Allergies
Allergic rhinitis is an inflammation of the nasal membranes and eyes caused by certain particles in our environment (like, pollen and molds, or dust mites and animal dander). The symptoms of allergic rhinitis are a runny or stuffy nose, sneezing, itching of the eyes, nose, or throat, and sometimes headache and fatigue.
If you suspect that your child has seasonal allergies and he/she does not respond to simple home treatment, he/she should be evaluated by their pediatrician to help make the diagnosis.
What follows below are some helpful hints in treating allergy symptoms.
Allergen avoidance
The first step in helping your child is to avoid the allergens causing the problem. Dust mites, mold, and pets are the major indoor allergens. Concentrating on eliminating allergens from the bedroom is often effective, since children spend eight to twelve hours each day in the bedroom.
For pollen allergies, pollen counts are usually highest between 5 a.m. and 10 a.m. Keep your child's bedroom window closed at night during pollen season. It is also helpful to keep car windows closed to avoid pollen blowing into children's faces while driving in the car. Because children spend at least one third of their day in the bedroom, it is worth trying to keep the bedroom as pollen-free as possible. Don't bring anything in to the bedroom that might carry pollen from outdoors. This might include removing coats, hats, and even shoes before the child returns to the bedroom. Don't let pets that have been outside bring pollen in to the bedroom. Consider washing your child's hair before bed to avoid bringing pollen from outside into the bedroom and on to the pillow.
Dust mites are microscopic organisms which live in bedding, rugs, and upholstered furniture. They survive by ingesting human and animal skin cells, fabric fiber and food crumbs and thrive when the humidity rises above 50%. The most effective way to decrease your child's contact with dust mites is to cover the bedding, mattresses and box springs in air-tight vinyl or nylon cases that zip shut. Also, remove drapes and upholstered furniture and wash linens, area rugs and stuffed animals frequently using water hotter than 130 degrees. Cold or warm water does not kill dust mites. Other effective control measures are to remove bedroom carpeting, avoid wool blankets and use synthetic pillows (not down or feathers).
Mold grows where humidity is high. In addition to the above measures, use chlorine bleach to reduce mold growth in bathrooms, cellars and other damp areas. Consider removing pets with fur or feathers from the house, but if this is not possible at least do not let them in the child's bedroom. A weekly bath will decrease the amount of allergen a furry animal sheds. Outdoors, the problem is usually pollen.
Medications
In general, allergy medications can help relieve many, but not all, symptoms. It is generally a good idea to have your child take allergy medication(s) regularly during the allergy season, rather than just when they have symptoms. These medicines are often more effective at preventing the onset of symptoms than at treating them once symptoms occur, and they also can take several days before becoming effective.
Oral Medications
The main treatment option for seasonal allergies is oral antihistamines. The non-sedating oral antihistamines (Claritin®, Zyrtec®, Allegra® or Xyzal {R}) are all available over the counter without a prescription. They all can be given in a single, 24 hour, dose, though Allegra for kids is usually given twice a day. We recommend either Zyrtec® (cetirizine) or Claritin® (loratadine) as a first choice in this category and Allegra® (fexofenadine) or Xyzal® (levocetirizine) as a second option.
Eye Drops
Zaditor® (ketotifen) is the most effective eye drop for allergy symptoms of itchy, teary or red eyes. It is available over the counter.
Nose Sprays
Steroid nose sprays are generally more effective than oral medicines for nasal congestion, runny nose, and sneezing. Flonase® (fluticasone) and Nasacort® and others are available over the counter without a prescription. If your child is taking an oral non-sedating antihistamines and is not getting as much relief as you would like, adding a nose spray is a good next step.
Allergy evaluation
Occasionally, environmental controls and medications will not relieve your child's allergy symptoms, so your pediatrician may refer your child to an allergist. Allergists might evaluate your child using specific skin tests to diagnose the offending agents and then may recommend a series of desensitizing injections ("allergy shots").
We generally resort to allergy testing and possible allergy shots only when the above efforts fail. Fortunately, this happens infrequently.
Please note: Allergy shots are not useful for food allergies.
Our "Take Home" message
With the correct treatments, most children will be able to find relief from allergy symptoms and be able to function normally.