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Allergic Rhinitis

  • Overview

    Allergic rhinitis is a reaction that occurs when your child breathes in something he or she is allergic to, like dust, dander or pollen. Sometimes, allergic rhinitis is called hay fever.

    • Almost always genetic
    • Affects up to 20 percent of children and 30 percent of adolescents
    • It's estimated that 75 percent of children with asthma also have allergic rhinitis

    How Children's approaches Allergic Rhinitis

    At Children's, allergy disorders are tackled by a team approach, coordinating care with immunotherapy, behavior modification and investigational therapies. In addition, we offer numerous workshops and one-on-one consultations to help you and your child learn to live with chronic rhinitis.

    Children's is widely recognized as one of the world leaders in allergy and immunology treatment and research.

    Boston Children's Hospital 
    300 Longwood Avenue, Fegan 6
    Boston MA 02115


    Boston Children's at Lexington
    482 Bedford Street
    Lexington MA 02420

     fax: 781-672-2145
    Boston Children's at Peabody
    1 Essex Center Drive
    Peabody MA 01960

     fax: 978-538-3610

  • In-Depth

    What is allergic rhinitis?

    Rhinitis is a common reaction that occurs airborne irritants trigger the release of histamines. This can cause inflammation and excess fluid in the nose, sinuses and eyelids.

    Types of allergic rhinitis


    • Occurs mostly during pollen seasons.
    • Doesn't usually develop until after 6 years of age.


    • Occurs throughout the year
    • Commonly seen in younger children

    What causes allergic rhinitis?

    The most common causes of allergic rhinitis are:

    • Pollen
    • Dust mites
    • Mold
    • Animal dander

    Is allergic rhinitis inherited?

    Allergic rhinitis is almost always inherited.

    • Affects up to 20 percent of children and 30 percent of adolescents
    • It's estimated that 75 percent of children with asthma also have allergic rhinitis

    What are the symptoms of allergic rhinitis?

    Each child may experience symptoms of allergic rhinitis differently, but common symptoms include:

    •  Sneezing
    •  Congestion
    •  Runny nose
    •  Itchy nose, throat, eyes and ears
    •  Nosebleeds
    • Clear drainage from the nose

    Symptoms of perennial allergic rhinitis may also include the following:

    • Recurrent ear infections
    • Snoring
    • Mouth breathing
    • Fatigue
    • Poor performance in school
    •  "Allergic salute" - when a child rubs his hand upward across the  bridge of the nose while sniffing.

    The symptoms of allergic rhinitis may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.

    Can allergic rhinitis be prevented?

    You can help your child avoid allergic rhinitis by:

    • Using air conditioning, instead of open windows, during pollen season
    • Avoiding areas where there is heavy dust, mites or molds
    • Avoiding pets
  • Tests

    How do I know if it's allergic rhinitis?

    If your child has been experiencing any combination of the above symptoms, he or she should see a physician. A physician will conduct a physical exam and look for:

    • Dark circles under the eyes
    • Creases under the eyes
    • Swollen tissue inside the nose
  • Treatments for allergic rhinitis vary depending on your child's age, overall health, medical history, extent of the reaction, and tolerance for specific medications, procedures, or therapies.

    Be sure to check with your doctor before administering any treatment to your child.

    Standard treatment for allergic rhinitis:

    • Avoidance of the allergen
      • Simply avoiding the allergens causing the problem is the best treatment.
    • Over-the-counter antihistamines
      • Antihistamines-like Benadryl or Atarax-help decrease the release of  histamine,  possibly decreasing the symptoms of itching, sneezing, or runny  nose. These can cause drowsiness
    • Non-sedating prescription antihistamines
      • Will not cause drowsiness
      • Can include cetirizine (Zyrtec), loratadine (Claritin), or fexofenadine   (Allegra)
    • Anti-inflammatory nasal sprays
      • Can help decrease the swelling in the nose
    • Corticosteroid nasal sprays
      • Can help decrease the swelling in the nose
      • Work best before symptoms start, but can also be used during a flare-up.
    • Decongestants
      • Help by making the blood vessels in the nose smaller, thus decreasing congestion. Available either over-the-counter or by prescription.

    Advanced treatment for allergic rhinitis

    If your child doesn't respond to avoidance or to the above medications, a Children's allergist may recommend allergy shots or immunotherapy. Immunotherapy usually involves a three to five year course of repeated injections of specific allergens. This will help decrease your child's reaction to these allergens.

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