Springdale Mason Pediatrics

Nose Allergy (Hay Fever)

Definition

  • An allergic reaction of the nose
  • Main symptoms are an itchy nose, clear discharge and sneezing
  • The medical name is allergic rhinitis

Call or Return If

  • Symptoms are not better in 2 days after starting allergy medicine
  • You think your child needs to be seen
  • Your child becomes worse

About This Topic

Symptoms

  • Clear nasal discharge with sneezing, sniffing, and itching of nose (100%)
  • Eye allergies (itchy, red, watery and puffy) also can occur (70%)
  • Ear and sinus congestion or fullness can occur
  • Throat can also feel scratchy or have a tickly feeling at times
  • Itchy ear canals and itchy skin sometimes also occur
  • Cough and hoarse voice may occur (allergic cough).

How to Tell Nasal Allergies from the Common Cold

  • Symptoms happen during pollen season
  • Had the same symptoms during the same month last year
  • Hay fever symptoms last 6-8 weeks for each pollen. (Colds last 1-3 weeks).
  • Both have a runny nose and watery eyes. Can also have a cough with both, but less common with allergies.
  • Allergies: Itchy eyes and nose. Not seen with colds.
  • Colds: Fever and sore throat. Not seen with allergies.

Causes

  • Hay fever is an allergic reaction of the nose and sinuses. It is a reaction to an inhaled substance (called an allergen). Most often, this is a pollen.
  • Grass, trees, weeds and molds are the most common pollens.
  • Allergens can also be from cats, dogs, horses, rabbits and other animals.

After Care Advice

Overview:
  • Hay fever is very common. It happens in about 15% of children.
  • Nose and eye symptoms can be controlled by giving allergy medicines. Use either a short-acting (Benadryl) or long-acting (Zyrtec).
  • Pollens are in the air every day during pollen season. So, allergy meds must be given daily.
  • Here is some care advice that should help.
Allergy Medicines Short-Acting:
  • Allergy medicines are called antihistamines. They are the drug of choice for nasal allergies.
  • They will help control the symptoms. These include a runny nose, nasal itching and sneezing.
  • Benadryl or Chlorpheniramine (CTM) products are helpful. No prescription is needed. They need to be given every 6 to 8 hours.
  • The bedtime dosage is especially important for healing the lining of the nose.
  • The key to control is to give allergy meds every day during pollen season.
Allergy Medicines Long-Acting:
  • Cetirizine (Zyrtec) and Loratadine (Claritin) are long-acting allergy medicines. No prescription is needed.
  • Advantage: Causes less sedation than older allergy meds such as Benadryl and chlorpheniramine. They are long-acting and last up to 24 hours.
  • AGE 2- 6 years old, discuss with your child's doctor. If approved, give 2.5 mg (2.5 ml or 1/2 teaspoon) of liquid syrup. Use once daily in the morning.
  • AGE 6-12 years old, give 5 mg chewable tablet once daily in morning.
  • AGE: 12 years and older, give 10 mg tablet once daily in morning.
  • Downside: Doesn't control hay fever symptoms as well as older allergy medicines. Also, sometimes will have breakthrough symptoms before 24 hours. If that happens, you can give a single dose of Benadryl or CTM.
  • Cost: Ask the pharmacist for a store brand. Reason: Costs less than Claritin or Zyrtec brand.
Nasal Saline to Wash Out Pollen:
  • Use saline (salt water) nose drops or spray. This helps to wash out pollen or to loosen up dried mucus. If you don't have saline, you can use bottled water or a few drops of clean tap water.
  • STEP 1: Put 3 drops in each nostril.
  • STEP 2: Blow each nostril out while closing off the other nostril.
  • STEP 3: Repeat nose drops and blowing until the discharge is clear.
  • How often: Do nasal saline rinses when the nose is very itchy or blocked.
  • Saline nose drops or spray can be bought in any drugstore. No prescription is needed.
  • Saline nose drops can also be made at home. Use 1/2 teaspoon (2 ml) of table salt. Stir the salt into 1 cup (8 ounces or 240 ml) of clean water. You must use bottled or boiled water for this purpose.
Eye Allergies:
  • For eye symptoms, wash off the face and eyelids. This will remove pollen.
  • Most often, an allergy medicine given by mouth will help the eye symptoms. Sometimes, eye drops are also needed.
  • Antihistamine Eye Drops - Ketotifen (1st Choice). Dose: 1 drop every 12 hours.
  • Examples are Zaditor or Alaway. No prescription is needed.
  • For best control, use ketotifen eyedrops every day during pollen season.
  • Antihistamine/Vasoconstrictive Eyedrops (2nd Choice). Dose: 1 drop every 8 hours
  • Ask your pharmacist to suggest a brand. Some are Naphcon A, Opcon A, or Visine A.
  • Do not use this type for over 5 days. (Reason: Will cause red eyes from rebound effect).
Wash Pollen Off Body:
  • Remove pollen from the hair and skin with shampoo and a shower.
What to Expect:
  • Antihistamines should bring your allergy symptoms under control quickly.
  • Since pollen allergies recur each year, learn to control the symptoms.
Prevention - How to Reduce the Pollen Your Child Breathes:
  • Pollen is carried in the air.
  • Keep windows closed in the home, at least in your child's bedroom.
  • Keep windows closed in car. Turn the air conditioner on recirculate.
  • Avoid window fans or attic fans. They pull in pollen.
  • Try to stay indoors on windy days. Reason: The pollen count is much higher.
  • Avoid playing with the outdoor dog. Reason: Pollen collects in the fur.
  • Pollen Count: Get your daily pollen count from www.pollen.com. Just type in your zip code.

Author: Barton Schmitt MD, FAAP
Copyright 2000-2020 Schmitt Pediatric Guidelines LLC
Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it.
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