What is the recommended approach for mild persistent allergic rhinitis?

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In mild persistent allergic rhinitis, the mainstay of treatment is daily intranasal corticosteroids. They reduce nasal inflammation directly in the lining of the nose, addressing the core symptoms of congestion, sneezing, and itching with a favorable safety profile when used as directed. Systemic corticosteroids are not preferred because they carry more systemic side effects and are unnecessary for routine allergic rhinitis management. Nonpharmacologic steps, like avoiding known triggers (dust, pollen, pets, mold) and using saline nasal irrigation, support symptom control. Antihistamines (oral or intranasal) can be added to help with itch and sneezing, and decongestants may provide short-term relief for nasal congestion but are not intended for long-term control due to potential side effects and tachyphylaxis. Overall, daily intranasal corticosteroids form the foundation, with adjunctive therapies and environmental measures tailoring the plan to the individual.