Hay fever, or allergic rhinitis, is a term used to describe allergic reactions. The reactions that take place when an airborne allergen such as pollen, mold, dust, or dander is inhaled through the nose or mouth. Symptoms may include sneezing, runny or stuffy nose, watery eyes, and a scratchy or burning palate or throat. Common allergens include:
There are two types of allergic rhinitis:
Symptoms occur only at certain times of the year, usually spring, summer, and early fall. In most cases, people with seasonal allergic rhinitis are sensitive to pollens from trees, grasses, or weeds, or airborne mold spores.
Perennial allergic rhinitis causes symptoms all year-round. People who have this form of allergic rhinitis are generally allergic to house dust mites, cockroaches, animal dander, and/or mold spores. Occasionally, food allergies may cause perennial allergic rhinitis.
There is no cure for allergic rhinitis, but treatment may reduce or stop your child’s symptoms. The primary treatment methods include:
There are many types of allergens. It is nearly impossible to eliminate all of them from your environment. Fortunately, however, it is rarely necessary to eliminate all allergens. There are many things you can do to help minimize your child’s exposure to allergy triggers. These include:
Click here for details on how to control these allergens.
There are many types of medications—both over-the-counter and prescription—that can be used to treat symptoms of allergic rhinitis. Each class of medication functions differently in the body. The most commonly prescribed medications include:
Antihistamines
Antihistamines are used to relieve or prevent runny noses, sneezing, and itchy eyes. They may also relieve itchiness in some allergic skin conditions. Antihistamines are available as pills, liquids, and nasal sprays. While antihistamine sprays are still quite new, they may have less tendency to make children sleepy than do oral medications. Especially older or “first generation” antihistamines. Montelukast, while not an antihistamine, is effective for treatment of allergic rhinitis and may be prescribed when other treatments do not prove helpful.
Anti-inflammatory Nose Sprays
These drugs reduce nasal itching, sneezing, and clear drainage. Those containing corticosteroid anti-inflammatory medications are the most effective drug treatments for adults. Expert opinion suggests this is also the case for children . Treatment with inhaled corticosteroids can temporarily affect growth if continued for long periods of time at high dosages. There is little or no data to suggest that children being treated for allergic rhinitis are at any enhanced risk of growth retardation Cortisone-containing nose sprays require a doctor’s prescription. Disodium cromoglycate can be purchased without a prescription and has some value in treating rhinitis. However, it must be used several times a day and is relatively costly. For most families wishing over-the-counter treatment an antihistamine may be the better choice.
Nasal Decongestants
Nasal decongestants are often combined with an antihistamine to relieve a runny or stuffy nose. Decongestants can be harmful or even fatal to children under two, so be sure to discuss with your doctor before using them in youngsters.
Click here for more information on these and other types of allergy medications.
Immunotherapy is often recommended for people who have developed severe side effects from medication, or whose allergy symptoms do not respond well to medication. It may also be helpful for people who have frequent, unavoidable exposure to allergens. Some evidence indicates that immunotherapy is effective in approximately 80% to 90% of people who receive the treatment consistently.
Click here for more information on allergy shots.
As always, your doctor and pharmacist can answer your questions and provide more information about your child’s medicines. Remember, treatment results and side effects may vary greatly from child to child. It will be up to you and your child’s pediatrician to determine which treatment approach will be most effective for your child. Often, physicians will conduct a trial of different medications in order to determine what works best for your child. Therefore, it is a good idea to keep track of your child’s progress on specific allergy medicines and schedule regular doctor’s appointments. If your child's allergy symptoms aren't getting any better with medication, contact your doctor.
RESOURCES:
American Academy of Allergy, Asthma, and Immunology
http://www.aaaai.org/
American Academy of Family Physicians
http://www.aafp.org
CANADIAN RESOURCES:
AboutKidsHealth
http://www.aboutkidshealth.ca/
Allergy Asthma Information Association
http://aaia.ca/
References:
American Academy of Allergy, Asthma, and Immunology website. Available at: http://www.aaaai.org/patients/publicedmat/tips/asthmaallergymedications.stm. Accessed on May 6, 2003
American College of Allergy, Asthma, and Immunology website. Available at: http://allergy.mcg.edu/patients/allergist.html Accessed on May 6, 2003.
Nayak A, Langdon RB. Montelukast in the treatment of allergic rhinitis: an evidence-based review. Drugs. 2007;67(6):887-901.
Roberge RJ, Hirani KH, Rowland PL 3rd, Berkeley R, Krenzelok EP. Dextromethorphan- and pseudoephedrine-induced agitated psychosis and ataxia: case report. J Emerg Med. 1999 Mar-Apr;17(2):285-8
Skoner DP, Gentile D, Angelini B, Kane R, Birdsall D, Banerji D. The effects of intranasal triamcinolone acetonide and intranasal fluticasone propionate on short-term bone growth and HPA axis in children with allergic rhinitis. Ann Allergy Asthma Immunol. 2003 Jan;90(1):56-62.
Walls RS, Heddle RJ, Tang ML, Basger BJ, Solley GO, Yeo GT. Optimising the management of allergic rhinitis: an Australian perspective. Med J Aust. 2005 Jan 3;182(1):28-33.
Last reviewed March 2008 by Lawrence Frisch, MD, MPH
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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