What If You Were Told to Do Surgery for Your Allergy?

As a rhinologist, I often see patients struggling with nasal allergies—sneezing, congestion, runny nose, and itching—that significantly impact their quality of life. Most patients expect a solution in the form of medications, allergen avoidance, or immunotherapy, but occasionally, some ask: “Can surgery cure my allergy?”. The first thing to clarify is that allergic rhinitis (AR) is an immune-mediated condition, primarily driven by an overreaction to allergens like dust mites, pollen, or pet dander. It’s not a structural problem that surgery can “fix.” Unlike recurrent acute sinusitis, where surgery can physically remove disease, allergies involve systemic immune dysregulation that surgery cannot fundamentally alter.

When Is Surgery Considered?

There are cases where surgical intervention might be beneficial—not to cure allergies, but to alleviate symptoms caused by nasal obstruction and hypersensitivity. Surgery might be an option if:

You have persistent nasal congestion despite optimal medical therapy – In some patients, swollen turbinates or a deviated septum worsen airflow obstruction, making allergic symptoms more severe. Inferior turbinate reduction or septoplasty can help.
You experience recurrent acute sinus infections due to AR-related swelling – Frequent episodes of sinusitis triggered by allergic inflammation can lead to prolonged nasal obstruction and infection. In these cases, endoscopic sinus surgery (ESS) can help by improving sinus drainage.
Your rhinorrhea (runny nose) is excessive and resistant to medications – If medical therapy fails, procedures like posterior nasal nerve ablation or vidian neurectomy may reduce nasal secretions, especially in patients with mixed allergic and non-allergic rhinitis.

Conclusion:

If someone told me I needed surgery for my allergies, my first response would be: “What’s the goal?” Surgery does not treat the underlying allergic process—only immunotherapy or biologic medications can modulate the immune response. However, in patients with persistent nasal obstruction, recurrent acute infections, or severe rhinorrhea, surgical interventions may provide significant symptomatic relief.

Ultimately, surgery should be seen as a complement, not a cure, for allergic rhinitis. The best outcomes come from a tailored, multidisciplinary approach that combines medical therapy, environmental control, and, when necessary, carefully selected surgical intervention.

Asst.Prof. Wirach Chitsuthipakorn, MD.