Allergic rhinitis control in children

Overview

Allergic rhinitis is a condition where the inside of the nose becomes swollen and irritated because of tiny particles in the air, like pollen (from grass, trees, or weeds), dust mites, mold, or pet dander. It is also called hay fever.

Yes, allergic rhinitis is very common in children. Many children will have some form of hay fever during their school years.

It can affect children of all ages, but it often first appears in early childhood or the teenage years.

Symptoms

Common symptoms

• Sneezing, especially in the morning or after being outdoors
• A runny or stuffy nose
• Itchy eyes, nose, or throat
• Watery eyes

Symptoms in children

• Frequent nose rubbing or sniffling
• Dark circles under the eyes (called allergic shiners)
• Mouth breathing because the nose is blocked
• Poor sleep and tiredness during the day

Symptoms in older adults

• Less obvious symptoms, often more congestion than sneezing
• Long-term stuffy nose
• Less watery eyes

Causes

Main causes

• Pollen from trees, grass, and weeds
• Dust mites (tiny bugs found in bedding and carpets)
• Mold spores (from damp areas)
• Pet dander (tiny flakes of skin from animals like cats and dogs)

Risk factors

• Family history of allergies or asthma
• Having other allergic conditions like eczema
• Living in an area with high pollen levels or indoor dampness
• Exposure to tobacco smoke

When to see a doctor

See a doctor urgently if:

• If your child has trouble breathing after being around a possible allergen
• If the nose is so blocked that the child cannot eat or drink properly

Book a routine appointment if:

• If symptoms last more than a few weeks and bother the child
• If over-the-counter remedies (like antihistamine syrups) do not help
• If symptoms interfere with school, play, or sleep

Diagnosis

A doctor will ask about your child's symptoms, when they happen, and whether there is a family history of allergies. They will also look inside the nose with a small light.

Tests that may be done

• Skin prick test – a small drop of allergen is placed on the skin and lightly pricked to see if a reaction occurs
• Blood test – measures the level of allergy-related antibodies to common allergens

What to expect at your appointment

The doctor may suggest keeping a symptom diary first. If needed, they can refer your child to an allergy specialist for more detailed testing.

Treatment

The main treatment for allergic rhinitis in children is avoiding triggers and using medicines that help control symptoms. Most children can get good relief with proper management.

Self-care at home

• Keep windows closed during high pollen days, especially in the morning and evening
• Wash bedding in hot water at least once a week to kill dust mites
• Use a saline (salt water) nasal rinse to clear allergens from the nose
• Vacuum carpets and soft furniture regularly

Medical treatments

Doctors may recommend medicines such as antihistamines (which block the allergic reaction) or nasal sprays that reduce swelling in the nose. These are available as liquids, tablets, or sprays. Always follow the doctor's dosing advice for children.

When is surgery considered?

Surgery is rarely needed for allergic rhinitis in children. It may be considered only if a child has very large nasal polyps (growths) or a severely blocked nose that does not improve with other treatments.

Living with this condition

Helping your child avoid triggers is the most important part of daily life. For example, on high pollen days, keep them indoors as much as possible and have them take a bath and change clothes after playing outside.

Lifestyle tips

• Use allergy-proof pillow and mattress covers
• Shower and wash hair after being outdoors to remove pollen
• Keep pets out of the bedroom and off upholstered furniture

Diet and exercise

There is no special diet for allergic rhinitis, but eating a balanced diet helps overall health. Exercise is good, but if pollen makes symptoms worse, consider indoor activities like swimming or gym on high pollen days.

Mental health and emotional wellbeing

Allergic rhinitis can affect a child's mood and focus because it disrupts sleep and causes discomfort. This can lead to frustration or trouble at school. It is important to treat symptoms so the child can feel better and enjoy daily activities.

Prevention

Allergic rhinitis cannot always be prevented, but reducing exposure to triggers can lower the chance of symptoms. For example, using air filters, keeping windows closed, and washing bedding often can help.

Vaccines

There are no routine vaccines for allergic rhinitis. However, some children may benefit from allergy immunotherapy (allergy shots or drops) which can reduce sensitivity over time.

Screening programmes

Routine screening for allergies is not recommended for all children. But if your child has bothersome symptoms, an allergy test can help identify specific triggers.

Complications

If left untreated

• Ear infections (because fluid builds up behind the eardrum)
• Sinus infections (when the sinuses become blocked and infected)
• Poor sleep and daytime tiredness
• Worsening of asthma symptoms if the child also has asthma

Long-term outlook

With proper management, most children with allergic rhinitis can control their symptoms and lead a normal, active life. Many children find that their symptoms improve as they get older. Treatment is safe and effective, and there is good reason to be hopeful.

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