Sauna for allergic rhinitis
Evidence review
Overview
In a small randomized trial of Thai adults with skin-test-confirmed allergic rhinitis, 6 weeks of sauna sessions 3 days per week increased peak nasal inspiratory flow and FEV1 compared with education alone; symptom scores were not reported in the abstract. A second Thai trial randomized 64 patients to steam baths with or without herbs, 30 minutes 3 times a week for 4 weeks; nasal symptoms fell in both groups with no difference between them, but without a no-steam control the trial cannot separate a heat effect from time or expectation. A small Japanese crossover study found that one 10-minute warm mist sauna relieved nasal congestion and increased nasal volume for 30-90 minutes, longer than an ordinary 104 F tub bath; it measured acute effects only.
Key findings
- Peak nasal inspiratory flow 103.0 (control) vs 161.9 (sauna) after 6 weeks (Kunbootsri 2013, n=26)
- FEV1 80.1 vs 95.6 (units not stated in abstract), both significant (Kunbootsri 2013)
- Herbal vs plain steam bath: symptoms decreased in both arms over 4 weeks, no between-group difference (Tungsukruthai 2018, n=64)
- Single 10-min mist sauna (room about 104 F, 100% humidity) vs ordinary 104 F tub bath: nasal congestion and nasal volume improved for 30-90 min after the mist sauna but only immediately after the bath (Hotehama 2006, crossover, n=10)
Every study we reviewed
2 found benefit · 1 mixed results
Each study was checked on PubMed. The colored edge shows the direction of the result. The research library lists 4 studies on allergic rhinitis, across all heat and cold therapies, including case reports and older work not graded here.
The effect of six-weeks of sauna on treatment autonomic nervous system, peak nasal inspiratory flow and lung functions of allergic rhinitis Thai patients.
Kunbootsri N et al. Asian Pac J Allergy Immunol. 2013. PubMed 23859414 · DOI
- Who
- Thai adults with allergic rhinitis confirmed by history, examination and positive skin prick test
- What
- sauna sessions vs education and normal life
- Protocol
- 30 total heat (6 x 5 min sets alternating with 5 min rest) min · 3/wk · 6 wk
- Measured
- heart rate variability, peak nasal inspiratory flow, lung function
- Result
- After 6 weeks, PNIF 103.0 vs 161.9 and FEV1 80.1 vs 95.6 (control vs sauna), both significantly higher with sauna; HF component 51.8 vs 35.4, LF 48.1 vs 64.5, LF/HF 0.9 vs 2.5.
- Limitations
- small; unblinded; symptom scores not reported in abstract; units not given in abstract; single site
Efficacy and safety of herbal steam bath in allergic rhinitis: a randomized controlled trial.
Tungsukruthai P et al. J Integr Med. 2018. PubMed 29397091 · DOI
- Who
- Thai adults with allergic rhinitis at a traditional-medicine hospital
- What
- whole-body steam bath with herbs vs steam bath without herbs
- Protocol
- 30 min · 3/wk · 4 wk
- Measured
- allergic rhinitis symptoms (visual analog scale), quality of life, treatment satisfaction
- Result
- Rhinorrhea, sneezing, nasal itching and congestion decreased significantly over 4 weeks in both groups, with no significant difference between herbal and plain steam baths; satisfaction higher with herbs (P<0.05).
- Limitations
- randomized comparison tested herbs, not heat: there was no no-steam control, so symptom reduction within arms is uncontrolled; single blind; symptom scores not given in abstract
Mist Sauna Effect on Nasal Allergy
Hotehama M et al. Jibi Inkoka Tembo (Oto-Rhino-Laryngology, Tokyo). 2006. Not in PubMed: sourceJapanese publication; title and summary translated by SaunaLMN. Original title: 鼻アレルギーに対するミストサウナの効果
- Who
- 10 adults with hay fever or suspected nasal allergy (8 men, 2 women, mean age 35.7); 9 had seasonal allergic rhinitis by RAST (Japan)
- What
- Single 10-min mist sauna in a home-style bathroom (118.4 F (48 C) mist, room about 104 F (40 C), humidity about 100%) vs a normal 104 F (40 C) tub bath, on different days in random order
- Protocol
- 104 °F · 10 min
- Measured
- Nasal congestion (VAS and 7-point scale) and nasal cavity volume by acoustic rhinometry for up to 90 min
- Result
- Mist sauna reduced nasal congestion immediately (VAS p<0.01) and at 10 min (p<0.05) and increased nasal cavity volume at 10 and 30 min; it was superior to the normal bath on VAS at 30 and 50 min and on the 7-point scale up to 90 min. The normal bath improved VAS only immediately after bathing, with no increase in nasal volume.
- Limitations
- Single sessions with acute outcomes only; unblinded; 10 participants, one without confirmed allergic rhinitis; study run in an energy company's laboratory by company authors.
Protocols used in the studies
Sauna on 3 days per week for 6 weeks, each day 6 sets of 5 minutes of heat alternating with 5 minutes of rest (30 minutes of heat per day); or a 30-minute whole-body steam bath 3 times per week for 4 weeks. Temperatures were not given in the abstracts. An acute crossover study used a single 10-minute mist sauna (118.4 F (48 C) mist, room about 104 F (40 C), about 100% humidity).
What is still unknown
Effect on validated symptom scores, quality of life and medication use against a no-heat control; replication outside Thailand; comparison with standard pharmacotherapy.
Safety
Cautions for sauna in this condition
- Patients with coexisting asthma: cold air or cold showers after sauna may trigger bronchospasm (PMID 2281065).
- See general-safety.
For clinicians
Suggested rationale
In a small randomized trial in allergic rhinitis (Kunbootsri 2013), 6 weeks of sauna sessions 3 days per week increased peak nasal inspiratory flow and FEV1 compared with education alone; a second trial (Tungsukruthai 2018) saw symptom reduction with steam baths but had no no-heat control, so symptom benefit from heat has not been demonstrated.
Suggested wording only. The treating clinician decides whether it reflects their clinical judgment for this patient.
Typical ICD-10 codes: J30.9, J30.2. Examples only; the clinician assigns the code.
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