Allergies and Runny Noses

The Nose That Runs

                                                                                                                Update 4/08 KLH

Allergy symptoms in our area peak in three seasons. Tree pollen often starts in the spring soon after St. Patrick's Day.  Each tree type sheds pollen for about 2 weeks, so symptoms may only peak for that period.  The duration of allergy suffering really depends how many types of pollen your child is allergic to.  Most trees have finished by Mother's Day.  Grass pollen arrives in late spring and summer.  Your child may flare with symptoms as the neighborhood mows the lawn.  Weed pollens, such as ragweed, bloom in August as school is ready to start.  Mold and mildew allergies tend to really flare as the leaves fall in autumn.  Pet allergies can be managed with the strategies noted below as well.

DISTINGUISHING ALLERGIES FROM A COLD

Symptoms of colds and allergies can overlap and the diagnosis can be difficult to sort out initially.  The hallmark signs of allergies are itch and drip:  itchy and watery eyes, itchy and runny nose, and scratchy throat.  There may be a dry cough or throat clearing from post nasal drip.  Children with asthma may have increased coughing and wheezing during their allergy season.

The tendency to have allergies runs in families although the severity of symptoms and what the allergic trigger is are unique to each individual.

Allergies do not cause fevers.  A cold may be associated with a fever at the outset.

Discharge (mucus) from the nose and eyes is clear with allergies.  A cold or sinus infection may have clear or colored discharge.

Allergies may be associated with decreased energy levels if the symptoms are disrupting sleep.

HOW TO MANAGE ALLERGY SYMPTOMS

Avoidance of the offending substance is the best way to prevent allergy symptoms.  Defining what that substance is can be tricky, but a thorough history of symptoms will often help pinpoint the allergen.

Pollens are impossible to avoid completely.  Limit exposure by keeping windows shut AT ALL TIMES during the allergy season and run the air conditioner with a clean air filter.  HEPA filters can be helpful in removing pollen from the air.  The value of electrostatic filters is debatable.  Wash hands and face immediately upon coming indoors.  Bathe nightly and wash hair to remove pollen.  Damp towel family pets when they come inside and limit their access to family sleeping quarters.

Medications most commonly used to combat allergy symptoms are known as anti-histamines.  Listed below are some of the medications available at your pharmacy. They come in a variety of forms: liquids, melt-aways, chewables and pills.  The active ingredient is listed in bold.  You can decide whether to use the generic or a brand name.  Effects are similar, taste may vary. Follow dosing instructions on the label. ( Many insurance plans now require documentation of failure of the over the counter medications before they will cover a prescription allergy medication).   Since many trees and weeds have about a 2 week blooming period, you may find your child needs medication daily for that period of time.  Antihistamines can also be used on an "as needed basis" for intermittent allergy symptoms

    When to use decongestants:  decongestants work to decrease swelling and mucus production in the nose and sinuses.  For severe allergy symptoms, they offer relief of facial fullness and headache. They may be included in a pill with an antihistamine.  These products will usually state "Decongestant" on the label or have a "D" after the name of the medication.  Decongestants can decrease appetite, cause jitteriness and restlessness. Limit the use of caffeine or "energy products" if using a decongestant.  They can be dangerous in young children by their actions on the heart and brain.  Please do not use a product containing a decongestant in children under 12 years without consulting your pediatrician.  Do not give your child decongestants if they are on medication for ADD/ADHD without consulting your prescribing doctor. 

If your child has chronic health issues, is on other medications or is under 2 years old, please contact your doctor or pharmacist before giving any over the counter medications!

DIPHENHYDRAMINE HCL (Brand Name = Benadryl).  This is a great medication for allergy symptoms. Drawbacks:  effects only last about 6 hours and it can cause significant drowsiness.

CHLORPHENIRAMINE MALEATE (Brand Name = Chlor-Trimeton).  Effects last 4 to 6 hours. Can cause drowsiness.

LORATADINE (Brand Name = Claritin, also Alavert). Once daily dosing.  Does not cause drowsiness for most children.

CERTIRIZINE HYDROCHLORIDE (Brand Name = Zyrtec). Once daily dosing.  May cause a little drowsiness.

EYE SYMPTOMS may not respond fully to antihistamines taken by mouth.  Cool compresses or saline drops to the eyes can relieve mild eye redness and itching.  Medicated eye drops may be needed.  Some options available at your pharmacy are listed below. Contact your doctor or pharmacist if more assistance is needed. Follow dosing instructions on label.

NAPHAZOLINE HYDROCHLORIDE / PHENIRAMINEMALEATE (Brand names = Naphcon A, also Visine A)

KETOTIFEN FUMARATE (Brand Name = Zaditor)

Your pediatrician is your first resource in treating allergies.  Please make an appointment if the above recommendations do not relieve your child's allergy symptoms. Criteria for referral to an allergist include year round medication needs, severe seasonal symptoms, or symptoms that are not relieved by avoidance and medication.