdescribes an itch on any part of the body. It is caused when theimmune systemreleases a chemical calledhistaminethat mediatesinflammation(the body’s natural response to disease, injury, or infection).
Once released, histamine attaches to different cellular receptors in the body, including one called histamine type 1 (H1R). The attachment to H1R causes the rapid, repeated firing of nerves connected to the receptors, resulting in sensations recognized as an itch.
H1R receptors are populated throughout the body, including the nasal passages.
Many different that can trigger the release of histamine. Some of these are normal and intentional and others are abnormal and unintentional.
Allergic rhinitis affects between 20% and 30% of adults in the United States and a larger percentage of children. The symptoms may beseasonal(limited to “pollen season”) orperennial(occurring year-round).
Symptoms of allergic rhinitis include:
Over-the-counter (OTC)antihistaminessuch as Zyrtec (cetirizine), Allegra (fexofenadine), and Clarinex (desloratadine) are the main form of treatment for allergic rhinitis. There are also antihistamine nasal sprays that can treat nasal symptoms directly.
Best Antihistamines for Nasal Allergies
Environmental Irritants
Environmental irritants are those in the environment that can irritate the skin, eyes, or respiratory tract. These include aerosolized irritants such as:
Breathing in these irritants can cause the rapid onset of inflammation in the respiratory tract, leading to symptoms like:
The response can differ, with some people being more sensitive to them than others.
The best way to deal with environmental irritants is to remove yourself from the source of the exposure or to wear the appropriate face mask, such as anN95 maskor a full-facial respiratory mask.
Sinusitis describes the inflammation of the sinuses, most often due to an infection. Also known asacute rhinosinusitis, the condition is most often linked to viral infections such as:
Bacteria can also sometimes cause sinus infections, includingStreptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.
Fungal sinusitis is more commonly attributed toimmunosuppressivediseases, like HIV, that allow normally occurring fungi to overgrow and establish an infection.
Symptoms of sinusitis include:
Most viral infections are allowed to run their course; treatment is mainly focused on managing symptoms. Bacterial or fungal infections may be treated, respectively, with oral or intravenous (IV) antibiotics or antifungal drugs.
In the United States, the eight most common food allergens are:
With a food allergy, your body is overreacting to a specific food protein that most immune systems regard as harmless. If your immune system is hypersensitive to that protein, it can cause allergy symptoms like:
Food allergies can often be effectively treated with oral antihistamines.
Can Food Allergies Kill You?In rare cases, a food allergy can trigger a potentially life-threatening, whole-body allergy known asanaphylaxis. Symptoms include:Dizziness or lightheadednessHives or rashSwelling of the lips, face, or throatShortness of breath and wheezingIrregular or rapid heartbeatsShallow, rapid breathingA cold sweatA feeling of impending doomIf not treated immediately with a shot ofepinephrine, anaphylaxis can lead to shock and death.
Can Food Allergies Kill You?
In rare cases, a food allergy can trigger a potentially life-threatening, whole-body allergy known asanaphylaxis. Symptoms include:Dizziness or lightheadednessHives or rashSwelling of the lips, face, or throatShortness of breath and wheezingIrregular or rapid heartbeatsShallow, rapid breathingA cold sweatA feeling of impending doomIf not treated immediately with a shot ofepinephrine, anaphylaxis can lead to shock and death.
In rare cases, a food allergy can trigger a potentially life-threatening, whole-body allergy known asanaphylaxis. Symptoms include:
If not treated immediately with a shot ofepinephrine, anaphylaxis can lead to shock and death.
Nasal polypsare soft, benign (non-cancerous) growths that develop inside the sinus or nasal passages. They are often teardrop-shaped and grow in clusters. While small polyps may not be problematic, large polyps can block airways and lead to sinus inflammation (referred to as chronic sinusitis).
Nasal polyps are common and mostly affect people in their 30s and 40s. Infections, allergies, or any condition that causes long-term sinus inflammation can lead to nasal polyps. Polyps are also closely linked toasthmaandaspirin sensitivity.
Symptoms of nasal polyps include:
How Nasal Polyps Are Treated
Sleep apneais a condition in which breathing repeatedly stops during sleep, either due to airway obstruction (obstructive sleep apnea) or the disruption of the part of the brain that regulates breathing (central sleep apnea).
Nasal pruritus occurs when the constant air pressure from the CPAP machine causes nasal tissues to dry out and become inflamed. There may also be skin irritation from the mask itself, especially if it is ill-fitting.
Other side effects of a CPAP machine include:
Nasal and paranasaltumorsare abnormal growths of tissues. They differ from polyps in that they are comprised of abnormal cells, while polyps are comprised of normal cells. Nasal tumors are those that develop in the main nasal passage, while paranasal tumors occur in the paranasal sinuses.
Nasal and paranasal tumors are generally non-cancerous but some can turn cancerous. The two most commontypes of nasal canceraresquamous cell carcinoma(SCC)andadenocarcinoma.
Symptoms of nasal tumors, both benign and cancerous, include:
If the tumor is cancerous and starts to spread, it can cause double vision, eye bulging, facial swelling, jaw numbness, andtrismus(lockjaw).
Surgery is the first line of treatment for benign tumors that affect breathing and all cancerous tumors irrespective of stage.
Radiationcan be used after cancer surgery to clear any remaining cancer cells.Chemotherapyandtargeted therapiesmay also be used.
As surprising as it may seem, nasal itching may be a tell-tale sign of a brain tumor. As far back as the 1970s, scientists in Europe noticed that roughly one in five people experienced sometimes intense and persistent pruritis localized to the nostrils.
Further investigation revealed that most tumors were localized to a specific part of the brain called thebrainstemwhich regulates many vital functions, including respiration and sneezing.
Other recent studies have revealed that brain tumors in different parts of the brain trigger pruritus in different parts of the body, including the head and trunk.
While brainstem tumors are rare in exceptionally rare in adults, a typically cancerous type calledbrainstem gliomaaccounts for approximately 15% of all childhood brain tumors.
Symptoms of an advanced brainstem glioma may include:
In some cases, intense localized itching (resistant to antihistamines and other medications) may be the sole symptom of a brainstem tumor in children.
Surgery is possible for only some types of brainstem tumors; radiation tends to be reserved for advanced cases due to the impact it may have on vital functions. Chemotherapy has limited use in all but high-grade (aggressive) cancers.
How Nasal Pruritus Is Diagnosed
The otolaryngologist will ask you about your symptoms and medical history before giving you a physical exam, which will involve looking into your ears, nose, and throat.
Medical imaging may be used to confirm a diagnosis, including the use of acomputed tomography (CT) scanto help detect nasal polyps or tumors.
If an allergic condition is suspected,allergy testingwith askin prick testorRAST blood testmay be used to confirm this and identify which substances cause the allergy.
Summary
Common causes of nasal pruritis (itchiness) include hay fever, food allergies, sinus infections, airborne irritants, and nasal polyps. CPAP machines used to treat sleep apnea can cause nasal dryness that leads to itching. Less common causes of nasal pruritus are nasal tumors and brainstem cancer.
If nasal itchiness does not respond to over-the-counter antihistamines or steroid nasal sprays, ask for a referral to an otolaryngologist (ear, nose, and throat specialist) for further evaluation. An allergist can also help identify and treat respiratory or food allergies.
19 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Thurmond RL, Kazerouni K, Chaplan SR, Greenspan AJ.Chapter 10. Peripheral neuronal mechanism of itch. In:Itch: Mechanisms and Treatment. Boca Raton, FL: CRC Press/Taylor & Lewis; 2014.Hoyte FCL, Nelson HS.Recent advances in allergic rhinitis.F1000Res. 2018;7:F1000 Faculty Rev-1333. doi:10.12688/f1000research.15367.1Church MK, Church DS.Pharmacology of antihistamines.Indian J Dermatol. 2013;58(3):219-224. doi:10.4103/0019-5154.110832Kurt OK, Zhang J, Pinkerton KE.Pulmonary health effects of air pollution.Curr Opin Pulm Med. 2016;22(2):138–143. doi:10.1097/MCP.0000000000000248Kong X, Bennett WC, Jania CM, et al.Identification of an ATP/P2X7/mast cell pathway mediating ozone-induced bronchial hyperresponsiveness.JCI Insight.2021;6(21):e140207. doi:10.1172/jci.insight.140207Pynnonen MA, Lynn S, Kern HE, et al.Diagnosis and treatment of acute sinusitis in the primary care setting: a retrospective cohort.Laryngoscope. 2015;125(10):2266–2272. doi:10.1002/lary.25363DeMuri GP, Gern JE, Eickhoff JC, Lynch SV, Wald ER.Dynamics of bacterial colonization withStreptococcus pneumoniae,Haemophilus influenzae, andMoraxella catarrhalisduring symptomatic and asymptomatic viral upper respiratory tract infection.Clin Infect Dis. 2018;66(7):1045-1053. doi:10.1093/cid/cix941Savage J, Johns CB.Food allergy: epidemiology and natural history.Immunol Allergy Clin North Am. 2015;35(1):45-59. doi.org/10.1016/j.iac.2014.09.004Valenta R, Hochwallner H, Linhart B, Pahr S.Food allergies: the basics.Gastroenterology. 2015;148(6):1120–1131.e4. doi:10.1053/j.gastro.2015.02.006American Academy of Allergy, Asthma and Immunology.Anaphylaxis.American Academy of Allergy, Asthma, and Immunology.Nasal polyps.National Library of Medicine: MedlinePlus.Nasal polyps.Cowie MR.Sleep apnea: state of the art.Trends Cardiovasc Med. 2017;27(4):280-289. doi:10.1016/j.tcm.2016.12.005National Heart, Lung, and Blood Institute.CPAP.Cedars Sinai.Nasal and sinus tumors.National Cancer Institute.Paranasal sinus and nasal cavity cancer treatment (adult) (PDQ): health professional version.Fardel MA, Brenaut E, Guellec D.Pruritus and brain tumours: a prospective and descriptive study.Skin Health Dis. 2023;3(3):e202. doi:10.1002/ski2.202Weill-Cornell Medicine.Brainstem tumors.Soltani-Arabshahi R, Vanderhooft S, Hansen CD.Intractable localized pruritus as the sole manifestation of intramedullary tumor in a child: case report a review of the literature.JAMA Dermatol.2013;149(4):446-449. doi:10.1001/jamadermatol.2013.2032
19 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Thurmond RL, Kazerouni K, Chaplan SR, Greenspan AJ.Chapter 10. Peripheral neuronal mechanism of itch. In:Itch: Mechanisms and Treatment. Boca Raton, FL: CRC Press/Taylor & Lewis; 2014.Hoyte FCL, Nelson HS.Recent advances in allergic rhinitis.F1000Res. 2018;7:F1000 Faculty Rev-1333. doi:10.12688/f1000research.15367.1Church MK, Church DS.Pharmacology of antihistamines.Indian J Dermatol. 2013;58(3):219-224. doi:10.4103/0019-5154.110832Kurt OK, Zhang J, Pinkerton KE.Pulmonary health effects of air pollution.Curr Opin Pulm Med. 2016;22(2):138–143. doi:10.1097/MCP.0000000000000248Kong X, Bennett WC, Jania CM, et al.Identification of an ATP/P2X7/mast cell pathway mediating ozone-induced bronchial hyperresponsiveness.JCI Insight.2021;6(21):e140207. doi:10.1172/jci.insight.140207Pynnonen MA, Lynn S, Kern HE, et al.Diagnosis and treatment of acute sinusitis in the primary care setting: a retrospective cohort.Laryngoscope. 2015;125(10):2266–2272. doi:10.1002/lary.25363DeMuri GP, Gern JE, Eickhoff JC, Lynch SV, Wald ER.Dynamics of bacterial colonization withStreptococcus pneumoniae,Haemophilus influenzae, andMoraxella catarrhalisduring symptomatic and asymptomatic viral upper respiratory tract infection.Clin Infect Dis. 2018;66(7):1045-1053. doi:10.1093/cid/cix941Savage J, Johns CB.Food allergy: epidemiology and natural history.Immunol Allergy Clin North Am. 2015;35(1):45-59. doi.org/10.1016/j.iac.2014.09.004Valenta R, Hochwallner H, Linhart B, Pahr S.Food allergies: the basics.Gastroenterology. 2015;148(6):1120–1131.e4. doi:10.1053/j.gastro.2015.02.006American Academy of Allergy, Asthma and Immunology.Anaphylaxis.American Academy of Allergy, Asthma, and Immunology.Nasal polyps.National Library of Medicine: MedlinePlus.Nasal polyps.Cowie MR.Sleep apnea: state of the art.Trends Cardiovasc Med. 2017;27(4):280-289. doi:10.1016/j.tcm.2016.12.005National Heart, Lung, and Blood Institute.CPAP.Cedars Sinai.Nasal and sinus tumors.National Cancer Institute.Paranasal sinus and nasal cavity cancer treatment (adult) (PDQ): health professional version.Fardel MA, Brenaut E, Guellec D.Pruritus and brain tumours: a prospective and descriptive study.Skin Health Dis. 2023;3(3):e202. doi:10.1002/ski2.202Weill-Cornell Medicine.Brainstem tumors.Soltani-Arabshahi R, Vanderhooft S, Hansen CD.Intractable localized pruritus as the sole manifestation of intramedullary tumor in a child: case report a review of the literature.JAMA Dermatol.2013;149(4):446-449. doi:10.1001/jamadermatol.2013.2032
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Thurmond RL, Kazerouni K, Chaplan SR, Greenspan AJ.Chapter 10. Peripheral neuronal mechanism of itch. In:Itch: Mechanisms and Treatment. Boca Raton, FL: CRC Press/Taylor & Lewis; 2014.Hoyte FCL, Nelson HS.Recent advances in allergic rhinitis.F1000Res. 2018;7:F1000 Faculty Rev-1333. doi:10.12688/f1000research.15367.1Church MK, Church DS.Pharmacology of antihistamines.Indian J Dermatol. 2013;58(3):219-224. doi:10.4103/0019-5154.110832Kurt OK, Zhang J, Pinkerton KE.Pulmonary health effects of air pollution.Curr Opin Pulm Med. 2016;22(2):138–143. doi:10.1097/MCP.0000000000000248Kong X, Bennett WC, Jania CM, et al.Identification of an ATP/P2X7/mast cell pathway mediating ozone-induced bronchial hyperresponsiveness.JCI Insight.2021;6(21):e140207. doi:10.1172/jci.insight.140207Pynnonen MA, Lynn S, Kern HE, et al.Diagnosis and treatment of acute sinusitis in the primary care setting: a retrospective cohort.Laryngoscope. 2015;125(10):2266–2272. doi:10.1002/lary.25363DeMuri GP, Gern JE, Eickhoff JC, Lynch SV, Wald ER.Dynamics of bacterial colonization withStreptococcus pneumoniae,Haemophilus influenzae, andMoraxella catarrhalisduring symptomatic and asymptomatic viral upper respiratory tract infection.Clin Infect Dis. 2018;66(7):1045-1053. doi:10.1093/cid/cix941Savage J, Johns CB.Food allergy: epidemiology and natural history.Immunol Allergy Clin North Am. 2015;35(1):45-59. doi.org/10.1016/j.iac.2014.09.004Valenta R, Hochwallner H, Linhart B, Pahr S.Food allergies: the basics.Gastroenterology. 2015;148(6):1120–1131.e4. doi:10.1053/j.gastro.2015.02.006American Academy of Allergy, Asthma and Immunology.Anaphylaxis.American Academy of Allergy, Asthma, and Immunology.Nasal polyps.National Library of Medicine: MedlinePlus.Nasal polyps.Cowie MR.Sleep apnea: state of the art.Trends Cardiovasc Med. 2017;27(4):280-289. doi:10.1016/j.tcm.2016.12.005National Heart, Lung, and Blood Institute.CPAP.Cedars Sinai.Nasal and sinus tumors.National Cancer Institute.Paranasal sinus and nasal cavity cancer treatment (adult) (PDQ): health professional version.Fardel MA, Brenaut E, Guellec D.Pruritus and brain tumours: a prospective and descriptive study.Skin Health Dis. 2023;3(3):e202. doi:10.1002/ski2.202Weill-Cornell Medicine.Brainstem tumors.Soltani-Arabshahi R, Vanderhooft S, Hansen CD.Intractable localized pruritus as the sole manifestation of intramedullary tumor in a child: case report a review of the literature.JAMA Dermatol.2013;149(4):446-449. doi:10.1001/jamadermatol.2013.2032
Thurmond RL, Kazerouni K, Chaplan SR, Greenspan AJ.Chapter 10. Peripheral neuronal mechanism of itch. In:Itch: Mechanisms and Treatment. Boca Raton, FL: CRC Press/Taylor & Lewis; 2014.
Hoyte FCL, Nelson HS.Recent advances in allergic rhinitis.F1000Res. 2018;7:F1000 Faculty Rev-1333. doi:10.12688/f1000research.15367.1
Church MK, Church DS.Pharmacology of antihistamines.Indian J Dermatol. 2013;58(3):219-224. doi:10.4103/0019-5154.110832
Kurt OK, Zhang J, Pinkerton KE.Pulmonary health effects of air pollution.Curr Opin Pulm Med. 2016;22(2):138–143. doi:10.1097/MCP.0000000000000248
Kong X, Bennett WC, Jania CM, et al.Identification of an ATP/P2X7/mast cell pathway mediating ozone-induced bronchial hyperresponsiveness.JCI Insight.2021;6(21):e140207. doi:10.1172/jci.insight.140207
Pynnonen MA, Lynn S, Kern HE, et al.Diagnosis and treatment of acute sinusitis in the primary care setting: a retrospective cohort.Laryngoscope. 2015;125(10):2266–2272. doi:10.1002/lary.25363
DeMuri GP, Gern JE, Eickhoff JC, Lynch SV, Wald ER.Dynamics of bacterial colonization withStreptococcus pneumoniae,Haemophilus influenzae, andMoraxella catarrhalisduring symptomatic and asymptomatic viral upper respiratory tract infection.Clin Infect Dis. 2018;66(7):1045-1053. doi:10.1093/cid/cix941
Savage J, Johns CB.Food allergy: epidemiology and natural history.Immunol Allergy Clin North Am. 2015;35(1):45-59. doi.org/10.1016/j.iac.2014.09.004
Valenta R, Hochwallner H, Linhart B, Pahr S.Food allergies: the basics.Gastroenterology. 2015;148(6):1120–1131.e4. doi:10.1053/j.gastro.2015.02.006
American Academy of Allergy, Asthma and Immunology.Anaphylaxis.
American Academy of Allergy, Asthma, and Immunology.Nasal polyps.
National Library of Medicine: MedlinePlus.Nasal polyps.
Cowie MR.Sleep apnea: state of the art.Trends Cardiovasc Med. 2017;27(4):280-289. doi:10.1016/j.tcm.2016.12.005
National Heart, Lung, and Blood Institute.CPAP.
Cedars Sinai.Nasal and sinus tumors.
National Cancer Institute.Paranasal sinus and nasal cavity cancer treatment (adult) (PDQ): health professional version.
Fardel MA, Brenaut E, Guellec D.Pruritus and brain tumours: a prospective and descriptive study.Skin Health Dis. 2023;3(3):e202. doi:10.1002/ski2.202
Weill-Cornell Medicine.Brainstem tumors.
Soltani-Arabshahi R, Vanderhooft S, Hansen CD.Intractable localized pruritus as the sole manifestation of intramedullary tumor in a child: case report a review of the literature.JAMA Dermatol.2013;149(4):446-449. doi:10.1001/jamadermatol.2013.2032
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