Allergic rhinitis is probably the most common chronic disease of childhood, affecting approximately 15-25% of American children.
Also known as “hay fever,” it is not caused by hay nor is it associated with a fever.
It is an overreaction of our bodies to substances (called “allergens”) that are usually harmless to most people.
There are two main types of allergic rhinitis – seasonal and perennial.
Seasonal allergic rhinitis happens during specific times of the year when pollens are released.
In early spring tree pollens predominate. In late spring grass pollens become the main ones.
In summer and fall weed pollens dominate (including ragweed pollen). These are more common in older children.
Perennial allergic rhinitis happens year round and is triggered by dust mites, molds and animal dander.
It is more common in younger children.
The reaction that causes the symptoms of allergic rhinitis occurs when allergens trigger the release of histamine in the conjunctivae (linings of the eyelids and the white parts of the eyes), the nasal passages and the sinuses.
This causes these linings to become inflamed and to produce a clear fluid. It also makes these areas itch (along with the ears and throat).
Symptoms of allergic rhinitis also include sneezing, clear runny nose and eyes, nasal congestion, and dark circles and wrinkles under the eyes.
These symptoms can further lead to nosebleeds, a crease across the bridge of the nose (from rubbing it), snoring, mouth breathing and fatigue.
Allergic rhinitis is diagnosed by the patient’s history, his physical exam and by a family history of allergic disease.
What a patient is specifically allergic to can sometimes be guessed by the timing of her symptoms.
If a more definitive answer is needed, he can undergo allergy skin testing by an allergist. This can be helpful if multiple allergens are suspected or if immunotherapy may be required.
Treatment for allergic rhinitis includes oral and topical antihistamines.
Corticosteroid nasal sprays may also help symptoms. In older children decongestants are sometimes used.
Some children with allergies may need immunotherapy in order to improve or alleviate their symptoms. This is usually supervised by an allergist.
Very dilute amounts of the allergens that they are allergic to are given in slowly increasing concentrations in order to make their bodies tolerant to them.
It usually takes years, but for children looking at many years of allergic rhinitis symptoms, it is often worth it.
Dr. Charles Ison is a University of Kentucky graduate who has practiced in his hometown of Lexington since 1993. He is a partner in Pediatric and Adolescent Associates.