Allergic Rhinitis

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Allergic rhinitis (rie NIE tis) is a condition that occurs when the body (the immune system) overreacts to something in the environment (triggers) that most people have no problem with. When the symptoms occur in late summer or early fall, some people call it hayfever. Unlike what the name suggests, a child does not need to be near hay to have symptoms. Nor will the child have a fever.

There are two main types of allergic rhinitis: seasonal (occurs certain times of the year) and perennial (happens all year).

Seasonal allergic Allergic Rhinitis

Seasonal allergic rhinitis usually occurs in the spring, summer, and fall due to outdoor molds and pollens in the air from grass, trees and weeds. Symptoms normally improve when the weather turns cold, or after hard frosts.

Perennial allergic rhinitis

Perennial allergic rhinitis can occur throughout the year. Often symptoms are caused by things found indoors, such as dust mites, animal dander, cockroaches or indoor mold.

Allergic Rhinitis

Symptoms

If your child has allergic rhinitis, you may notice some of these symptoms:

  • itchy nose, mouth or eyes
  • stuffy nose (nasal congestion) or runny nose
  • frequent sneezing
  • mouth-breathing or snoring
  • red, watery, itchy eyes
  • puffy eyelids
  • dark circles under the eyes (allergic shiners)
  • cough (especially at night) caused by drainage from the nose going down the back of the throat
  • headaches
  • some loss of smell
  • ears "popping" or crackling
  • feeling tired
  • not able to focus, poor concentration

Treatment

Symptoms may improve by making small changes at home.

If your child is allergic to pollens or outdoor molds:

  • Keep windows closed at home and in the car when pollen counts are high.
  • If possible, use a fan or air conditioning (windows closed) in the home and in the car.

If allergic to things indoors:

For dust mites:

  • Cover the mattress, box spring and pillows with dust-mite-proof bedding.
  • Reduce the number of stuffed animals and other dust collectors in rooms where your child spends a lot of time.
  • Vacuum weekly or more often, if needed.
  • Set humidifier to below 50% (Picture 5).

For pet dander:

  • Have your child avoid contact with pets (Picture 6). Wash hands after petting any animal.
  • Consider finding a new home for the pet.

Allergic Rhinitis

Your child’s doctor may suggest medicines that are child-friendly and can be bought over-the-counter (OTC) or the doctor may prescribe medicines. They may be taken either orally (by mouth), or as eye drops or a nasal spray. Typically, the types of medicines include:

  • antihistamines
  • corticosteroids
  • decongestants

It is very important that your child takes the medicine exactly as ordered.

  • Read labels carefully.
  • Some OTC’s have the same active ingredients. If you give your child more than one type of medicine, make sure that they do not have the same ingredients. Even though you are buying a different medicine, you may, in fact, be giving your child too much of one type of medicine.
  • Make sure the medicine is safe for your child’s age.
  • Tell your doctor what OTC’s your child is taking.

Testing

If your child’s symptoms do not improve, the doctor may refer him or her to an allergist for more testing. The tests can help identify what allergies he has. In some cases, allergy shots (injections) may be recommended.

When to call the doctor

Call the doctor if:

  • Symptoms do not improve or if they worsen, even when your child is taking the
    medicine regularly.
  • The medicine makes your child drowsy (sleepy) or more active than usual.
  • If the nose drainage is thick or becomes yellow or greenish in color. This is not typical
    of allergic rhinitis. Your child might have a viral “cold” or an infection that might need to be treated.
  • Your child has a fever. 

Allergic Rhinitis (PDF)

HH-I-88 1/88, Revised 11/17 Copyright 1988 Nationwide Children’s Hospital