How to deal with exercise-induced rhinitis

What should you do if your runny nose starts to impede your cycling enjoyment? Andy Ward, a GP and cyclist – has the answers…

What is it?

Riding your bike can make your nose run – which is why cycling mitts come with a soft nose-wipe panel. While a dripping nose can be a bit embarrassing, exercise-induced rhinitis (EIR) can also cause congestion, sneezing, post-nasal drip and watery eyes. In one study, 40 per cent of athletes found that EIR adversely affected their performance.


In some cases, the cause is thought to be allergic, and vasomotor rhinitis has also been implicated. This is where increased blood flow to the nose causes it to produce a watery discharge. This can be triggered by air pollution, changes in the weather, alcohol, spicy food and stress. Symptoms are usually intermittent and the nose’s lining can appear bright red or purple.


Prevention through humidifying cold air can help – a buff pulled up over the nose on cold days is a good idea. Antihistamine nasal spray (Azelastine) is the usual first-line medical treatment. Failing that, a steroid nasal spray such as Beconase – available over the counter – can be effective. If there is an allergic element, antihistamines are useful. Decongestants in the form of drops (ephedrine or pseudoephedrine) can be used, but only for a maximum of seven days. More prolonged use can lead to rebound congestion on withdrawal. Pseudoephedrine in tablet form can also work, but it is banned by WADA in high doses. Unfortunately, unlike other causes of nasal symptoms, EIR does not seem to improve with increasing fitness… best keep wearing those mitts!

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