Allergic Rhinitis in Hong Kong

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.

What is allergic rhinitis?

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

How common is allergic rhinitis? Hong Kong vs the UK

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

	Hong Kong	United Kingdom
Adult prevalence	~25% of the general population¹	~26% of adults⁴
Children prevalence	~50% of schoolchildren¹	Up to 15% of children and adolescents⁴
Predominant allergen	House dust mites (year-round)²	Grass and tree pollen (seasonal)⁴
Symptom pattern	Perennial (all year)	Predominantly seasonal
Key environmental factor	Warm, humid climate; crowded indoor living	Temperate climate; high pollen seasons

Common causes of allergic rhinitis

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

Symptoms of allergic rhinitis

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

Why accurate diagnosis matters

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.

What to expect during an ENT examination

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:

Detailed history-taking: your symptoms, their timing, and any triggers you have noticed.
Anterior rhinoscopy: a straightforward examination of the inside of your nose using a speculum and light
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)
Allergy testing: skin prick testing or blood tests to identify specific allergens
Imaging: CT scans if structural issues or chronic sinusitis are suspected

Treatment options for allergic rhinitis

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

Treatment	How it works	Best suited for
Optimised medical management⁶	Prescription-strength intranasal corticosteroid sprays, combined antihistamine/steroid sprays, leukotriene receptor antagonists	Patients needing stronger or tailored medication combinations
Immunotherapy (sublingual)⁶	Daily tablets or drops placed under the tongue to gradually desensitise the immune system	Patients with identified specific allergens who prefer a non-injection approach
Immunotherapy (subcutaneous)⁶	Injections administered in a clinical setting over a course of treatment	Patients with identified specific allergens, administered under clinical supervision
Turbinate reduction⁷	Surgical procedure to reduce chronically swollen turbinates and improve nasal airflow	Chronic nasal obstruction not responding to medical treatment
Septoplasty⁸	Corrects a deviated nasal septum that worsens congestion	Structural contribution to nasal blockage

Frequently asked questions

Can allergic rhinitis be cured?

There is no outright cure, but symptoms can be very effectively managed. Immunotherapy is the closest available treatment to a long-term solution, as it can reduce sensitivity to specific allergens over time.

Is immunotherapy suitable for everyone?

Immunotherapy is most effective when specific allergens have been identified through testing. Your ENT specialist will assess whether it is appropriate based on your allergy profile, symptom severity, and overall health.

Why is allergic rhinitis worse in Hong Kong than in many other cities?

Hong Kong's warm, humid climate creates ideal conditions for house dust mites to thrive year-round.² Combined with dense urban housing and limited ventilation in many homes, allergen exposure tends to be high and constant rather than seasonal.²

Summary

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.

Dr Henry Pau

Otorhinolaryngology (ENT)

MBChB (Leic)
MD (Lpool)
FRCSEd, FRCSEd (ORL)
FRCS (Eng)

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References

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].
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.
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].
Gov.uk. (2025). 'Hay fever and airborne allergens.' Available at: https://www.gov.uk/guidance/hay-fever-and-airborne-allergens [Accessed: 19 August 2026].
NHS. (2026). 'Allergic rhinitis.' Available at: https://www.nhs.uk/conditions/allergic-rhinitis/ [Accessed: 14 August 2026].
Akhouri, S. and House, S.A. (2023). 'Allergic rhinitis.' StatPearls. Available at: https://www.ncbi.nlm.nih.gov/books/NBK538186/ [Accessed: 19 August 2026].
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.
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.