Allergic Rhinitis

Allergic Rhinitis

What is Allergic Rhinitis?

Allergic rhinitis, commonly referred to as allergies or hay fever, affects more than 10 percent of U.S. children aged 17 years and under, according to the American Academy of Allergy, Asthma & Immunology. The numbers continue to rise.

What are the signs and symptoms of Allergic Rhinitis?

  • Sneezing
  • Runny nose
  • Itchy or congested nose, sinuses or eyes

Other symptoms include:

  • Itchy skin
  • Decreased sense of smell
  • Clogged ears
  • Watery eyes
  • Coughing
  • Sore throat
  • Fatigue and irritability
  • Headache

Unlike with a cold, symptoms are not caused by a virus. Symptoms, both mild and severe, can persist for years and lead to related problems such as sinusitis and ear infections. Severity of symptoms can fluctuate throughout the year.

When your child breathes in an allergen, a reaction in the nose triggers the release of an inflammatory substance called histamine. Symptoms can also occur when your child eats a food that he is allergic to. Researchers are not sure what causes the immune system reaction.

If you suspect your child suffers from allergies, you should consult a physician as soon as possible. Signs that your child should see a physician include:

  • Severe hay fever symptoms
  • Treatment that once worked for your child no longer works
  • Your child’s symptoms do not respond to treatment

How is Allergic Rhinitis diagnosed?

If your child’s allergy symptoms appear to be severe, your child may need an allergy test to determine exactly what she is allergic to.

This can involve skin tests, where the physician places a small amount of an allergen into your child’s skin to see if it causes an allergic reaction. The most common skin test methods include:

  • Skin-prick test – This involves placement of a small amount of substances on the skin (forearm, upper arm, or back). The skin is then pricked, to allow the allergen to go under the skin’s surface. The physician watches for signs of a reaction (e.g., swelling or redness). Results are typically seen in 15 to 20 minutes. Several allergens can be tested simultaneously.
  • The intradermal skin test – The physician injects a small amount of allergen into the skin and awaits a sign of reaction. The test is more often used to find out if the patient is allergic to something specific, such as penicillin or bee venom.
  • Patch testing – This method diagnoses the cause of skin reactions that occur after a substance touches the skin. Possible allergens are taped to the skin for 48 hours. The physician will then look at the area in 72 to 96 hours.

Other tests suitable for children include:

  • Nasal smear
  • Complete blood count with differential
  • Serum IgE
  • Allergen-specific IgE testing (radioallergosorbent test [RAST]): This can be helpful if a specific allergen is suspected.

In most cases, children will not need additional testing. But in some cases, your child’s doctor may want to do other tests to make sure that another condition isn’t creating the symptoms.

In general, imaging studies are not needed in pediatric allergic rhinitis unless sinusitis is suspected. In such cases, a limited computed tomography (CT) scan of the sinuses may be done.

Allergic rhinitis testing can not only help your child’s physician know whether allergic rhinitis is causing symptoms but can also help the doctor determine the best treatment.

What are the causes of Allergic Rhinitis?

Allergies stem from an overreaction of your child’s immune system to inhaled particles in the air. Your child’s immune system will attack the particles (allergens) in your body. This process leads to symptoms that resemble the common cold.

There are two types of allergic rhinitis:

  • Seasonal (hay fever): Allergens encountered outdoors cause seasonal hay fever
  • Perennial (year round): Perennial allergic rhinitis is caused by indoor allergens such as dust mites, pet dander and mold.

Many children who have allergic rhinitis also suffer from asthma, although the link between the two conditions is not fully understood.

How is Allergic Rhinitis treated?

While there is no cure for allergic rhinitis, the condition can be well managed by behavior adjustments and medication.

Physicians advise that one of the best things your child can do is to avoid the substances that cause his allergies. True, it can be impossible to avoid all pollen and other allergens, but you and your child can take steps to reduce exposure. Here are a number of approaches which may help control allergies:

  • Clean your house often to get rid of dust, animal dander or molds.
  • Have your child stay indoors and close windows when pollen counts are high.
  • Use an air conditioner in your home and car.
  • Avoid using fans that draw in air from outdoors.
  • Don’t hang laundry outside to dry.
  • Have your child bathe or shower and change her clothes after being outside.
  • Cover your child’s pillows and mattress with dust mite-resistant covers.
  • Remove carpet and install tile or hardwood floors. Use area rugs and wash them often in very hot water.
  • Use blinds instead of curtains.
  • Keep pets out of your child’s bedroom.
  • Use a HEPA filter on your vacuum.
  • Use an air purifier.
  • Wash bedding and toys such as stuffed animals in very hot water once a week.

Your child’s doctor may prescribe medicine to treat allergic rhinitis. The type of medicine the doctor prescribes will depend on your child’s symptoms and their severity, her age and whether she has another medical condition such as asthma.

Medical treatments for allergic rhinitis include:

  • Antihistamines – These work well for treating allergy symptoms and may be used when symptoms do not happen often or do not last long. Antihistamine nasal sprays are particularly effective.
  • Corticosteroids – Nasal corticosteroid sprays are considered the most effective treatment for allergic rhinitis. They work best when used continually, but they can also help when used for shorter periods of time.
  • Intranasal decongestants – These can help in reducing symptoms such as nasal stuffiness. But don’t use nasal spray decongestants for more than three days.
  • Leukotriene inhibitors – These are prescription medicines that block leukotrienes. These chemicals are released by the body in response to an allergen that also triggers symptoms.
  • Allergy shots (immunotherapy) – Allergy shots are sometimes recommended when your child cannot avoid the pollen and his symptoms are hard to control. This includes regular shots of the pollen he is allergic to. Each dose is slightly larger than the dose before it, until your child reaches the dose that helps control his symptoms. Allergy shots may help your child’s body adjust to the pollen that is causing the reaction.

Most symptoms of allergic rhinitis can be managed. More severe cases need allergy shots.

Children may outgrow an allergy as the immune system becomes less sensitive to the trigger. But once a substance, such as pollen, causes allergies, it often continues to have a long-term effect.

Frequently Asked Questions

  • How does allergic rhinitis affect an individual?

    An allergen triggers an allergy. Specifically, when breathed in, the allergen causes the immune system to release substances (IgEs) into the nasal passages and inflammatory chemicals such as histamines.

  • What plants cause hay fever?

    Hay fever results from an allergic reaction to pollen. Plants that cause hay fever are trees, grasses and weeds. Their pollen is carried through the air by wind. However, the type of plant that causes hay fever can vary from person to person. Other allergies occur when a person breathes in an allergen such as mold, animal dander or dust.

  • Does an allergy like hay fever run in families?

    Quite often it does. If you or your spouse has hay fever or other allergies, your child is likely to suffer from them, too.

  • Does weather impact the severity of symptoms?

    Yes. There is more pollen in the air during hot, dry, windy days. On cool, damp, rainy days, most pollen is washed to the ground. That is why most weather reports now include a forecasted pollen count. You may want to keep your child indoors on days when the pollen count is especially high.

  • Are there complications with allergic rhinitis?

    Yes, complications can occur if your child’s condition is not treated. Long-lasting allergic rhinitis can lead to sinusitis, clogged ears and ear infections, sleep apnea and asthma. It can also lead to an overall feeling of malaise.

  • Can a physician cure my child’s allergic rhinitis?

    Most likely, no, there is no cure. Severity of symptoms may significantly diminish over the years, but the condition probably will have long-standing effects.