This long winter has put a strain on all of us and along with you, I am welcoming spring with open arms. The sunshine, cool breeze and the glimpse of green in our lawn are all inviting. However, the spring season also brings challenges to people who suffer from seasonal allergies or “hay fever.”
Hay fever is not caused by hay and does not produce fever. At least, approximately 35 million in the US have seasonal allergies and there have been 6.7 million reported cases in children in the past 12 months. Hay fever is also known as allergic rhinitis. “Rhinitis” refers to inflammation of the nasal passages. This inflammation can cause a variety of symptoms, including runny nose, itchy eyes, congestion, sneezing, and sinus pressure.
Most seasonal allergies are caused by pollens from trees, grass or weeds, and mold spores, which grow when the weather is humid, wet or damp. Normally, people breathe in these substances without a problem. The immune system of allergic sufferers acts as if the substance is harmful to the body and causes the release of a chemical called “histamine” which causes the cascade of reactions. Seasonal allergies usually do not appear until after the age of two.
Young children often do not know how to blow their nose, but instead sniff, cough or clear their throat. “Allergic shiners” – swollen, blue-colored skin under the eyes – may also be evident. Children with allergies can also have decreased sense of smell or taste. They can have trouble sleeping, therefore affecting their performance in school and even trouble with sports. There is
increased susceptibility to developing sinusitis, middle ear infections and worsening asthma.
In our pediatric office, we often get this question, “Is it allergies or is it a cold?” Allergies cause a runny nose with a thin, watery discharge versus a watery, thick, yellow discharge from a cold. The onset of allergies is immediate after the exposure to allergens, and colds are manifested 1-3 days after exposure to a cold virus. There is no fever with allergies and children with a respiratory virus can have a fever with associated body aches. The duration of allergies lasts as long as you are exposed to the allergens, and colds usually last for 3 -7 days.
The diagnosis of allergic rhinitis is based upon a physical examination and the above symptoms described. It is often possible to identify what triggers your allergic rhinitis by: recalling the factors that precede symptoms, noting the timing and location at which symptoms begin.
You may want to see your allergist, if symptoms are not well-controlled, or if identifying the allergen is difficult. A skin test may be indicated to identify the allergens.
There are several treatments for seasonal allergies:
SALINE SPRAYS AND NOSE RINSES: Rinsing the nose with salt water(saline) helps clear out the allergens and irritants from the nose. It also helps before applying any nasal sprays with medication. A salt solution made with distilled or boiled water or sterile saline not tap water) is recommended for each nostril.
NASAL STEROIDS: Nasal sprays works best when used properly and medication remains in the nose rather than draining down the back of the throat. The head should be positioned normally or with chin slightly tucked.
ANTIHISTAMINES relieve the itching, sneezing, and runny nose of allergic rhinitis but may not relieve nasal congestion. Combined treatment with a nasal steroid or decongestant may
provide greater relief.
ALLERGY SHOTS also known as allergen immunotherapy are given to reduce the sensitivity to the allergens. In children, immunotherapy can help prevent developing allergic asthma later in life. Shots are only available for common allergens, such as pollens, cat and dog dander, dust mites and molds. There is no proven way to avoid getting allergies in the first place. The best thing to do is to reduce the exposure. Stay indoors on dry windy days. The best time to go outside is after a good rain. Keep car and house windows closed and use air conditioning. Shower to rinse pollen off of hair and skin. Use a vacuum with a special filter (HEPA filter) to keep the indoors as clean as possible. If a child gets symptoms at the same time every year, medication can be started 1 or 2 weeks before exposure starts.
With the start of seasonal allergies you must NIP THEM in the BUD!!
The author practices Pediatric and Adolescent Medicine at Pediatrics of Sleepy Hollow, LLP. 150 White Plains Road, Suite 101, Tarrytown, NY 10591.