Battling Springtime Allergies

By Bonnie Owens on April 13th, 2009

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Spring is here, and so are allergies.  The reason for the spike in allergy flare ups in spring is because all the trees and plants are blooming, and pollen from the flowers get carried by the wind, and end up in our nose, eyes, and lungs.  Immune cells in these body tissues react to the pollen and release histamine, a chemical that causes fluids to leak out of our bloodstream and into the tissues.  In the nose, this results in swelling and mucus production.  In the eyes, this causes redness and tearing.  In the lungs, this triggers swelling, wheezing, and mucus production.  Histamine is also responsible for the itching that occurs in the eyes, nose and throat.  Here is a guide to understanding the most common springtime allergic condition, nasal allergies.

What are the symptoms?

• Nasal congestion
• Clear runny nose
• Itchy nose
• Itchy throat and post-nasal drip
• Crease across the top of the nose from constant wiping
• Excessive sneezing
• Dark circles under eyes
• Persistent cough, often rattling

How do you tell if your child has allergies or just a simple cold?

 You notice that your child is displaying the symptoms above and you wonder if it is allergies or just a common cold virus.  Many parents end up at the doctor’s office with this very question.  During the early stages of these symptoms, it doesn’t matter if this is an allergy or a cold.  Neither condition needs an antibiotic and the child doesn’t need to be in the office.  If you really want to know whether your child is suffering from allergies or just a cold, you need to wait and see if symptoms persist longer than one to three months, this is perhaps the single most important indicator of allergies.  All children go through normal coughs and colds.  Some children may have several back-to-back colds during winter that make it seem like they may have allergies.  However, before you delve into an all-out effort to prevent your child’s allergies, you should allow at least two or even three months to pass.  Mild allergies or a string of colds will usually work themselves out within this time period, making allergy intervention unnecessary.  You may alleviate your child’s symptoms with over-the-counter allergy medications during this time if necessary.  One exception to this three-month rule is for young infants where formula allergy or an allergy to food in mom’s breast milk should be investigated after one month of symptoms.

How do you treat allergies?

 Step one – no treatment at all.
If your child’s symptoms are mild, and do not seem to interfere with his life very much, then you really do not need to give any medication at all.

Step two – nasal saline spray.
If the symptoms are mildly troubling, simply squirt this into your child’s nose several times a day to flush out the allergens, and blow the nose periodically.

Step three – non-prescription nasal decongestant and/or antihistamine medications.
If the symptoms bother your child enough and are interfering with his daily life, and the saline spray doesn’t seem to be enough, then you can try the following medications:

•  Over-the-counter antihistamines – these work by blocking the action of histamine like I mentioned earlier.  They treat the itchy, sneezy, runny nose, itchy watery eyes, and itchy throat.  They can also help with nasal congestion. 
• Decongestants – drug name is pseudoephedrine.  While these drugs do nothing to fight the histamine effects of allergies, they can improve nasal congestion associated with allergies.  They are especially helpful in conjunction with an antihistamine when the major allergy symptom is nasal congestion.  Over-the-counter decongestants are virtually the same as prescription ones.  
• Combination antihistamine/decongestants – the above over-the-counter antihistamines also come combined with a decongestant. 
• Cromolyn nasal spray – this acts like an antihistamine directly in the nose. 
• Decongestant nasal spray – this isn’t actually an allergy spray.  It is very effective at temporarily relieving severe nasal congestion, but does not prevent allergy symptoms.  Warning – do not use more than 3 days at a time or your nose may become dependent on it to stay clear.

Note: Because nasal sprays usually take one or two weeks to start working, they shouldn’t be used only one day here and there as this isn’t effective.

Step four – prescription medications.

• Prescription antihistamines – common brands include Claritin ™, Zyrtec ™, and Allegra ™. Some of these are now approved for children as young as two years old. 
• Antihistamine nasal spray – there is only one on the market right now, available only by prescription, called Astelin ™. In 2000, it became approved for use in children as young as 5 years. It works well, and has the benefit of acting directly in the nose, compared to oral antihistamines. It can be used safely for many months at a time with very few side effects.
• Steroid nasal sprays – the word “steroid” can be scary for a parent. But these steroids are different than the “body building” ones taken by weightlifters.  This steroid also stays in the nasal lining.  Very little of it is absorbed into the body.  They are currently approved for children as young as two years.  They come either as wet sprays or dry aerosols. If your child hates one kind, switch to the other.

How can I prevent my child’s allergies in the first place?

Some parents may be reluctant to use medication for a problem that they may be able to prevent from even occurring.  Prevention is important, but don’t knock yourself out trying to track down your child’s allergies unless they truly are persistent and bothersome.  The most common source of springtime allergies is pollen. 

If you suspect that your child has seasonal allergies due to pollens, here are the steps you can take to minimize the exposure:

• Stay indoors on windy days during the pollen season and when the pollen counts are high.  Local weather websites usually have pollen count information. 
• Don’t allow your child to play in fields with flowers and tall grass. 
• Keep all the windows and doors closed during your child’s specific allergy season.  This keeps the pollen out. 
• Wash hats and jackets more frequently during pollen season. 
• Give your child a bath and wash hair before bedtime to get the pollen out. 
• Don’t hang-dry your child’s laundry outside as it can pick up pollen. 
• Install a special filter into your central heating and cooling system that cleans the air as it comes in from outside. You can buy these from a hardware store. 
• Buy a portable Hepa filter – High Efficiency Particulate Accumulator filters can remove dust mite droppings, pollens, molds, spores, animal dander and many other irritants. They cost $100 – $200.  Place it in the main living area of the house during the night to clean the air while you sleep.  Then run it in the bedroom during the afternoon so the air will be clean while you sleep. 
• Pollen counts are usually highest during late morning and early afternoon.  Limit outside playtime to early morning, late afternoon and evenings during allergy season. 
• Put window air conditioning units on recirculate to keep out the outside air. 
• Keep trees and bushes near the house well pruned to avoid heavy vegetation. 
• Keep car windows rolled up while driving.