Rhinitis: Why am I sensitive to cold air?

I am acutely sensitive to cold air. The effects are immediate and the colder the air the worse things are. I flinch on exposure to the cold at this time of year as if sniffing smelling salts. This is followed by a thumping headache and painful soreness in the eyes and nostrils. Further exposure can result in heavy nasal congestion and pain spreading all around my eyes, jaws and teeth. I am confined to the house from October to June and even in summer have to be wary of air-conditioning. The problem started after a spell in hospital due to pneumonia and a pulmonary embolism. Can you offer any help as to what it might be, what has caused it and what can be done?

Dr Fred Kavalier answers your health question:

Inhaling cold air is sometimes a trigger that sets off asthma in young children. Occasionally it is the first indication that a child is going to get asthma later in life. And some people who have very sensitive teeth notice pain in the teeth if they inhale cold air. Your symptoms suggest a condition called cold air-induced rhinitis, or non-infectious, non-allergic rhinitis (Ninar).In people who suffer from this problem, the lining of the nose produces an excess of certain chemical substances when it is exposed to cold, dry air. The reaction is similar to an allergic reaction to dust or pollen, but it occurs in response to cold air, rather than to something that you are allergic to. The symptoms tend to be like sinus problems, with pain around the nose and eyes.There have been some experiments treating this with a nasal spray that contains capsaicin (one of the substances that makes peppers hot). This seems to help the problem, but unfortunately the spray is not commercially available. You might get some help from an allergy specialist, if you can find one.Send questions and suggestions to A Question of Health, 'The Independent', Independent House, 191 Marsh Wall, London E14 9RS; fax 020-7005 2182; or e-mail health@independent.co.uk. Dr Kavalier regrets that he is unable to respond personally to questions.

Please mail your questions for Dr Fred to health@independent.co.uk. He regrets that he is unable to respond personally to questions.