Allergic rhinitis, sometimes called “hay fever,” affects 15-25% of American children and is probably the most common chronic disease in childhood.
Although it’s called “hay fever,” allergic rhinitis is not caused by hay, nor is it associated with a fever.
Instead, it is an overreaction of the immune system to substances (allergens) that are harmless to most people.
The symptoms of allergic rhinitis can be triggered by pollen (especially tree, grass and ragweed), mold spores, dust mites, pet dander and cockroaches.
Symptoms include a clear runny nose, nasal congestion, itchiness of the nose, postnasal drip, sneezing and coughing.
The eyes may be red, itchy and have clear drainage.
Complications of allergic rhinitis include mouth breathing – this can lead to long-term dental and facial bone abnormal growth.
Restless sleep can lead to daytime fatigue.
The ears can be affected, which can lead to retained fluid in the middle ears, raising the potential for ear infections, hearing problems, and then problems with speech in children.
The tendency to have allergies is often inherited. What a child is allergic to, though, is usually not.
Allergic rhinitis is diagnosed by history, physical exam and sometimes by allergy skin testing.
Specific allergies may be tested for in children 5 and older by putting diluted samples of suspected allergens on the skin that has been scratched or pricked.
Sometimes the allergen samples are injected into the skin.
A red, hive-like reaction is usually a positive sign for that particular allergen.
Treatment consists of avoidance, medications and sometimes immunotherapy.
During the season, it is recommended to avoid the peak pollen and mold spore time of 5-10 a.m.
Staying indoors, using air conditioning and mattress covers, and removing rugs and carpeting may help.
Antihistamines by mouth or as nasal sprays, or eye drops in children as young as 6 months may be used.
Steroid nasal sprays and oral leukotriene inhibitors can also be effective.
If avoidance and medications provide no relief, immunotherapy may be tried.
Diluted mixtures of a child’s offending allergens are injected into the skin in slowly increasing concentrations over years.
This trains the immune system to eventually become tolerant of (and not react to) these allergens.