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Home / Symptoms / Runny Nose & Congestion in Japan: Allergies or Cold?

Runny Nose & Congestion in Japan: Allergies or Cold?

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A runny nose in Japan can have many causes, and the treatment approach differs significantly depending on which one is at play. Is it Japan's legendary cedar pollen season? A common cold picked up on the Shinkansen? Dry heated air in your hotel room? Or sinusitis that needs prescription medication? This guide walks you through the differences and your options.

Cedar Pollen Season: Japan's Most Famous Allergen

Sugi-kafunshō (スギ花粉症, cedar pollinosis) is one of Japan's most widespread health conditions, affecting an estimated 40% of the population. The pollen season runs from late January through April, with peak levels typically in February and March in central Japan.

Even tourists who have never experienced hay fever before can develop reactions upon first heavy exposure to Japanese cedar pollen. Symptoms include:

  • Watery, runny nose (水っぽい鼻水)
  • Frequent sneezing
  • Itchy, watery eyes
  • Nasal congestion
  • Mild fatigue

The Japanese Meteorological Agency publishes daily pollen forecasts (花粉情報), and many weather apps include pollen count data. On high-pollen days, counts can reach into the thousands of particles per square centimeter.

Common Causes of Runny Nose in Japan

Viral rhinitis (common cold) — the most common cause year-round. Typically accompanied by sore throat, mild fever, and cough. Nasal discharge often changes from clear to yellow-green as the infection progresses.

Allergic rhinitis — from cedar or cypress pollen (spring), house dust mites (year-round), mold, or pet dander.

Sinusitis — inflammation of the sinus cavities, which can follow a cold. Symptoms include facial pain/pressure, yellow or green discharge, post-nasal drip, and reduced sense of smell. May require antibiotics if bacterial.

Vasomotor rhinitis — non-allergic nasal congestion triggered by temperature changes (particularly common when moving between cold outdoor air and heated interiors in Japan's winter).

Dry air — Japan's winter heating dries out nasal passages, causing irritation and excessive mucus production.

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Self-Care vs. When to See a Doctor

Situation

Recommended Action

Clear, watery runny nose during pollen season

OTC antihistamines, nasal spray

Mild cold symptoms, no fever

OTC cold medicine, rest, fluids

Runny nose clearing after 7–10 days

No doctor needed

Yellow/green discharge persisting >10 days

See a doctor — possible sinusitis

Facial pain or pressure with congestion

See ENT — possible sinusitis

Nosebleed that won't stop after 20 minutes

See a doctor or ENT

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Guides

Nasal polyps suspected (loss of smell)

See ENT

Runny nose with high fever

See internal medicine doctor

Child with one-sided discharge

See pediatrician — possible foreign body

Severe allergy symptoms not responding to OTC

See ENT for prescription antihistamines

OTC Medicines at Japanese Pharmacies

Allegra FX (アレグラFX) — fexofenadine, the same active ingredient as Allegra. Non-drowsy antihistamine. Excellent for allergic rhinitis. Available OTC since 2012 in Japan. One of the best-selling OTC allergy medicines.

Claritin (ロラタジン) — loratadine-based non-drowsy antihistamine. Also very effective.

Zyrtec (セチリジン) — cetirizine, mildly sedating but very effective for severe allergy symptoms. Available OTC in Japan.

Nasal decongestant sprays — look for "点鼻薬" (*ten biyaku*) with xylometazoline or oxymetazoline. Provide rapid congestion relief but should not be used for more than 3–5 days consecutively (rebound congestion risk).

Saline nasal spray (生理食塩水スプレー) — gentle, non-medicated nasal wash. Suitable for all ages including children. Widely available.

Pabron S or Colgen Kowa — combination cold medicines with antihistamine component for runny nose.

Ryūkakusan — for throat irritation accompanying post-nasal drip.

Finding a Doctor in Japan

For persistent symptoms, sinusitis, or allergy management beyond OTC options, an ENT specialist (耳鼻咽喉科, *jibiin'ōkōka*) is the ideal specialist. ENT clinics in Japan also perform nasal allergy testing and can prescribe stronger antihistamines, steroid nasal sprays, or sublingual immunotherapy (舌下免疫療法).

Translation apps and devices have limited accuracy in medical contexts. We recommend clinics with English-speaking staff. Find English-capable ENT clinics at Traveler's Hospital ENT search.

Estimated Costs

Service

Approximate Cost (JPY)

ENT consultation

¥3,000–¥6,000

Allergy blood test (specific IgE panel)

¥5,000–¥15,000

Nasal endoscopy

¥2,000–¥5,000

Prescription steroid nasal spray

¥1,000–¥3,000

Prescription antihistamines (1 month)

¥1,000–¥3,000

Sinusitis antibiotic course

¥1,500–¥4,000

Useful Japanese Phrases for Your Doctor Visit

English

Japanese

Pronunciation

I have a runny nose.

鼻水が出ます。

Hanamizu ga demasu.

I am very congested.

鼻が詰まっています。

Hana ga tsumatte imasu.

I sneeze a lot.

くしゃみが多いです。

Kushami ga ōi desu.

I think I have hay fever.

花粉症だと思います。

Kafunshō da to omoimasu.

I have sinus pressure/pain.

副鼻腔が痛いです。

Fukukōkū ga itai desu.

The discharge is yellow/green.

鼻水が黄色/緑色です。

Hanamizu ga kiiro/midoriiro desu.

I lost my sense of smell.

匂いがわかりません。

Nioi ga wakarimasen.

Internal Links

If congestion is accompanied by a sore throat, see the sore throat guide. For a productive cough with post-nasal drip, see the cough guide. Find ENT clinics at Traveler's Hospital.

FAQ

Q: Can I get prescription allergy medicine in Japan as a tourist?

A: Yes. After a brief consultation with an ENT or internal medicine doctor, you can receive prescription-strength antihistamines (e.g., bilastine, desloratadine) or topical nasal steroids (e.g., Nasonex equivalent). Costs are very reasonable.

Q: Are OTC antihistamines the same in Japan as at home?

A: The active ingredients are the same (fexofenadine = Allegra, loratadine = Claritin, cetirizine = Zyrtec), but branding and packaging differ. Japanese formulations often come in blister packs. The pharmacist can confirm the active ingredient if you show them your home-country medicine.

Q: Does wearing a mask help during pollen season?

A: Yes. Surgical or N95 masks reduce inhaled pollen load significantly. Japanese people routinely wear masks during pollen season. They are inexpensive and available everywhere.

Q: How long does cedar pollen season last?

A: Typically late January through late April, with regional variation. Hokkaido has a shorter, later season (March–May) due to its colder climate. After cedar pollen, cypress (hinoki) pollen season begins April–May, extending symptoms for many allergy sufferers.

Q: My nasal congestion spray stopped working after a few days — why?

A: This is called "rebound congestion" or rhinitis medicamentosa. Decongestant sprays (oxymetazoline, xylometazoline) should not be used for more than 3–5 consecutive days. If you have become dependent on a decongestant spray, see an ENT for advice on tapering off.

Q: Can sinusitis resolve without antibiotics?

A: Most acute sinusitis is viral and resolves on its own within 7–10 days. Antibiotics are appropriate for bacterial sinusitis (typically indicated by symptoms persisting beyond 10 days, worsening after initial improvement, or high fever with severe facial pain). Japanese doctors are appropriately conservative about antibiotic prescribing.

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