September 17, 2026

Allergic rhinitis affects roughly one in four people in Hong Kong¹, with house dust mites as the predominant trigger in the city's warm, humid climate.² While many people self-treat with over-the-counter antihistamines, persistent symptoms may signal a need for specialist evaluation. Dr Henry Pau, a Specialist in Otorhinolaryngology/Ear Nose and Throat Surgery (ENT) explains what happens during an Ear Nose and Throat (ENT) examination, when to seek specialist care, and the advanced treatment options available beyond first-line pharmacy medicines.

If you have been living with a constantly blocked or runny nose, frequent sneezing, or disrupted sleep, you are not alone. Allergic rhinitis is one of the most common chronic conditions in Hong Kong, yet many people put up with their symptoms for years without seeking a proper diagnosis. Understanding when to move beyond self-treatment and consult an ENT specialist can make a real difference to your quality of life.

Allergic rhinitis occurs when your immune system overreacts to normally harmless substances in the environment. When you inhale an allergen, your nasal passages become inflamed, triggering symptoms that can range from mildly annoying to genuinely debilitating.³

The condition is distinct from non-allergic rhinitis, which can be caused by infections, hormonal imbalance, irritants or side effects of some medications rather than an immune-mediated response.³

Both regions report similar adult prevalence rates, but the pattern of disease differs significantly.

The allergens that trigger allergic rhinitis vary by environment. The most common include²:

• House dust mites, the leading cause in Hong Kong

• Pet dander from cats and dogs

• Mould spores, common in humid environments

• Cockroach, particularly relevant in Hong Kong's urban housing

• Pollen from trees, grasses, and weeds (more significant in temperate climates)

A parental history of allergic rhinitis is associated with a more than twofold increase in the risk of developing the condition.²

The symptoms of allergic rhinitis often overlap with those of a common cold, which is one reason the condition is frequently overlooked. 

Common symptoms include^2,5:

• Rhinorrhea (runny nose)

• Sneezing

• Nasal itching

• Blocked nose 

• Itchy, red, and watery eyes

• Cough

• Itchiness in the roof of the mouth

Complications

• Infectious rhinosinusitis 

• Chronic sinusitis

• Otitis media

• Nasal polyps

• Sleep problems

Many people self-treat with over-the-counter antihistamines for years without a clear diagnosis. While this may provide temporary relief, it can mask underlying issues. Not all chronic nasal symptoms are allergic in origin. Conditions that produce similar symptoms but require different treatment include⁶:

• Vasomotor rhinitis: triggered by temperature changes, strong odours, or stress rather than allergens
• Nasal polyps: soft growths in the nasal passages that cause persistent blockage
• Deviated septum: a structural issue that restricts airflow through one or both nostrils
• Chronic sinusitis: ongoing inflammation or infection of the sinus cavities

An accurate diagnosis ensures you receive the right treatment from the start.

Referral to an ENT specialist may be considered when initial pharmacy treatments are ineffective or following evaluation by a GP. The aim of the ENT assessment is to distinguish allergic rhinitis from other causes, identify the specific allergens driving your condition, and assess whether structural factors are contributing to your symptoms.

A typical ENT examination may include the following on case-by-case basis⁶:

1. Detailed history-taking: your symptoms, their timing, and any triggers you have noticed.
2. Anterior rhinoscopy: a straightforward examination of the inside of your nose using a speculum and light
3. Nasal endoscopy: a thin, flexible camera passed into the nasal cavity to examine the turbinates, nasal septum, and sinus openings in detail (quick, may cause mild discomfort but is not painful)
4. Allergy testing: skin prick testing or blood tests to identify specific allergens
5. Imaging: CT scans if structural issues or chronic sinusitis are suspected

When the over-the-counter medications have not provided adequate relief, an ENT specialist can offer several additional approaches.

Allergic rhinitis is common in Hong Kong, and the year-round presence of house dust mites and sometimes mould means many residents experience chronic rather than seasonal symptoms.

An ENT specialist can provide a thorough assessment, pinpoint the cause, and offer targeted treatments including immunotherapy and, where appropriate, surgical options.

If your symptoms persist, keep coming back, or start affecting your sleep or daily life, consult your GP or an ENT Specialist.

1. CUHK. (2025). 'CUHK-designed Chinese medicine formula "Yu-Ping-Feng powder with variations" improves the symptoms of allergic rhinitis and quality of life for 40% of patients.' Available at: https://www.cpr.cuhk.edu.hk/en/press/cuhk-designed-chinese-medicine-formula-yu-ping-feng-powder-with-variations-improves-the-symptoms-of-allergic-rhinitis-and-quality-of-life-for-40-of-patients/ [Accessed: 19 August 2026].
2. Lam, C.W.K., Lit, L.C.W., Hjelm, N.M., Fung, H.K., Vrijmoed, L.L.P., Wong, M.C. and Woo, J.K.S. (1998). 'Aetiology of allergic rhinitis in Hong Kong.' Allergology International, 47(1), pp. 23 to 28. 
3. Yeung, W.M. (2017). 'Management of allergic rhinitis for the family physicians.' Hong Kong Practitioner, 39(3), pp. 88 to 94. Available at: https://hkcfp.org.hk/Upload/HK_Practitioner/2017/hkp2017vol39Sep/update_article.html [Accessed: 19 August 2026].
4. Gov.uk. (2025). 'Hay fever and airborne allergens.' Available at: https://www.gov.uk/guidance/hay-fever-and-airborne-allergens [Accessed: 19 August 2026].
5. NHS. (2026). 'Allergic rhinitis.' Available at: https://www.nhs.uk/conditions/allergic-rhinitis/ [Accessed: 14 August 2026].
6. Akhouri, S. and House, S.A. (2023). 'Allergic rhinitis.' StatPearls. Available at: https://www.ncbi.nlm.nih.gov/books/NBK538186/ [Accessed: 19 August 2026].
7. Park, S.C., Kim, D.H., Jun, Y.J., Kim, S.W., Yang, H.J., Yang, S.I., Kim, H.J. and Kim, D.K. (2023). 'Long-term outcomes of turbinate surgery in patients with allergic rhinitis: a systematic review and meta-analysis.' JAMA Otolaryngology–Head and Neck Surgery, 149(1), pp. 15 to 23. Available at: https://doi.org/10.1001/jamaoto.2022.3567.
8. Wu, Y., Yu, T., Zhang, Z., Wang, X. and Gao, S. (2024). 'The benefits of septoplasty for patients with deviated nasal septum and allergic rhinitis: a meta-analysis.' Scientific Reports, 14(1), p. 28855. Available at: https://doi.org/10.1038/s41598-024-80377-3.