Understanding Your Child’s Allergies
Written by: Marie-Helene Sajous, MD, MS, Allergy Department
Springtime means allergies are in full bloom. Allergic rhinitis, also known as hay fever, affects approximately 20 percent of the population. Allergic rhinitis can begin at any age, although most develop symptoms before the age of 20. The risk of developing allergic rhinitis is much higher in people with asthma or eczema and in those with a family history of allergies.
Allergic rhinitis is caused by a reaction to small airborne particles called allergens. This reaction causes inflammation that can cause a variety of annoying symptoms that include sneezing, itchiness in the nose, throat and ears, stuffy and runny nose, post-nasal drip, itchy, red, watery eyes, and allergic shiners, which is swelling and blueness of the skin below the eyes. In some people, these particles can also cause a reaction in the lungs which cause asthma.
Allergic rhinitis can be seasonal or occur year round. The allergens that most commonly cause seasonal allergic rhinitis include pollens from trees, grasses and weeds. The allergens that most commonly cause perennial allergic rhinitis are dust mites, animal dander, cockroaches and mold spores.
The diagnosis of allergic rhinitis is based upon a physical examination and the symptoms described above. Skin testing by an allergy specialist is the best method to identify the allergic trigger or sometimes a blood test can also be done. The treatment of allergic rhinitis includes reducing exposure to allergens and other triggers in combination with medication therapy and/or allergy shots.
The most effective medication for persistent and significant nasal symptoms is a glucocorticoid nasal spray, which can dramatically relieve symptoms in most people. Some other therapies include oral or nasal antihistamines and leukotriene modifiers which can be used for those with milder symptoms or in conjunction with a nasal steroid spray for more severe symptoms. In addition, nasal irrigation and saline sprays, used to rinse out allergens and irritants from the nose, can also be effective.
People with severe allergic rhinitis or those who want to avoid taking medications long-term may benefit from allergen immunotherapy or allergy shots. Allergy shots are injections given to reduce a person’s sensitivity to allergens. These shots contain solutions of the allergens to which a specific person is allergic and are made up individually for each person. The process of immunotherapy changes the person’s immune response to the allergens over time. As a result, being exposed to the allergen causes fewer or even no symptoms. In children, immunotherapy can help prevent developing allergic asthma later in life.
Marie-Helene Sajous, MD, MS works in the Allergy Department at Dartmouth-Hitchcock Specialty Care at Bedford Medical Park. For more information, please visit dartmouth-hitchcock.org for more information.