Allergic rhinitis and Nazla Haar: An integrative review of Unani perspectives

Allergic rhinitis (AR) is a common immunoglobulin E (IgE)-mediated hypersensitivity disorder characterized by nasal congestion, sneezing, rhinorrhea, and itching, often triggered by allergens such as pollen, dust mites, and animal dander. In modern medicine, the pathophysiology of AR involves an exaggerated immune response to harmless antigens, with mast cell activation and subsequent release of histamines and cytokines. Diagnosis is based on clinical presentation and allergy testing, while treatment includes antihistamines, intranasal corticosteroids, and immunotherapy. In the Unani system of medicine, AR is closely associated with diseases caused by sue mizaj barid wa ratab (abnormal cold and moist temperament) or nazla harr wa barid and is often equated with nazla or zukaam. It is considered a result of deranged humors (particularly balgham) and the accumulation of morbid matter in the nasal passages. Management in Unani involves ilaj bil ghiza (dietotherapy), ilaj bil dawa (pharmacotherapy), and ilaj bil tadbeer (regimenal therapy), using herbal formulations such as joshanda, tiryaq-e-nazla, and decoctions of expectorant, anti-inflammatory, and immunomodulatory herbs. Unani therapies emphasize restoring humoral balance and strengthening immunity. This integrative review highlights the need for a holistic approach in managing allergic rhinitis by combining the evidence-based strategies of modern medicine with the individualized, temperament-based treatments of Unani medicine, thereby enhancing patient outcomes and promoting long-term relief.