Allergies in Children
Wednesday, June 06, 2012
by Megan Westbrook, MD, Pediatrician at The Everett Clinic at Snohomish

Allergic rhinitis (seasonal allergies) is a common condition seen by pediatricians and refers to inflammation of the nasal passages due to environmental irritants called allergens. It causes many annoying symptoms including sneezing, painful, itchy or red eyes, sore throat, hoarse voice, nasal congestion, runny nose, post-nasal drip, facial pressure or pain as well as difficulties with sleep. Brief symptoms (lasting less than two weeks) like a runny nose are often cause by viral infections, while more chronic runny nose and congestion is often caused by allergies. Seasonal allergies affect about 20 percent of people at all ages. It can start at any age, but tends to be worse in children and those aged 30-40 years old. Children with a personal or family history of asthma and eczema are at greater risk of developing allergic rhinitis. Common causes of allergic rhinitis include grass, pollen, weeds and molds. When a child is affected by these allergens, we call them their “triggers.” Perennial rhinitis refers to symptoms that are present year round. These are commonly caused by cockroaches, animal dander, fungi or molds and tend to be more difficult to treat.

Treatment includes avoidance of exposure to triggers in combination with medication therapy. Helpful measures that can be tried at home include nasal saline irrigation or lavages. Rinsing the nose with a salt-water solution helps to clear the nasal mucosa of the irritants causing the symptoms. To make at home, mix 1 cup of distilled or boiled (and cooled) water with ½ teaspoon of salt. Usually about ¾ cup of fluid is recommended for each nostril. Over the counter medications that can be safely used in children include antihistamines like Zyrtec® (Cetirizine) or Claritin® (Loratidine) which also have the added benefit of being less sedating than Benadryl®. Commonly prescribed medications include nasal glucocorticoids like Flonase® (Fluticasone). These medications are most helpful when taken daily during allergy season as they are most effective after several days to two weeks of use. You should see a primary care physician if you suspect your child suffers from allergic rhinitis and over the counter measures aren’t providing adequate relief.