October 24, 2021
Perennial allergic rhinitis (PAR) is a significant health problem, which can significantly affect patient's quality of life. The main symptoms of Allergic rhinitis are nasal congestion, nasal itch, rhinorrhea, and sneezing. Perennial allergic rhinitis is very common in Western countries, affecting 20–30% of the population, and evidence suggests that the prevalence of the disorder is increasing.
Allergic rhinitis impairs quality of life, sleep, and social activities. It is a significant cause of reduced productivity at work and absence from school. Also, poor sleep quality may cause daily drowsiness. The impact is correlated with the severity of symptoms.
The guidelines for treatment are based on the frequency, duration, and severity of symptoms. Since the treatment goal is the relief of symptoms and reduction of their impact on quality of life, it is recommended to use different pharmacological treatments, which can be increased step by step according to disease severity. Antihistamines and intranasal corticosteroids are the most frequently prescribed drugs for relieving allergic rhinitis symptoms and are recommended as the first-line therapy, either alone or in combination.
However, to achieve maximum benefit and relief, nasal corticosteroids should be used continually for 3–4 weeks, thus underlining the importance of patient adherence. Indeed, adherence is imperative in the management of AR, and lack of adherence can be an obstacle to effective treatment. One reason for non-adherence is that, although intranasal corticosteroids are the most effective pharmacotherapy for AR, their overall efficacy is moderate, and most patients are concerned about long-term steroid treatment. Another common reason is the bothersome side effects, including nasal dryness, burning, stinging, sneezing, and bleeding.
Aromatherapy, especially the direct inhalation of aroma compounds of essential oil (EO) fragrance, has long been used for various inflammatory diseases. Recently, EOs containing monoterpenes have shown an anti-inflammatory effect in treating patients with AR. A clinical study found that an intranasal spray consisting of hypertonic seawater, rosemary floral water, and the essential oils ravintsara, geranium, eucalyptus (E. radiata), and niaouli improved symptoms of PAR.
Forty-three patients (33 women and 10 men) were recruited during a follow-up visit to the outpatient allergy clinic of 3 academic hospitals: 2 located in France (18 and 12 patients) and 1 in Belgium (13 patients). . All patients were over 18 years of age and diagnosed with AR. All patients used Puressentiel® Respiratory-Decongestant Nasal Spray which is a combination of hypertonic seawater and organic rosemary floral water with 4 EOs (ravintsara, geranium, eucalyptus radiata, and niaouli).The nasal spray was used twice daily for four weeks (2 sprays in each nostril morning and evening, every day at 8 a.m. and 8 p.m.).
The current study showed the excellent tolerance of a nasal spray of hypertonic saline and EOs and found an association between its use and the reduction of symptoms in patients with PAR. A hypertonic EO-based nasal spray could be a new and natural option in the management of PAR. It could also be used as an add-on therapy when nasal symptoms are not fully controlled.