Allergic Rhinitis

Allergic Rhinities

What is allergic rhinitis?

Rhinitis is a reaction that occurs in the nose when airborne irritants (allergens) trigger the release of histamine. Histamine causes inflammation and fluid production in the fragile linings of nasal passages, sinuses, and eyelids.

Allergic rhinitis, one type of rhinitis, is uncommon in children younger than three years of age. However, prevalence increases with age. There is usually a family history of allergic rhinitis.

Allergic rhinitis affects up to 20 percent of children and 15 to 30 percent of adolescents. It is estimated that 75 percent of children with asthma also have allergic rhinitis.

What are the types of allergic rhinitis?

There are two categories:

  • Seasonal: occurs particularly during pollen seasons. Seasonal allergic rhinitis usually does not develop until after six years of age.
  • Perennial: occurs throughout the year. This type of allergic rhinitis is commonly seen in younger children.

What are the causes of allergic rhinitis?

The most common causes of allergic rhinitis include the following:

  • Pollen
  • Dust mites
  • Mold
  • Animal dander

What are the symptoms of allergic rhinitis?

Each child may experience symptoms differently. The most common symptoms of allergic rhinitis are:

  • Sneezing
  • Congestion
  • Runny nose
  • Itchy nose, throat, eyes, and ears
  • Nosebleeds
  • Clear drainage from the nose

Children with perennial allergic rhinitis may also have the following:

  • Recurrent ear infections
  • Snoring
  • Mouth breathing
  • Fatigue
  • Poor performance in school
  • “allergic salute”: a line or crease across the bridge of the nose caused by a child rubbing the hand upward while sniffling

Always check with your child’s doctor for a diagnosis because these symptoms can resemble other conditions or medical problems.

How do you diagnose allergic rhinitis?

We start with a thorough medical history and physical examination. In addition to the above symptoms, your child may also have dark circles under the eyes, creases under the eyes, and swollen tissue inside the nose.

How do you treat allergic rhinitis?

The best treatment is to avoid allergens that are causing the problem. Your child’s physician will determine the best treatment based on:

  • Your child’s age, overall health, and medical history
  • Extent of the reaction
  • Your child’s tolerance for specific medications, procedures, or therapies
  • Expectations for the course of the allergic reaction
  • Your opinion or preference

What are some of the treatment options?

  • Antihistamines to decrease the release of histamine, possibly decreasing the symptoms of itching, sneezing, or runny nose. Some examples of antihistamines are diphenhydramine (Benadryl) and hydroxyzine (Atarax). These medications may cause drowsiness. Consult your child’s physician to determine the proper dosage for your child.
  • Non-sedating antihistamines work like antihistamines but without the side effect of drowsiness. Non-sedating antihistamines include cetirizine (Zyrtec®) and loratadine (Claritin®). Consult your child’s physician to determine the proper dosage for your child.
  • anti-inflammatory nasal sprays to decrease the swelling in the nose. Consult your child’s physician to determine the proper dosage for your child.
  • Corticosteroid nasal sprays to decrease the swelling in the nose. Corticosteroid nasal sprays work best when used before the symptoms start, but they can also be used during a flare-up. Consult your child’s physician to determine the proper dosage for your child.
  • Decongestants to make the blood vessels in the nose smaller, thus decreasing congestion. Decongestants can be purchased either over the counter or by prescription. Consult your child’s physician to determine the proper dosage for your child.

If your child does not improve by avoiding suspected allergens or from using the above medications, your child’s physician may refer you to an allergist for testing. The allergist may recommend immunotherapy based on the test results. Immunotherapy usually involves a three-to-five-year course of repeated injections of specific allergens to decrease the reaction to these allergens when your child comes into contact with them. Consult your child’s physician for more information.

How do you prevent allergic rhinitis?

Preventive measures for avoiding allergic rhinitis include:

  • Environmental controls, such as air conditioning during pollen season
  • Avoiding areas where there is heavy dust, mites, molds
  • Avoiding pets