As winter arrives, the sounds of sniffles echo in offices and classrooms, with sneezes and coughs all around.
—The flu is really rampant lately, and my nose is acting up too.
—Must be a chill. It’ll pass in a few days.
So, cold medicines and antiviral remedies come into play. Yet after three or four weeks of toughing it out, not only is there no improvement—the nose feels worse.
You might be overlooking one thing:
Winter is indeed the peak season for influenza, but it’s also the peak season for allergic rhinitis.
01
Why Is Rhinitis So Often Mistaken for the Flu in Winter?
The reasons are actually quite straightforward.
First, the symptoms are too similar.
Nasal congestion, runny nose, sneezing, and a foggy head—these symptoms aren’t exclusive to any single illness. Many people automatically assume they have a cold or the flu as soon as a runny nose appears. In fact, these are also the core symptoms of allergic rhinitis.
Second, the timing overlaps significantly.
Winter presents several factors that are particularly unfriendly to the nose:
Large temperature differences between indoors and outdoors cause frequent constriction and dilation of nasal blood vessels.
Heating and air conditioning dry out the air, weakening the mucosal barrier.
Concentrations of indoor allergens like dust mites and mold increase.
In such an environment, people with allergic tendencies are prone to having rhinitis triggered or worsened.
Third, awareness of rhinitis is insufficient.
Many still perceive rhinitis as: “Just nasal discomfort, not a real illness.”
So they endure and delay, leading to recurrent symptoms without ever treating it as a problem that needs addressing.
02
The Flu vs. Allergic Rhinitis: An Invasion vs. a Misunderstanding
To distinguish between the two, it’s essential to understand their nature.
The flu is a “viral invasion.”
The influenza virus invades your body, triggering your immune system to sound the alarm and fight back fiercely, resulting in systemic reactions, including high fever and severe pain.
The flu is a “full-body assault.” It strikes suddenly without warning—you might feel fine in the morning but be bedridden by the afternoon.
You’ll feel “like you’ve been hit by a truck”: high fever (often above 38.5°C), headache, muscle and joint pain, extreme fatigue, and difficulty even getting out of bed. Coughing and sore throat may also occur, but systemic symptoms far outweigh nasal ones.
However, it strikes hard and leaves relatively quickly. The acute phase lasts about 3–5 days, though fatigue may linger for weeks.
Allergic rhinitis is an “immune misunderstanding.”
Your body mistakes harmless substances (like pollen or dust mites) for enemies, releasing chemicals like histamine to attack, causing an exaggerated response in localized areas like the nose and eyes.
Allergic rhinitis is a “rebellion of the senses.” Symptoms erupt quickly after exposure to triggers, such as entering a garden, cleaning a room, or encountering pets.
You’ll feel like “your nose and eyes are rebelling”: sudden bouts of sneezing, uncontrollable clear runny nose, intense itching in the nose, eyes, and throat, along with possible tearing and red eyes. A key point: no high fever, and energy levels remain largely normal.
It recurs endlessly, persisting as long as the allergen is present (e.g., throughout pollen season).
Simply put, the flu is an acute infection requiring vigilance, while allergic rhinitis is a chronic inflammation requiring management.
03
What Happens If Rhinitis Is Left Untreated?
The nose isn’t an isolated structure. Surrounding the nasal cavity are sinuses like the maxillary, ethmoid, and frontal sinuses, which rely on clear nasal passages for drainage and ventilation.
When allergic rhinitis is left uncontrolled, the nasal mucosa remains swollen, secretions increase and thicken, and the sinus openings become repeatedly blocked.
Over time, stagnant secretions allow inflammation to take root in the sinuses, gradually developing into sinusitis.
This is why many sinusitis patients trace their history back to a case of untreated rhinitis.
This isn’t a rare issue. According to the “Chinese Guidelines for the Diagnosis and Treatment of Allergic Rhinitis,” the prevalence of allergic rhinitis in China is approximately 17%–20%.
Among these cases, a significant proportion develop complications like sinusitis, sleep disturbances, and attention deficits due to prolonged poor control.
04
When in Doubt, Remember This Three-Step Approach
Of course, an accurate diagnosis requires professional evaluation.
Especially if symptoms recur or affect sleep, work, and quality of life, getting a clear diagnosis early is far more important than toughing it out.
Step 1: Preliminary Self-Assessment
Use the knowledge above to calmly analyze your symptoms.
Step 2: Recognize Warning Signs
Suspected flu, especially with high fever and systemic symptoms.
Severe symptoms unrelieved by self-medication.
Difficulty breathing, chest pain, ear pain, or yellow-green thick nasal discharge accompanied by facial pressure or pain (possible sinusitis).
If any of these occur, or if you’re unsure and concerned, seek medical help immediately.
Step 3: Seek Professional Diagnosis
An ENT specialist can clarify the diagnosis through:
High-definition nasal endoscopy: A clear, direct view of whether the nasal mucosa is pale and swollen (typical of allergies) or congested, and the state of sinus drainage.
Allergen testing (if needed): Pinpoint the exact triggers via skin prick tests or blood tests.
Sinus CT scan (if needed): A comprehensive assessment of sinus conditions, the gold standard for diagnosing sinusitis.
Winter is harsh on the respiratory system.
Influenza, allergies, dry cold, and temperature swings all challenge our noses.
If you mistake rhinitis for the flu and tough it out, the toll on your body may be greater than imagined.
Understanding the true cause behind your symptoms is the responsible choice for your health.
