Runny Nose: What It Is, Types and Causes of Rhinitis

Tissues in your pocket, in your bag and in your coat pocket, and your nose is still running. Everyone knows a runny nose, and precisely because it's so familiar it's rarely taken seriously — yet it can drag on for weeks. Let's look at what happens inside and when it's time to see a doctor.

What a runny nose, rhinitis and rhinorrhea are

Rhinitis is inflammation of the nasal mucosa, a set of signs rather than a separate disease. Catarrhal rhinitis with rhinorrhea (discharge of mucus from the nose) is what people commonly call a runny nose. A doctor speaks of rhinitis when two of three symptoms are present: difficulty breathing through the nose, discharge, itching or burning in the nose together with sneezing. Persistent rhinitis is diagnosed if this lasts at least an hour a day and at least two weeks during the year.

Congestion appears when the tissues lining the nose swell because of inflamed blood vessels. If mucus runs down the back of the throat (postnasal drip), it causes a cough or sore throat.

Acute rhinitis and its stages

It begins with frequent sneezing, watery eyes and malaise. Then copious serous-mucous discharge appears, later becoming mucopurulent. The second stage of infectious rhinitis is called the wet stage — clear discharge is typical of it. Temperature is usually normal or rises to 37.0—37.5 °C, nasal breathing is difficult, and the sense of smell weakens.

Acute infectious rhinitis is more common in children: before the age of five a child has 6—8 episodes a year, and in nursery their number grows by 10—15 % in the first and second year of attendance.

Causes of a runny nose

One cause is viruses. Cold symptoms build up over 2—3 days, improvement comes after 1—2 weeks, later in young children.

Then there is flu, sinusitis, allergy, polyps (growths of inflamed tissue in the nose or sinuses), pregnancy, vasomotor rhinitis — the mucosa reacts violently to cold air or a strong odor. Rhinitis also occurs after injury to the mucosa: mechanical, thermal, chemical, radiation. Contributing factors include chilling, dusty and polluted air.

A separate cause is over-the-counter nose drops and sprays: when used for longer than three days, congestion may worsen. Chronic rhinitis is often the outcome of acute rhinitis or a consequence of prolonged exposure to poor working conditions and local circulatory impairment.

Why a runny nose is sometimes white or endless

The color of the discharge is a rough but useful guide. Doctors consider white and yellow discharge normal, while other shades, an unpleasant odor and discharge from only one side of the nose are cause for concern. Green color is a sign of infection; clear discharge is typical of vasomotor and allergic rhinitis.

An "endless" runny nose usually has an explanation. Congestion often resolves on its own within a week, but people see a doctor if symptoms last longer than three weeks, and with a cold the benchmark is different — no improvement after 10 days. A runny nose is persistent in chronic rhinitis — it may be the outcome of acute rhinitis or a consequence of prolonged exposure to adverse environmental factors and working conditions.

Pain between the eyebrows with a runny nose: what it may mean

Pressure and heaviness in the face and forehead during a cold are common. Swelling of the forehead, eyes, side of the nose or cheek and blurred vision are cause for concern: these warrant a doctor's visit. Pain between the eyebrows is not considered a separate sign; the doctor assesses such complaints together with the other symptoms. Discharge from the nose after a head injury is a separate reason for a visit.

When a runny nose requires seeing a doctor

The doctor examines the ears, nose, throat and airways. If necessary, allergy tests (skin tests), blood tests, sputum culture and a throat swab, X-rays of the sinuses and chest are ordered.

Book an appointment:

• fever lasts longer than three days or rises very high, with fever and chills;
• symptoms do not ease after 10 days or worsen;
• cough lasts longer than three weeks, discharge has an unpleasant odor, comes from one nostril or is an unusual color;
• a runny nose against a background of diabetes, heart, lung or kidney disease, or weakened immunity — for example, during chemotherapy.

A runny nose by itself is not a reason to call an ambulance. 103 or 112 — if severe shortness of breath or chest pain resembling a heart attack appears, or signs of a stroke.

This material is for reference: it explains what happens in the nose and when a doctor is needed, but it does not replace a consultation — it is better to show your nose to a specialist.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer