Clear Runny Nose: What’s Causing It?

1. Common cold

Symptoms

• Runny nose
• Sneezing
• Congestion
• Post-nasal drip
• Sore throat

The common cold is one of the most frequent causes of a runny nose. There are more than 200 viruses that can cause colds. Most children and adults get a few each year. Typically, a cold will resolve on its own without treatment.

Sometimes, the virus can cause inflammation in the sinuses, leading to sinusitis. Like a cold, you may have a runny nose and nasal congestion. But the drainage tends to be thicker and colored, and can cause facial pain.

Try nasal saline rinses to clear out mucus. Taking decongestants, for a short time, can help relieve stuffiness. Antibiotics aren’t needed to treat a cold—they aren’t effective against viruses.

2. Allergic rhinitis

Symptoms

• Clear nasal discharge (runny nose)
• Sneezing
• Itchy, watery eyes
• Itchy nose
• Nasal congestion (stuffy nose)

Allergic rhinitis is another common cause of a clear runny nose. Allergens like dust, pollens, animal danders, and molds enter the nose and can stimulate the allergy cells that line the airway. These cells release several substances, such as histamine, that cause blood vessels to leak and produce the watery discharge—a runny nose. It’s often accompanied by sneezing and itchy, watery eyes.

There are two types of allergic rhinitis: seasonal allergies and perennial (year-round) allergies. Seasonal allergies are caused by pollens and molds that occur during certain times of the year. Year-round allergies are caused by triggers like dust or animal danders.

There are many treatments for allergies. You can do allergy testing to help identify what you’re allergic to. Then you can try to avoid the triggers.

When that’s not possible, medications can also help.

• Over-the-counter nasal steroid sprays treat a runny nose and other allergy symptoms.
• Over-the-counter and prescription antihistamines are used to help with sneezing and itching.
• For more severe allergy sufferers, allergy shots may be used. They can help improve or sometimes even get rid of allergies.

3. Non-allergic rhinitis

Symptoms

• Runny nose
• Sneezing
• Congestion
• Postnasal drip

Nonallergic rhinitis is a broad term used to describe any kind of rhinitis that isn’t caused by allergies. The distinction is important, since allergies involve the immune system, while nonallergic rhinitis does not. If you have allergy-like symptoms, but your allergy testing is negative, you likely have a form of non-allergic rhinitis.

There are many causes of nonallergic rhinitis, though sometimes, a cause can’t be identified at all. Common causes include:

• Cold weather
• Exercise
• Side effects of medications
• Hormonal changes such as during pregnancy
• Eating spicy foods
• Pollution or smoke

In some cases, like in pregnancy, a runny nose will resolve on its own, while in other cases, you might need treatment if the symptoms continue to bother you. If your symptoms are occurring frequently, medications might be the next step.

Treatments include nasal steroid sprays, nasal antihistamine sprays, and a medication called ipratropium (which can help dry up mucus).

Other possible causes of clear runny nose

While a runny nose is typically a harmless condition, there are a few times when a runny nose might be a sign of something more serious:

• Cerebrospinal fluid (CSF) leak: CSF is a watery fluid that surrounds and protects your brain and spinal cord. If the membrane holding the CSF in place is damaged, like after a head injury, it can drain into the nostril and appear like a runny nose. CSF leaks usually affect only one nostril, while other causes of a runny nose affect both equally. 
• Autoimmune diseases: Autoimmune diseases occur when the immune system identifies the body’s own tissues as a threat, leading to inflammation. Some of these disorders involve the nose and the sinuses. One example is Churg-Strauss syndrome, which can lead to sinus inflammation. However, people with autoimmune diseases have multiple symptoms, not just a runny nose.

When to call the doctor

A runny nose from a viral infection usually gets better on its own. However, if you start running a fever, notice colored or thick drainage, or your symptoms haven’t improved on their own, call your doctor. You might have a bacterial infection, which will need to be treated with antibiotics.

You may also want to see your doctor if you’re not sure what’s causing your runny nose. By discussing your history of symptoms and possibly being tested for allergies, you may be able to identify the cause.

If over-the-counter remedies aren’t working, the doctor can also discuss prescription options.

When to go to the ER for a clear runny nose

Call 911 or go directly to the ER if you have a severe headache with clear drainage from one nostril, especially after a head trauma. It could be a sign of a cerebrospinal fluid leak.

Treatments

At-home care

The following treatments can help treat a runny nose, depending on its cause:

• Saline sprays and rinses: If your runny nose is caused by a cold, a gentle saline spray or rinse can help flush excess mucus out of your nose and make it easier to breathe.
• Nasal steroid sprays: These are first-line treatments for allergies. When used daily, they can help prevent a runny nose. Nasal sprays may also relieve sneezing and congestion.

Other treatment options

• Antibiotics if you develop a bacterial infection.
• Allergy testing, either through a skin prick test or blood test.
• Prescription medications if over-the-counter options are not effective.

FAQs about runny nose

Here are some frequently asked questions about runny nose.

Why is my nose runny in the morning?

A runny nose (rhinorrhea) in the morning is often caused by allergic rhinitis. Allergic rhinitis is swelling of the mucus membranes and production of mucus because of exposure to some sort of allergen while you are sleeping. This could be anything from dust to dust mites to pollen to the waste of rodents or roaches.

When is a runny nose contagious?

Runny noses (rhinorrhea) are contagious when they are associated with a cold, that is to say when they are not allergic or the product of cold weather. This means that if you have other signs of a cold or a flu including a fever, chills, or a sore throat your runny nose may be contagious.

What does it mean when your nose runs clear liquid?

This is a sign of a runny nose (rhinorrhea) and is the normal drainage. Clear nasal fluid is common in cold weather. Other types of runny noses caused by allergy or infection may also run clear or be colored depending on the specific cause of the nasal discharge.