The Sniffing Season: What to do About Seasonal...

Have you heard of the allergic salute? This is the motion of a hand rising up to rub a runny and itchy nose over and over again. Allergic shiners are the dark circles that some children have under their eyes when allergy season comes around. My young patients find these terms funny, but no one who has suffered through allergies laughs at the painful, annoying symptoms. What can you do to help your child get through allergy season?

Diagnosing Allergies

First, you should know how to tell if allergies are to blame for your child’s symptoms. If she has a constantly runny nose, sneezes a lot, has red, itchy or watery eyes—all of which start when the seasons change—she may be suffering from seasonal allergies. Some children also get swollen eyes, with dark circles under them. The circles and swelling are caused by sinuses that are congested with mucous, or by blood that cannot flow properly because of blocked, stuffy sinuses.

Seasonal allergies can occur in any season except, usually, winter. Spring brings lots of pollen when the trees and flowers start to bud. Summer seems to be a time for grasses to do their dirty work. Late summer and fall is time for ragweed allergy.

It may be hard to determine exactly what outdoor allergens are triggering your child’s allergy. Simple skin testing—where a small amount of potential allergens are inserted under the skin to see if it causes a reaction—can be done to sort out what triggers the cascade of allergic symptoms in your child. But since there is not much you can do to prevent these outdoor phenomenon, short of keeping the windows closed and your child indoors, the focus is more on treatment.

Treating Allergies in Children

I generally do not treat children who have runny noses or lots of sneezes if they are not fatigued, they have no other complaints, and they look healthy. If the child looks exhausted, develops a chronic cough from post-nasal drip, or the allergies are influencing his life in other ways such as causing a loss of appetite, I recommend starting with an over-the-counter, non-sedating antihistamine such as Claritin. If this does not work and the symptoms are mainly nasal congestion and the child is over three years old, I may prescribe a nasal steroid. This nose spray may take several weeks to work.

For red, itchy eyes, sometimes the over-the-counter antihistamines work, but if they do not, there are prescription and non-prescription antihistamine eye drops that can be helpful.

Your child is more likely to suffer from seasonal allergies if she has other allergic conditions such as eczema or asthma. There is thought to be a genetic link to these conditions—meaning that if you are affected then it is more likely your children will also be— but the genetic markers are complex and have yet to be worked out.

Work with your doctor to come up with a treatment plan that makes sense for your child. Since these conditions seem to have a genetic component, if your family has lots of allergies, be on the look for them in your child. Those numerous colds may turn out to be seasonal allergies.

Dr. Victoria McEvoy graduated from Harvard Medical School in 1975 and is currently an Assistant Professor of Pediatrics at HMS. She is the Medical Director and Chief of Pediatrics at Mass General West Medical Group. She has practiced pediatrics for almost thirty years. She has been married to Earl for thirty six years and raised four children. She currently enjoys writing, traveling, reading, almost all sports, and spending time with her two grandsons.

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