Scope of Care · A
Allergic rhinitis
Last updated: 2026-09-20 · Prepared by licensed TCM physicians · Updated 2026-09
Key Points
Allergic rhinitis is an over-reaction of the nasal lining to allergens (pollen, dust mites, pet dander), causing sneezing bouts, watery runny nose, itching and congestion.
- Affects roughly 10-20% of the population worldwide; commonest in children and young adults
- Classic four symptoms: sneezing, clear discharge, nasal itching, congestion — often with itchy, watery eyes
- Two forms: seasonal (hay fever) and perennial (dust mites, moulds)
- Acupuncture is listed among WHO indications, with comparatively solid clinical evidence
First, what cannot wait
- After allergen exposure: difficulty breathing, wheeze, swelling of face or throat — possible anaphylaxis, call emergency services
- One-sided nasal obstruction steadily worsening with bleeding — structural disease must be ruled out
- Chest tightness, wheezing or night-time cough — possible asthma
- Purulent discharge, facial pressure, reduced smell — possible sinusitis
- Chronic congestion disturbing sleep and daytime function warrants systematic assessment
Understanding the Condition
Allergic rhinitis is not "weak immunity" — it is the immune system on excessive alert to harmless substances. On allergen contact, the nasal lining releases histamine and other mediators, producing bouts of sneezing, a relentless clear discharge, and nose and eyes that itch more the more you rub them.
It may look minor, but left unmanaged it erodes sleep, concentration and quality of life — and it is a major risk factor for asthma: roughly one in three patients with allergic rhinitis has, or develops, asthma.
Why It Keeps Coming Back
Conventional options are limited: allergen avoidance (near-impossible for dust mites) and antihistamines or nasal steroids, which stop working once discontinued. For many, control remains patchy.
Beyond suppressing symptoms, another layer is often ignored: why, in the same environment, do some people react violently while others do not? That constitutional question is where TCM steps in.
Our Pattern-Based Approach
TCM calls allergic rhinitis "bi qiu" (nasal snivelling). The core mechanism is insufficiency of yang qi in the lung, spleen and kidney, leaving the exterior unguarded so wind-cold or foreign qi invades the nose. Common patterns: lung qi deficiency with cold — sneezing at the first cold breeze with watery discharge; lung-spleen qi deficiency — marked congestion, fatigue, loose stools; kidney yang insufficiency — pronounced cold intolerance, year-round symptoms, worst on waking.
Acupuncture commonly uses Yingxiang (LI20), Fengchi (GB20) and Yintang to open the nose, with Feishu (BL13), Pishu (BL20), Zusanli (ST36) and Gaohuang (BL43) to strengthen lung and spleen. For winter-predominant sufferers, herbal patching (sanfu tie) on Feishu, Dingchuan and related points during the hottest summer days is a classic supportive approach. The goal: fewer, milder episodes and less reliance on medication.
Common patterns and treatment directions
| Pattern | Typical presentation | Approach |
|---|---|---|
| Lung qi deficiency with cold | Flares in cold wind, bouts of sneezing, profuse watery discharge, nasal itching, chilliness, frequent colds | Warm the lung, dispel cold, consolidate the exterior and open the nose: Yingxiang (LI20), Fengchi (GB20), Feishu (BL13), Fengmen (BL12), gentle moxa on Dazhui (GV14) |
| Lung-spleen qi deficiency | Marked congestion, copious clear discharge, fatigue, poor appetite, loose stools, pale complexion | Tonify lung and spleen: Zusanli (ST36), Pishu (BL20), Feishu (BL13), Gaohuang (BL43) — gentle reinforcing needling with moxibustion |
| Kidney yang insufficiency | Year-round symptoms worst on waking, aversion to cold, cold limbs, sore lower back, frequent night urination | Warm kidney yang and consolidate: Shenshu (BL23), Mingmen (GV4), Guanyuan (CV4) with moxa; a key constitution type for sanfu patching |
| Accumulated heat invading the nose | Yellowish or sticky discharge, burning dryness in the nose, dry mouth, itchy throat, red tongue | Clear and vent accumulated heat: Hegu (LI4), Yingxiang (LI20), Lieque (LU7); reduce moxa, keep the diet light |
Patterns are determined in person. This list is for orientation only and is not a self-diagnosis tool.
The Evidence
- A Cochrane systematic review of randomised trials of acupuncture (needle and moxibustion) for allergic rhinitis suggested improvement in symptom scores versus sham acupuncture or medication controls, though the authors note the quality of included studies is limited and more high-quality trials are needed.
— Cochrane Database of Systematic Reviews — Acupuncture for allergic rhinitis - Allergic rhinitis appears on the WHO indication list for acupuncture.
— WHO, Acupuncture: Review and Analysis of Reports on Controlled Clinical Trials
What to expect: first visit to follow-up
- First visit · about 40 minutesBring allergy-test results and your medication list. We map the rhythm and triggers of your symptoms, read pulse and tongue, establish the pattern — and screen for asthma, referring for spirometry if indicated.
- Plan discussion · same dayWe explain the working diagnosis, point selection, treatment frequency, whether sanfu patching is appropriate, and the key avoidance measures; prescribed nasal sprays and antihistamines continue in parallel.
- Weeks 1-4One to two acupuncture sessions weekly, plus home saline rinsing and avoidance measures; you log weekly symptoms.
- Week 4-8 · first reviewFrequency, severity and medication use are compared against baseline to decide: consolidate, adjust points, or lengthen intervals into maintenance.
Course of care and follow-up
- Evaluation runs in 4-8 week cycles; once stable, maintenance every 2-4 weeks
- Seasonal sufferers: intensive care starting 4-6 weeks before the season, adjusted as needed during it
- Annual review of allergen status and constitution; pattern plans updated accordingly
- Coordinated care with ENT/respiratory physicians — never stop nasal steroids or antihistamines on your own
When to Seek Care
Before your visit:
- Get allergy testing to clarify what to avoid (dust mites: hot-wash bedding weekly, control humidity)
- In pollen season keep windows shut, wear a mask outdoors, wash face and rinse nose on returning home
- Use prescribed nasal steroids or antihistamines regularly during flares — not on-and-off
Consider an in-person consultation if:
- Year-round or worsening symptoms despite self-management
- Asthma warning signs: chest tightness, wheeze, night-time cough
- Medication controls symptoms poorly and you wish to reduce reliance on it
Supportive Care
- Dust-mite avoidance first: weekly hot-water bedding wash, no carpets or plush toys in the bedroom
- Saline nasal rinse morning and evening — cheap and genuinely useful
- If cold air triggers symptoms, keep the neck and upper back warm; move indoors a few minutes before going out
- For seasonal patterns, start constitutional care 1-2 months before your season begins
FAQ
How long does a course of acupuncture take?
Typically 1-2 sessions weekly for 4-8 weeks as one evaluation cycle, then maintenance as needed. For seasonal symptoms, start about 4-6 weeks before your usual season. We promise no "cure" — outcomes are judged by frequency, severity and medication use.
Are the summer herbal patches (sanfu tie) actually useful?
Patching during the hottest summer days is a traditional supportive measure for respiratory conditions that flare in winter, suited to cold-sensitive constitutions with yang insufficiency. It is adjunctive — it never replaces allergen avoidance or prescribed medication — and suitability is judged in person.
Want your situation assessed? Book a consultation.
Prepared by licensed TCM physicians · Updated 2026-09
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