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Warm, red and swollen nose. Can allergy cause this? Can anxiety worsen the condition? Related to urticaria?

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Warm and Red Nose

I have been experiencing a warm, red and swollen nose from time to time. At first my nose would only turn red and warm after coming inside from cooler weather to a warm environment. Now it is happening randomly during the day and night (especially when I lie down to go to sleep).

I have very bad seasonal allergies and right now hayfever is in full bloom where I live and I am assuming that this is allergies but am not sure. (I do get allergy shots every 2 weeks). This past weekend I went to the emergency room because my nose was hurting so much. The ER doctor looked up my nose and said that it is very, very swollen and that my turbinates are almost touching. I asked him why my nose turns red when I change temperatures and he said that it is likely a vasomotor response. He prescribed me a 10 course of steroids.

1. Can allergies make the outside of your nose turn red and cause it to be swollen? Why does it happen randomly throughout the day? I asked the ER doctor if it could possibly be rosacea and he said no. I am just trying to understand what is happening.

2. When my nose is not warm or red, it seems that it is very cold. There does not seem to be a "normal temperature" going on with my nose. It is almost like my nose is having trouble regulating its temperature and is very sensitive to everything. Also, it seems that when I exert myself or get warm, my nose turns red. I guess that could be a normal reaction though? I asked this question in the, "Allergy community" and another doctor responded saying that my cold nose could be Raynaud's but what about the warmness and redness that occurs? Is that Raynaud's as well? my hands and feet do get cold from time to time and sometimes my feet will turn a dark red or purple color when I am nervous or cold.

3. I am experiencing a lot of anxiety over my red nose and am wondering if that is actually worsening the red flushed nose?
4. I also have dermographic urticaria. Could this all be related?

Thank you!
Posted Sat, 21 Apr 2012 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Naveen Kumar 7 hours later
Hi

Thanks for the query

Nasal blushing or Red nose is one of the commonest symptoms of allergy, alcohol consumption, skin irritation, prolonged exposure to cold temperatures, infection, rhinophyma (large, bulbous reddened nose due to unknown cause), etc.

Q: Can allergies make the outside of your nose turn red and cause it to be swollen? Why does it happen randomly throughout the day?
A: Yes, Allergic Rhinitis (Hay fever) in some individuals can cause swelling and redness of the nose because of the vasomotor stimulation and retention of the blood in the capillaries. The randomness depends on the factors stimulating the vasomotor reflex such as change of temperature, stress, dust, etc.

Q: Is that Raynaud's as well? my hands and feet do get cold from time to time and sometimes my feet will turn a dark red or purple color when I am nervous or cold.
A: The possibility of Raynaud's phenomenon cannot be ruled out, but to confirm this you will have to undergo few tests such as vascular ultrasound and a cold stimulation test.

Q: I am experiencing a lot of anxiety over my red nose and am wondering if that is actually worsening the red flushed nose?
A: As I have mentioned above, even emotional upset can cause blushing of the nose but it is usually transient and disappears once the stimulation is gone.

Q: I also have dermographic urticaria. Could this all be related?
A: Dermographism is also an allergic condition and nasal allergy (Hay fever) too is a part of it. Yes, all of these conditions are inter-related.

To sum it up, the blushing and intermittent swelling of your nose could be mainly due to allergic related problem. Acne Rosacea is a condition associated with intermittent facial flushing or blushing, sometimes with burning sensation, red bumps, and small cysts. And, Rosacea evolves in various stages with inflammation of the skin over the forehead, cheeks, nose, and chin. Rhinophyma is ruled out as there is retention of fluid and increased thickness of the skin.

I would suggest you to consult a good ENT specialist for a thorough examination and appropriate management.

Hope I have answered your query; I will be available for the follow-up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
 
Follow-up: Warm, red and swollen nose. Can allergy cause this? Can anxiety worsen the condition? Related to urticaria? 3 days later
Dear Dr. XXXXXXX

Thank you for your response, it is helpful. My nose will often be painful inside like it is burning. Do you know what would be causing the pain? It is not all of the time, just occasional. It will feel dry and swollen inside. It especially burns if I am outside breathing in cool air. Sometimes it will turn red and get stuffy when I lie down to go to sleep; I suppose that is from the blood rushing to my face because I am lying down?

So I should not be worried about the transient redness of my nose? It seems to worsen if I am thinking or anxious about it. I can often make myself blush just by looking in the mirror and feeling anxiety about it.

Also, it is possible to have non-allergenic rhinitis and allergenic rhinitis at the same time?

Thank you again for your help!

Sincerely,
XXXXXXX
 
 
Answered by Dr. Naveen Kumar 1 hour later
Hi

Welcome Back

Q: My nose will often be painful inside like it is burning. Do you know what would be causing the pain?

A: The burning sensation inside the nose could be due to the drying of the nasal mucosa secondary to either Allergic Rhinitis or exposure to cold/hot climate. It so happens that after a brief exposure to the extremes of the climate, there is drying of the nasal mucosa leading to irritation of the nerve endings which is perceived as burning sensation. The same thing does happen in the case of Allergic Rhinitis also either because of excessive sneezing or running nose which drains of the moisture content from the mucosa leading to dryness and irritation of the mucosa.

Q: Sometimes it will turn red and get stuffy when I lie down to go to sleep; I suppose that is from the blood rushing to my face because I am lying down?

A: On lying down, there is reduced pooling of the blood in the extremities and distributed evenly to all parts of the body including the face, hence there will be nasal congestion leading to nasal block. Also, the dust on the pillow cover can lead to nasal stuffiness particularly in those individuals who are having allergy related problems. When the dust is inhaled there is stimulation of the nasal mucosa, because of which allergic mediators such as histamine is produced leading to stuffiness of the nasal mucosa.

Q: So I should not be worried about the transient redness of my nose?

A: Please, do not worry about the transient blushing of the nose, as it is natural to notice the redness during anxiety and allergic episodes. Well, you need to just keep a watch for any pimple like eruptions following blushing as it can be lead to Acne Rosacea.

Q: Also, it is possible to have non-allergenic rhinitis and allergenic rhinitis at the same time?

A: It is very unlikely to have both at the same time, the best differentiating feature is that, non-allergic rhinitis does not effectively reduce with an antihistaminic.

Wish you good health.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
 
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