Allergic Rhinitis (Hay Fever) in Children

When it comes to allergic rhinitis (hay fever), our immune system can develop an abnormal response to a typically harmless substance. This substance is called an allergen. The immune system answers to allergen by releasing histamine and chemical agents that cause symptoms in the throat, mouth, nose, eyes, ears and skin.

What are the Symptoms of Allergic Rhinitis in Children?

Allergic rhinitis(Hay Fever) symptoms include:

  • Itching in the nose, roof of the mouth, throat and eyes
  • Sneeze
  • Nasal congestion
  • Runny nose
  • Eye irritation
  • Dark circles under the eyes

What are the Types of Allergic Rhinitis in Children?

Allergic rhinitis occurs in two different ways:

  • Seasonal: Symptoms of seasonal allergic rhinitis can appear in spring, summer and early autumn. They often cause allergic sensitivity to airborne mold spores or pollen from grass, trees and weeds.
  • Perennial: People with perennial allergic rhinitis experience symptoms throughout the year. As an underlying cause or hidden food allergies rarely cause perennial nasal symptoms.

Some people can live two types of rhinitis at the same time, with perennial symptoms worsening during the pollen season. There are some non-allergic causes for rhinitis, which include cigarettes or other smoke, irritant products, cleaning products, and other irritants containing strong odors.

What Is The Difference Between Allergic Rhinitis And Flu In Children?

 While the flu and allergy symptoms are similar, there are also important differences. Changes in disease history and duration of symptoms often provide clues about which condition is present.

People should consider the following differences when trying to determine whether they have flu or allergies:

  • Itchy and watery eyes are usually signs that the symptoms are due to allergies.
  • Fever can occur with severe cold, especially in children, but it is not a sign of allergy.
  • A sore throat can occur with allergies, but it is more common with a cold.
  • Body aches are also not caused by allergies, they are common with a cold.
  • Some people with allergies also develop eczema which is not related to flu.

Allergic Rhinitis Diagnosis in Children

Allergy specialists get a detailed history by searching for clues to help determine the cause of your symptoms. You will be asked for information about your family’s medical history and the frequency and severity of your symptoms, among other things, your work and home settings (including your pet).

Sometimes allergic rhinitis can be confused with a range of conditions, such as a deviated septum or nasal polyps. Any of these conditions will get worse with cold. Treatment of nasal symptoms caused by multiple problems can often require difficult treatment that requires the cooperation of another specialist, such as an allergist and otolaryngologist. 

Your allergist may recommend a skin test with small amounts of suspicious allergens introduced into your skin.

Treatment and Prevention in Children

Once certain allergens are diagnosed, allergists / immunologists will work with you to develop a plan to protect yourself from allergens that trigger symptoms. For example, if you are allergic to dust mites or indoor molds, you will want to take steps to reduce these allergens as much as possible in your home.

For outdoor allergies such as pollen, protection measures include limiting outdoor activities at times of high pollen count.

Immunotherapy (allergy vaccines) is a proven treatment approach that provides long-term relief for many people suffering from allergic rhinitis.

Another form of allergy immunotherapy is the immunotherapy (SLIT) method called sublingual allergy tablets in the USA. Rather than vaccination, allergy tablets usually include daily administration of allergens under the tongue.

The allergist can prescribe medication to reduce the symptoms of allergic rhinitis. Allergist may prescribe nasal corticosteroid sprays, nasal antihistamine sprays, antihistamine drugs, or decongestant pills.

The majority of allergy medications for seasonal allergic rhinitis (hay fever) are best effective if started using before tree pollen get mixed into the air every spring and allergy symptoms develop. If medications are started before coming into contact with the spring allergens, the drugs can prevent the histamine and other chemicals. As a result, the development of allergy symptoms is prevented or less severe.

Allergic Rhinitis Drug Treatment in Children

Intranasal corticosteroids

Intranasal corticosteroids are the most effective drug class in the treatment of allergic rhinitis. It can significantly reduce nasal congestion, sneezing, itching and runny nose.

Antihistamines

Antihistamines are commonly used in the treatment of allergic rhinitis. These drugs counteract the effects of histamine, the irritant chemical released in the body when an allergic reaction occurs.

Decongestants

Decongestants help relieve congestion and pressure caused by swollen nasal tissue. They do not contain antihistamines, so they do not cause antihistamines side effects. They do not relieve other allergic rhinitis symptoms. Oral decongestants are available as prescription and over-the-counter medicines and are often used in combination with antihistamines or other medicines.

Nasal sprays

Over-the-counter saline nasal sprays will help prevent symptoms such as dry nasal passages or thick nasal snot. Unlike decongestant nasal sprays, a saline nasal spray can be used frequently when needed. Sometimes an allergist may recommend washing the nasal passage (washing with antiseptic water).

Leukotriene pathway inhibitors

Leukotriene pathway inhibitors (mon, zafirlukast and zileuton) block the effect of leukotriene, a substance that can cause symptoms of allergic rhinitis in the body. These drugs are also used to treat asthma.

Vaccine Treatment

Immunotherapy may be recommended for people who do not respond well to medication or who are exposed to the allergen that is unavoidable, or who want a more permanent solution to their allergies. Immunotherapy can be very effective in controlling allergic symptoms, but it does not help with symptoms produced by non-allergic rhinitis.

There are two types of immunotherapy: allergy vaccines and sublingual tablets.

  • Allergy vaccines: A treatment program, which can last three to five years, consists of diluted allergy extract injections, which are frequently applied in increasing doses until they reach a protection dose. The injection schedule is then changed to give the same dose at longer intervals between injections. Immunotherapy helps the body to resist the effects of the allergen, reduces the intensity of the symptoms caused by exposure to the allergen, and sometimes can really eliminate skin test reactions. As resistance develops in a few months, symptoms should improve.
  • Sublingual tablets: Starting a few months before the allergy season begins, patients dissolve one tablet under the tongue every day. Treatment can continue for three years. With this method, only a few allergens (some weed and canary pollen and house dust mite) can be treated, but it is a promising treatment for the future.