Why Does My Nose Always Run?

Don’t you just hate a runny nose? Does it seem to be getting worse the older you get?

A runny nose – also called rhinorrhea – is a symptom of a condition called rhinitis, the inflammation of the mucous membrane of your nose.

As you age, your nose goes through changes. And that is what has us reaching for the tissues more often.

By the year 2050, there will be 86 million Americans who are 65 years old, up from 35 million today. And many of them tend to neglect the symptoms of this annoying health issue.

So how do I get my nose to stop running?

“The long-term solution lies in narrowing down the cause,” says Dr. Corinna G. Levine, an otolaryngologist at the University of Miami Health System. “Your primary care doctor is the place to start to find out if your runny nose is a result of some type of rhinitis. Then, a combination of medication should be tried. We recommend nasal saline rinses followed by appropriate topical/ spray medication for one full month because it takes a month for the medication to have a significant impact. Most patients give up too soon.”

Repeatedly blowing our nose can actually do more harm than good. Hard blowing can cause mucus to be driven back into the sinuses. It can also irritate the tiny blood vessels in the nostrils causing inflammation and, you guessed it, more running.

Instead of blowing your nose:

• Hold a tissue or hankie under your nose to blot what’s running out. This more gentle treatment may help you begin to dry up.
• Minimize nasal irritation. Avoid putting anything in your nose (tissue, fingers, lotions, etc.) other than prescribed medication and saline.
• Humidification: Sit in a steam room or shower. Use a clean humidifier in the bedroom.
• Eat spicy foods to stimulate mucus production.
• Stay hydrated with non-caffeinated beverages — being dehydrated can aggravate your symptoms.

Runny nose can have a variety of causes.

• Allergies: The older you get, there is a smaller chance that allergies are the cause.
• Food: An increased runny nose caused by eating food, particularly highly seasoned foods is called gustatory rhinitis. Cold air may also be a trigger.
• Medication: More than 400 brand name drugs list rhinitis as a side effect. Older patients are frequently being treated for a variety of medical conditions which can result in that incessant dripping from your nose.
  • Decongestant nasal sprays: Sprays (in particular those with oxymetazoline as an active ingredient) can cause symptoms with overuse – which many of us tend to do while fighting a cold. Older people are at particular risk because they tend to have preexisting thinning and dryness of the nasal mucosa.
  • Some blood pressure-lowering drugs: Clonidine, guanethidine, propranolol, prazosin, hydralazine, and diuretics may cause nasal obstruction.
  • Estrogen: Your estrogen level may also increase nasal airway resistance and runny nose. Think menopause and pregnancy.
  • Anti-inflammatories: Aspirin and medications like ibuprofen are well-known triggers of bronchospasm in patients with nasal polyps and asthma. They can also cause severe rhinitis in asthmatics with and without associated polyps.
  • Psychiatric drugs and Viagra: Drugs likely to be used by older people have resulted in rhinitis.
• Nonallergic rhinitis with eosinophilia (NARES): Sometimes, it seems like you have an allergy, but you don’t. Patients with NARES don’t have an identified allergen. In NARES, the secretions contain numerous eosinophils (a type of inflammatory cell), and the nasal lining demonstrates a dense infiltration of eosinophils.
• Senile rhinitis: This is also called “dry nose syndrome” or “atrophic rhinitis.”  It occurs when the nasal glands that produce moisture fail to function adequately, which most often occurs with aging.
• Atrophic rhinitis: This condition is often seen in the elderly. Atrophy and crusting of the nasal mucous membrane occur with the resumption of the underlying bone.
• Idiopathic or vasomotor rhinitis: This refers to inflammation of the nasal mucous membrane unrelated to allergy, infection, structural lesions, medication or systemic disease. Frequently, symptoms are triggered by conditions, such as a change in pressure or temperature, strong smells, cold air, or strong smells. This also can be triggered by strong emotions or alcohol consumption.

A nasal rinse a day … may keep the mucous away

If your nose constantly runs, Dr. Levine says it helps to keep it simple with good nasal hygiene. Simply rinsing the nose with a salt water (saline) solution at least once a day is helpful for many people. Since your nose becomes drier as you age, you should use rinses to remove nasal irritants and mucus while moisturizing the nose, using over-the-counter saline nasal sprays or nasal rinse kits. By rinsing your nose first, the lining is freshly cleansed when the medication is applied.

For people with non-allergic rhinitis, daily use of a nasal glucocorticoid (steroid) or an antihistamine nasal spray can be helpful. These medications may be used alone or in combination. People often do not aim the medications properly, according to Dr. Levine. Nasal sprays should be aimed toward the outer corner of the eye on each side.

• Nasal glucocorticoids (steroids): Effective for symptoms of non-allergic rhinitis. Some are available over-the-counter, like Flonase Allergy Relief and Rhinocort Allergy, while others require a prescription.
• Nasal antihistamines: A prescription nasal antihistamine spray, such as Azelastaine, can relieve symptoms of postnasal drip, congestion, and sneezing. These sprays start to work within minutes after use and can be used to treat symptoms after they develop. However, they are most effective when used on a regular basis. Medications generally well tolerated by older people are second-generation antihistamines, including loratadine, cetirizine, fexofendaine, desloratadine, and levoceterizine.
• Ipratropium bromide: This prescription nasal spray will help reduce rhinorrhea by decreasing mucus production. Ask your doctor for more information.

Over time, some people can stop or lower the dose of any nasal medications. However, in most people, your runny nose is here to stay, and you may be stuck taking medicine on a daily basis.

Learn more about how you can alleviate the symptoms of a runny nose. Visit UHealthClinics.com today.

Mary Jo Blackwood, RN, MPH, is a freelance medical and consumer health writer based in St. Louis, MO, and Colorado.