Ask Dr. H: Why do our noses run?

Question:

Why does cold air make my nose run? I don't think it's from a cold, because it happens within minutes of my being out in the cold air.

Answer: Your nose isn't running from a cold. Or from allergies.

It's running to escape a particular irritant. For you, it's cold, dry air; for others, it may be perfume, cigarette/cigar smoke, or other noxious odor.

This common condition is called "vasomotor rhinitis." Nasal tissues swell, often weeping varying amounts of watery nasal discharge in response to some sort of irritant.

Vasomotor rhinitis seems to be due to an imbalance between the nerves that trigger the mucous glands in the nose to secrete fluid and make the blood vessels of the nose swell and constrict. If there's any particular value to this reaction, it might be to alert us of something undesirable and noxious, with a swollen, weeping nasal lining created to block and wash away an irritant.

There's no cure for it, except for avoiding exposure to the particular nasal irritant. Cover your face with a scarf when outdoors.

The leading treatments for the ongoing runny nose and congestion are nasal steroid sprays like Flonase or Nasonex to reduce tissue swelling and Atrovent nasal spray to dry up the runny nose. Afrin and Neo-Synephrine are tempting over-the-counter treatments, but avoid them; they'll work briefly but cause a rebound swelling of the nose that will worsen matters.

nolead begins

Q:

What causes cataracts? Is there anything besides surgery that can be done to treat them?

A: Cataract formation is a clouding of the lens that reduces light transmission and the ability to see. The vast majority of cataracts occur in older people, developing slowly over a number of years. About half of those 65 or older have some degree of cataract formation; roughly 70 percent of those older than 75 have significant cataracts that require treatment.

Besides advancing age, other factors attributable to the formation of cataracts include: long-term exposure to bright sunlight; diabetes; long-term use of steroids; prior history of eye injury; history of chronic eye inflammation; lead exposure; and a family history of cataracts.

While the usual treatment of mild cataracts is use of brighter light and improved eyeglasses, more bothersome cataracts in the United States are treated with surgical removal of the clouded lens and replacement with a clear synthetic lens.

But there are nonsurgical strategies to prevent and treat mild cataracts. For example, there's a nonprescription treatment for mild cataracts in the form of an eye drop that has been used in China, Japan, and nearly 40 other countries for nearly 60 years. Developed in China, pirenoxine (brand name Catalin) has many reports of happy customers but few actual patient studies.

In Switzerland, Alcon Pharmaceuticals markets Quinax as a treatment for cataracts (also sold throughout Eastern Europe, Hong Kong, and Singapore). In Russia, N-acetylcarnosine is sold as a treatment for cataracts under the brand name Can-C.

I cannot speak to the efficacy of any of these products, but I wonder if the potential economic threat of such products to the bottom line of ophthalmologists and replacement-lens manufacturers has impeded the evaluation of these products in the United States.