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Allergic rhinitis (hay fever): stepwise management

A detailed Australian summary of allergic rhinitis (hay fever): stepwise management, with source-attributed priorities, a practical workflow, safety escalation and state or territory implementation boundaries.

JurisdictionAustralia
Source check2026-08-20
Clinical reviewiatroX editorial team 路 Clinical editorial review 路 reviewed 2026-08-20 路 due 2027-08-20
AudienceHealthcare professionals practising in Australia
This is an iatroX educational summary of named Australia sources, not an official guideline. It does not replace the complete source documents, local policy, specialist advice or clinical judgement. Apply current TGA product information, PBS restrictions, state or territory law, local referral criteria, formulary and antimicrobial policy. A national recommendation does not create uniform service access.

Scope

Relate sneezing, itch, watery rhinorrhoea and congestion to seasonal or perennial exposure and examine for asthma, sinusitis and structural obstruction. Use allergen avoidance only when targeted and feasible, and teach regular intranasal corticosteroid direction and technique for persistent symptoms. This summary is limited to the population, decisions and escalation boundaries stated in the named source.
sources for this section:ASCIA allergic rhinitis

The Bottom Line

  • Relate sneezing, itch, watery rhinorrhoea and congestion to seasonal or perennial exposure and examine for asthma, sinusitis and structural obstruction.
  • Use allergen avoidance only when targeted and feasible, and teach regular intranasal corticosteroid direction and technique for persistent symptoms.
  • Inspect and treat coexisting asthma because uncontrolled rhinitis can worsen lower-airway symptoms and sleep.
  • Add a non-sedating antihistamine for itch and sneezing when needed, while avoiding long-term topical decongestants and sedating medicines in drivers.
sources for this section:ASCIA allergic rhinitis

Practical clinical workflow

1

Topic-specific assessment action

Relate sneezing, itch, watery rhinorrhoea and congestion to seasonal or perennial exposure and examine for asthma, sinusitis and structural obstruction.
2

Topic-specific diagnostic action

Add a non-sedating antihistamine for itch and sneezing when needed, while avoiding long-term topical decongestants and sedating medicines in drivers.
3

Topic-specific management action

Consider specific IgE testing only when history suggests a trigger and results will change avoidance or immunotherapy referral.
4

Topic-specific follow-through

Aim nasal spray away from the septum after gentle nose clearing to improve deposition and reduce bleeding.
sources for this section:ASCIA allergic rhinitis

Safety boundaries and escalation

  • Unilateral obstruction, recurrent bleeding, facial swelling, visual symptoms, severe asthma or suspected anaphylaxis requires urgent alternative assessment.
  • Allergen immunotherapy requires specialist confirmation of clinically relevant sensitisation and capacity to manage anaphylaxis.
sources for this section:ASCIA allergic rhinitis

Implementation

The named source is national or binational guidance used in Australia, but referral access, public-health directions, formularies and funded services can still differ by state, territory and health service. Check current TGA product information for medicines. Offer culturally safe care and use the NACCHO鈥揜ACGP National Guide where Aboriginal and Torres Strait Islander preventive or chronic-care recommendations differ.
sources for this section:ASCIA allergic rhinitis

Clinical use boundary

This independently written summary is not an official guideline. Check the linked source version, current TGA-approved product information where medicines are involved, and the applicable state, territory and local pathway at the point of care.

sources for this section:ASCIA allergic rhinitis

Source documents

Use the linked source documents for complete recommendations, evidence grading, exclusions and implementation detail.

  1. Australasian Society of Clinical Immunology and AllergyAllergic Rhinitis Clinical Update2024 clinical update 路 accessed 2026-08-20
    view source
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