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Complementary and alternative therapies for allergic rhinitis and conjunctivitis

Leonard Bielory, MD
Section Editor
Jonathan Corren, MD
Deputy Editor
Anna M Feldweg, MD


Complementary and alternative medicine (CAM) therapies for allergic rhinitis and conjunctivitis include Chinese herbal medicine (CHM), Ayurvedic medicine, other single and multiple herb preparations, acupuncture, homeopathy, and several other modalities. CAM therapies continue to gain popularity in the United States and throughout the world for the treatment of asthma and allergies.

This review is limited to those therapies about which there is published literature specifically concerning the treatment of allergic rhinitis/conjunctivitis. These therapies include traditional Chinese medicine (TCM), acupuncture, Ayurvedic medicine, a variety of herbal therapies, and several others.

CAM therapies for allergic rhinitis/conjunctivitis are discussed in this topic review. CHM for allergic diseases and CAM therapies for asthma are reviewed elsewhere. (See "Chinese herbal medicine for the treatment of allergic diseases" and "Investigational agents for asthma".)


Complementary and alternative medicine (CAM) is commonly defined as a group of diverse medical and healthcare systems, practices, and products that are not generally considered part of the conventional allopathic medical practices. Complementary therapies are used together with conventional allopathic medicine, while alternative therapies are used in place of conventional medicine. More general reviews of the principles of various CAM therapies are also found separately. (See "Overview of herbal medicine and dietary supplements" and "Complementary and alternative medicine in pediatrics" and "Acupuncture" and "Homeopathy".)

Popularity — More than 20 percent of the United States population appears to suffer from an atopic disorder, such as asthma, allergic rhinitis, and atopic dermatitis, and over 42 percent of people (both adults and children) have used CAM for their atopic disorder [1,2]. The popularity of CAM therapies for allergic disease is even greater in some European countries [3]. Thus, it is important to ask patients about the use of CAM therapies in a nonjudgmental manner [4].

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Literature review current through: Nov 2017. | This topic last updated: Sep 13, 2017.
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  1. Kapoor S, Bielory L. Allergic rhinoconjunctivitis: complementary treatments for the 21st century. Curr Allergy Asthma Rep 2009; 9:121.
  2. McClafferty H, Vohra S, Bailey M, et al. Pediatric Integrative Medicine. Pediatrics 2017; 140.
  3. Schäfer T. Epidemiology of complementary alternative medicine for asthma and allergy in Europe and Germany. Ann Allergy Asthma Immunol 2004; 93:S5.
  4. Kern J, Bielory L. Complementary and alternative therapy (CAM) in the treatment of allergic rhinitis. Curr Allergy Asthma Rep 2014; 14:479.
  5. Heimall J, Bielory L. Defining complementary and alternative medicine in allergies and asthma: benefits and risks. Clin Rev Allergy Immunol 2004; 27:93.
  6. Heimall J, Bielory L. Complementary and alternative therapy in treatment of allergic diseases. In: Allergy, Mahmoudi M (Ed), McGraw-Hill/Medical Publishing Division, 2007.
  7. Mainardi T, Kapoor S, Bielory L. Complementary and alternative medicine: herbs, phytochemicals and vitamins and their immunologic effects. J Allergy Clin Immunol 2009; 123:283.
  8. Li XM, Brown L. Efficacy and mechanisms of action of traditional Chinese medicines for treating asthma and allergy. J Allergy Clin Immunol 2009; 123:297.
  9. Yen HR, Liang KL, Huang TP, et al. Characteristics of traditional Chinese medicine use for children with allergic rhinitis: a nationwide population-based study. Int J Pediatr Otorhinolaryngol 2015; 79:591.
  10. Turner LA, Singh K, Garritty C, et al. An evaluation of the completeness of safety reporting in reports of complementary and alternative medicine trials. BMC Complement Altern Med 2011; 11:67.
  11. National Center for Complementary and Alternative Medicine. Expanding Horizons of Health Care: Strategic Plan 2005-2009. NIH publication no. 04-5568, National Center for Complementary and Alternative Medicine; NIH, Bethesda, MD 2005.
  12. Lee MS, Pittler MH, Shin BC, et al. Acupuncture for allergic rhinitis: a systematic review. Ann Allergy Asthma Immunol 2009; 102:269.
  13. Choi SM, Park JE, Li SS, et al. A multicenter, randomized, controlled trial testing the effects of acupuncture on allergic rhinitis. Allergy 2013; 68:365.
  14. Brinkhaus B, Ortiz M, Witt CM, et al. Acupuncture in patients with seasonal allergic rhinitis: a randomized trial. Ann Intern Med 2013; 158:225.
  15. Xue CC, An X, Cheung TP, et al. Acupuncture for persistent allergic rhinitis: a randomised, sham-controlled trial. Med J Aust 2007; 187:337.
  16. Ng DK, Chow PY, Ming SP, et al. A double-blind, randomized, placebo-controlled trial of acupuncture for the treatment of childhood persistent allergic rhinitis. Pediatrics 2004; 114:1242.
  17. Brinkhaus B, Witt CM, Jena S, et al. Acupuncture in patients with allergic rhinitis: a pragmatic randomized trial. Ann Allergy Asthma Immunol 2008; 101:535.
  18. Seidman MD, Gurgel RK, Lin SY, et al. Clinical practice guideline: Allergic rhinitis. Otolaryngol Head Neck Surg 2015; 152:S1.
  19. Reinhold T, Roll S, Willich SN, et al. Cost-effectiveness for acupuncture in seasonal allergic rhinitis: economic results of the ACUSAR trial. Ann Allergy Asthma Immunol 2013; 111:56.
  20. Ortiz M, Witt CM, Binting S, et al. A randomised multicentre trial of acupuncture in patients with seasonal allergic rhinitis--trial intervention including physician and treatment characteristics. BMC Complement Altern Med 2014; 14:128.
  21. Zhang CS, Xia J, Zhang AL, et al. Ear acupressure for perennial allergic rhinitis: A multicenter randomized controlled trial. Am J Rhinol Allergy 2014; 28:e152.
  22. Amit A, Saxena VS, Pratibha N, et al. Mast cell stabilization, lipoxygenase inhibition, hyaluronidase inhibition, antihistaminic and antispasmodic activities of Aller-7, a novel botanical formulation for allergic rhinitis. Drugs Exp Clin Res 2003; 29:107.
  23. Saxena VS, Venkateshwarlu K, Nadig P, et al. Multicenter clinical trials on a novel polyherbal formulation in allergic rhinitis. Int J Clin Pharmacol Res 2004; 24:79.
  24. Guo R, Pittler MH, Ernst E. Herbal medicines for the treatment of allergic rhinitis: a systematic review. Ann Allergy Asthma Immunol 2007; 99:483.
  25. The WHO publications are available through the WHO website. http://apps.who.int/medicinedocs/en/d/Js4927e/ (Accessed on January 03, 2013).
  26. www.ConsumerLabs.com (Accessed on January 04, 2013).
  27. Gardiner P. Dietary supplement use in children: concerns of efficacy and safety. Am Fam Physician 2005; 71:1068, 1071.
  28. Jackson CM, Lee DK, Lipworth BJ. The effects of butterbur on the histamine and allergen cutaneous response. Ann Allergy Asthma Immunol 2004; 92:250.
  29. Schapowal A, Study Group. Treating intermittent allergic rhinitis: a prospective, randomized, placebo and antihistamine-controlled study of Butterbur extract Ze 339. Phytother Res 2005; 19:530.
  30. Lee DK, Gray RD, Robb FM, et al. A placebo-controlled evaluation of butterbur and fexofenadine on objective and subjective outcomes in perennial allergic rhinitis. Clin Exp Allergy 2004; 34:646.
  31. Schapowal A, Petasites Study Group. Randomised controlled trial of butterbur and cetirizine for treating seasonal allergic rhinitis. BMJ 2002; 324:144.
  32. Aydın AA, Zerbes V, Parlar H, Letzel T. The medical plant butterbur (Petasites): analytical and physiological (re)view. J Pharm Biomed Anal 2013; 75:220.
  33. Cao Y, Colegate SM, Edgar JA. Safety assessment of food and herbal products containing hepatotoxic pyrrolizidine alkaloids: interlaboratory consistency and the importance of N-oxide determination. Phytochem Anal 2008; 19:526.
  34. WHO Pharmaceuticals Newsletter, 2012. No 4. http://apps.who.int/medicinedocs/documents/s19772en/s19772en.pdf (Accessed on January 03, 2013).
  35. Badar VA, Thawani VR, Wakode PT, et al. Efficacy of Tinospora cordifolia in allergic rhinitis. J Ethnopharmacol 2005; 96:445.
  36. Denis G, Gérard Y, Sahpaz S, et al. [Malarial prophylaxis with medicinal plants: toxic hepatitis due to Tinospora crispa]. Therapie 2007; 62:271.
  37. Chandrasekaran CV, Mathuram LN, Daivasigamani P, Bhatnagar U. Tinospora cordifolia, a safety evaluation. Toxicol In Vitro 2009; 23:1220.
  38. Corren J, Lemay M, Lin Y, et al. Clinical and biochemical effects of a combination botanical product (ClearGuard) for allergy: a pilot randomized double-blind placebo-controlled trial. Nutr J 2008; 7:20.
  39. Available in the United States as ClearGuard. Information available at: http://www.nutrilite.com/en-us/Science/NHI/BestOfScience/clear-guard.aspx? (Accessed on March 01, 2013).
  40. Sano M, Suzuki M, Miyase T, et al. Novel antiallergic catechin derivatives isolated from oolong tea. J Agric Food Chem 1999; 47:1906.
  41. Fujimura Y, Tachibana H, Maeda-Yamamoto M, et al. Antiallergic tea catechin, (-)-epigallocatechin-3-O-(3-O-methyl)-gallate, suppresses FcepsilonRI expression in human basophilic KU812 cells. J Agric Food Chem 2002; 50:5729.
  42. Maeda-Yamamoto M, Inagaki N, Kitaura J, et al. O-methylated catechins from tea leaves inhibit multiple protein kinases in mast cells. J Immunol 2004; 172:4486.
  43. Maeda-Yamamoto M, Ema K, Monobe M, et al. Epicatechin-3-O-(3″-O-methyl)-gallate content in various tea cultivars (Camellia sinensis L.) and its in vitro inhibitory effect on histamine release. J Agric Food Chem 2012; 60:2165.
  44. Masuda S, Maeda-Yamamoto M, Usui S, Fujisawa T. 'Benifuuki' green tea containing o-methylated catechin reduces symptoms of Japanese cedar pollinosis: a randomized, double-blind, placebo-controlled trial. Allergol Int 2014; 63:211.
  45. Chen Y. Efficacy of sodium cromoglicate eye drops combined with yupingfeng granules in the treatment of allergic conjunctivitis. Eye Sci 2013; 28:201.
  46. Blom HM, Van Rijswijk JB, Garrelds IM, et al. Intranasal capsaicin is efficacious in non-allergic, non-infectious perennial rhinitis. A placebo-controlled study. Clin Exp Allergy 1997; 27:796.
  47. Bernstein JA, Davis BP, Picard JK, et al. A randomized, double-blind, parallel trial comparing capsaicin nasal spray with placebo in subjects with a significant component of nonallergic rhinitis. Ann Allergy Asthma Immunol 2011; 107:171.
  48. In the United States, a product called Sinus Buster is available without a prescription.
  49. One such product available in the US and many other countries is called Nasal Ease.
  50. Josling P, Steadman S. Use of cellulose powder for the treatment of seasonal allergic rhinitis. Adv Ther 2003; 20:213.
  51. Emberlin JC, Lewis RA. A double blind, placebo-controlled cross over trial of cellulose powder by nasal provocation with Der p1 and Der f1. Curr Med Res Opin 2007; 23:2423.
  52. Åberg N, Dahl Å, Benson M. A nasally applied cellulose powder in seasonal allergic rhinitis (SAR) in children and adolescents; reduction of symptoms and relation to pollen load. Pediatr Allergy Immunol 2011; 22:594.
  53. Emberlin JC, Lewis RA. A double blind, placebo controlled trial of inert cellulose powder for the relief of symptoms of hay fever in adults. Curr Med Res Opin 2006; 22:275.
  54. Paz Lansberg M, DeTineo M, Lane J, et al. A clinical trial of a microcrystalline cellulose topical nasal spray on the acute response to allergen challenge. Am J Rhinol Allergy 2016; 30:269.
  55. A product called "Pollen Blocker" cream is manufactured by Dr. Theiss Alergol and available on line.
  56. Li Y, Wang D, Liu Q, Liu J. Randomized double-blind placebo-controlled crossover study of efficacy of pollen blocker cream for perennial allergic rhinitis. Am J Rhinol Allergy 2013; 27:299.
  57. Bufe A. A simple advice for the prevention of pollen-induced allergic rhinitis. Int Arch Allergy Immunol 2000; 121:85.
  58. Schwetz S, Olze H, Melchisedech S, et al. Efficacy of pollen blocker cream in the treatment of allergic rhinitis. Arch Otolaryngol Head Neck Surg 2004; 130:979.
  59. Geisthoff UW, Blum A, Rupp-Classen M, Plinkert PK. Lipid-based Nose Ointment for Allergic Rhinitis. Otolaryngol Head Neck Surg 2005; 133:754.
  60. Passalacqua G, Bousquet PJ, Carlsen KH, et al. ARIA update: I--Systematic review of complementary and alternative medicine for rhinitis and asthma. J Allergy Clin Immunol 2006; 117:1054.
  61. Weng Z, Zhang B, Asadi S, et al. Quercetin is more effective than cromolyn in blocking human mast cell cytokine release and inhibits contact dermatitis and photosensitivity in humans. PLoS One 2012; 7:e33805.
  62. Remberg P, Björk L, Hedner T, Sterner O. Characteristics, clinical effect profile and tolerability of a nasal spray preparation of Artemisia abrotanum L. for allergic rhinitis. Phytomedicine 2004; 11:36.
  63. Mittman P. Randomized, double-blind study of freeze-dried Urtica dioica in the treatment of allergic rhinitis. Planta Med 1990; 56:44.
  64. Takano H, Osakabe N, Sanbongi C, et al. Extract of Perilla frutescens enriched for rosmarinic acid, a polyphenolic phytochemical, inhibits seasonal allergic rhinoconjunctivitis in humans. Exp Biol Med (Maywood) 2004; 229:247.
  65. Burrow A, Eccles R, Jones AS. The effects of camphor, eucalyptus and menthol vapour on nasal resistance to airflow and nasal sensation. Acta Otolaryngol 1983; 96:157.
  66. Food and Drug Administration. Over-the-counter drugs. Final monograph for OTC nasal decongestant drug products. Federal Register 1994; 41:38408.
  67. Keh SM, Facer P, Yehia A, et al. The menthol and cold sensation receptor TRPM8 in normal human nasal mucosa and rhinitis. Rhinology 2011; 49:453.
  68. Liu SC, Lu HH, Cheng LH, et al. Identification of the cold receptor TRPM8 in the nasal mucosa. Am J Rhinol Allergy 2015; 29:e112.
  69. Volkner JH. [Inhalations of extracts from Gingko biloba in vasomotor rhinitis and in the bronchitic syndrome]. Dtsch Med J 1967; 18:527.
  70. Russo V, Stella A, Appezzati L, et al. Clinical efficacy of a Ginkgo biloba extract in the topical treatment of allergic conjunctivitis. Eur J Ophthalmol 2009; 19:331.
  71. Abenavoli L, Capasso R, Milic N, Capasso F. Milk thistle in liver diseases: past, present, future. Phytother Res 2010; 24:1423.
  72. Bakhshaee M, Jabbari F, Hoseini S, et al. Effect of silymarin in the treatment of allergic rhinitis. Otolaryngol Head Neck Surg 2011; 145:904.
  73. Toxicity. Milk thistle and indinavir. TreatmentUpdate 2002; 14:4.
  74. Doehmer J, Weiss G, McGregor GP, Appel K. Assessment of a dry extract from milk thistle (Silybum marianum) for interference with human liver cytochrome-P450 activities. Toxicol In Vitro 2011; 25:21.
  75. Bernstein DI, Bernstein CK, Deng C, et al. Evaluation of the clinical efficacy and safety of grapeseed extract in the treatment of fall seasonal allergic rhinitis: a pilot study. Ann Allergy Asthma Immunol 2002; 88:272.
  76. Khmel'kova NG, Makarova VL, Melent'eva EM, et al. [Does laser irradiation affect bronchial obstruction?]. Probl Tuberk 1995; :41.
  77. Faradzheva NA. [Efficiency of a combination of haloaerosols and helium-neon laser in the multimodality treatment of patients with bronchial asthma]. Probl Tuberk Bolezn Legk 2007; :50.
  78. Provotorov VM, Chesnokov PE, Kuznetsov SI. [The clinical efficacy of treating patients with nonspecific lung diseases using low-energy laser irradiation and intrapulmonary drug administration]. Ter Arkh 1991; 63:18.
  79. Zamotaev IP, Mamontova LI, Zavolovskaia LI, Rudakova OM. [Effect of laser acupuncture on the pulmonary vascular resistance in patients with obstructive chronic lung diseases]. Klin Med (Mosk) 1991; 69:68.
  80. Morton AR, Fazio SM, Miller D. Efficacy of laser-acupuncture in the prevention of exercise-induced asthma. Ann Allergy 1993; 70:295.
  81. Gruber W, Eber E, Malle-Scheid D, et al. Laser acupuncture in children and adolescents with exercise induced asthma. Thorax 2002; 57:222.
  82. Esaulenko IE, Nikitin AV, Shatalova OL. [The use of laseropuncture in patients with bronchial asthma and concomitant chronic rhinosinusitis]. Vopr Kurortol Fizioter Lech Fiz Kult 2009; :37.
  83. Nedeljković M, Ljustina-Pribić R, Savić K. Innovative approach to laser acupuncture therapy of acute obstruction in asthmatic children. Med Pregl 2008; 61:123.
  84. Tsai YL, Su CC, Lee HS, et al. Symptoms treatment for allergic rhinitis using diode laser: results after 6-year follow-up. Lasers Med Sci 2009; 24:230.
  85. Sandhu AS, Temple RH, Timms MS. Partial laser turbinectomy: two year outcomes in patients with allergic and non-allergic rhinitis. Rhinology 2004; 42:81.