When Your Child Has Nasal Allergies (Allergic Rhinitis)

Sick little girl coughing in bed.

Rhinitis is a reaction that occurs in the nose when airborne irritants (allergens) trigger the body to release histamine. Histamine causes itching, inflammation, and fluid or mucus production in the nasal and sinus linings and eyelids. Children with allergic rhinitis (also called nasal allergies) are sensitive to one or more substances in the air. Some children have allergies that come and go with the seasons (hay fever). Others may have allergies all year long. Nasal allergies can cause your child to lose sleep, feel tired, and have trouble paying attention in school. But you and your child’s doctor can develop a plan to help keep your child’s allergies under control.

What are the types of allergic rhinitis?

The two categories of allergic rhinitis are:

  • Seasonal. This type occurs particularly during pollen seasons.

  • Perennial. This type occurs throughout the year and is commonly seen in younger children.

What causes nasal allergies?

Nasal allergies are often caused by one or more of the following:

  • Dust mites (tiny insects that live in carpets, bedding, stuffed toys, and other fabric items)

  • Pollen from grasses, trees, and weeds

  • Cockroaches

  • Furry or feathered pets

  • Mold

  • Animal dander

  • Tobacco smoke

There is often a family history of allergic rhinitis.

What are the symptoms of nasal allergies?

Symptoms of nasal allergies can be mild or severe and include:

  • Sneezing

  • Runny (clear drainage) or stuffy nose

  • Itchy, watery, red, or swollen eyes

  • Itchy nose, throat, and ears

  • Nosebleeds

  • Cough from mucus dripping down the back of the throat (postnasal drip)

  • Sore throat

  • Wheezing

  • Dark circles under the eyes

  • Facial pressure or pain

  • Frequent ear or sinus infections

  • Snoring

  • Poor performance in school

The symptoms of allergic rhinitis may look like other health conditions. Always see your child's healthcare provider for a diagnosis.

How are nasal allergies diagnosed?

A health history and physical exam are usually all your child’s doctor needs to diagnose nasal allergies. Your child may be referred to an allergist. This is a doctor who is trained to do allergy skin testing. Skin or blood tests help identify which allergens your child is most sensitive to. This helps you and your child’s healthcare provider make a treatment plan.

How are nasal allergies treated?

Limiting your child’s exposure to allergens is a vital part of treatment. Talk with your child's healthcare provider about the best way to limit your child’s contact with things that trigger his or her allergies. Your healthcare provider may also suggest one or more medicines, including:

  • Antihistamines. These relieve itching, sneezing, and a runny nose. Antihistamines can be used on their own or along with steroid nasal sprays. You can buy some antihistamines over the counter. Others are available by prescription. Certain antihistamines can make your child drowsy.

  • Steroid nasal sprays. These help reduce swelling and relieve itching and sneezing. They aren’t the same as the decongestant nasal sprays you buy in the store. Steroid nasal sprays are usually used every day to prevent symptoms.

  • Other medicines. Healthcare providers sometimes prescribe other medicines, such as leukotriene inhibitors, cromolyn sodium, or allergy eye drops.

  • Allergy shots (immunotherapy). Allergy shots contain tiny amounts of the substances your child is allergic to, such as pollen or dust mites. The shots may make your child less sensitive to these allergens. Allergy shots are given in your healthcare provider’s office. They won’t work unless your child receives them regularly, often for a period of years. A type of immunotherapy given under the tongue is also available for home use.

Irritants make allergies worse

Irritants don’t cause nasal allergies, but they can make symptoms worse. Common irritants include:

  • Cigarette smoke

  • Perfume

  • Aerosol sprays

  • Smoke from wood stoves or fireplaces

  • Car exhaust 

  • Pets

When to call your child's healthcare provider

Call your child's healthcare provider if he or she has any of the following:

  • Trouble breathing

  • Wheezing

  • Frequent headaches

  • Fever and greenish or yellowish drainage from the nose

  • Worsening of your baseline allergy symptoms