Alternative therapies
Nasal saline irrigation has long been perceived as an adjunct treatment for rhinitis, although efficacy was only recently documented in a meta-analysis with no reported adverse reactions [121]. Recently, a real life study in children showed significant improvement of AR symptoms and reduction of medications, as these were assessed by VAS and CARAT, when nasal irrigation was added to standard treatment [122].
Use of nasal filters in AR adults with grass allergy during a natural in season exposure, provided significant efficacy, by means of improved nasal symptom score, while safety and usability were also documented [123]. It is however uncertain whether such intervention may be tolerable in children. In respect to other ‘alternative’ treatments, acupuncture has moderate to high evidence of efficacy for the treatment of subjects with rhinitis, while butterbar has shown showed moderate beneficial effects on AR symptoms [124]. Capsaicin is efficient for the treatment of non-AR in adults; however pediatric studies are lacking [125].