By: Stanislaw J. Gabryszewski, MD, PhD, FAAP
Allergies happen when the immune system, which normally protects the body from germs, overreacts to a usually harmless substance. That substance is called an allergen.
What is an allergic reaction?
Allergens can enter the body in several ways—through skin contact, breathing them in, eating or drinking them or through injections.
When this happens, the immune system may release chemicals that cause symptoms like itching, rashes, swelling, sneezing, wheezing, coughing and stomach problems such as vomiting. Sometimes, allergies can lead to a serious, life‑threatening reaction called anaphylaxis.
Common allergy triggers in children
Children can be allergic to many different things. Some of the most common allergens include:
Pollens from trees, grasses and weeds
Mold spores, both indoors and outdoors
Dust mites that live in bedding, carpeting and soft furniture
Animal allergens from skin flakes, saliva or urine (pee) of furry pets
Foods and food ingredients
Medicines such as antibiotics or pain relievers
Venom from insect stings
Environmental allergies (airborne allergies)
Environmental allergies happen when children react to allergens that are found in the air. These allergens can be found indoors or outdoors. They may be seasonal (such as pollens) or they may occur year-round (such as dust mite or animal dander).
Common environmental allergens
Typical symptoms of environmental allergies
Environmental allergies are called allergic rhinitis. Sometimes, they are called hay fever, although they are actually not caused by hay and do not cause fever.
Other allergic conditions in children
Food allergies
Food allergies occur when the immune system reacts to a specific food protein. The most common food allergens in children include:
Milk
Eggs
Peanuts
Tree nuts
Soy
Wheat
Fish
Shellfish
Sesame
There are different food allergy types. Some cause immediate symptoms, while others cause more delayed symptoms. These symptoms may include hives, vomiting, diarrhea, coughing, wheezing or swelling of the lips and face. Some food allergies can cause anaphylaxis, which requires immediate treatment with epinephrine.
Eczema (atopic dermatitis)
Eczema is chronic, itchy skin condition that often starts in infancy. It may flare with humidity or weather changes causing dry skin, sweating, irritants, allergens, infections or even stress.
Contact dermatitis
Contact dermatitis is a skin reaction that happens when the skin touches something that irritates it, such as poison ivy, nickel jewelry, soaps, detergents, fragrances or skin care products.
Urticaria (hives)
Uticaria is a skin condition that causes itchy, raised welts (hives) and sometimes swelling. The cause of hives is often unclear. They can be triggered by infections, foods, medicines, heat, cold, pressure or other factors.
Asthma
Many children with asthma can develop worse symptoms if they are exposed to certain triggers. These include allergic triggers, such as pollen, dust mites, mold or pet allergens. They may also have other triggers, like exposure to smoke and pollution.
Insect sting allergies
Some children have severe reactions to stings from insects like bees, wasps, yellow jackets or fire ants. This may cause hives, swelling, breathing trouble, or anaphylaxis.
Medication allergies
Some medicines can cause allergic reactions. These reactions can be mild, like a rash, or more serious and affect the whole body. Always tell your child’s doctor about any past reactions to medicines.
Are allergies inherited?
Allergies often run in families. If one parent has allergies, their child is more likely to develop allergies. The risk is even higher if both parents are allergic. However, whether they develop allergies, or which allergies they develop, differs from person to person.
How to figure out if my child has allergic triggers
The way that allergies are diagnosed differs by allergy type. Sometimes, explaining what happened when your child was exposed to a potential trigger is enough information. In other cases, allergy testing may be needed. Start by discussing your concerns with your pediatrician.
How to reduce allergy triggers at home
Once it is clear what your child's allergy triggers are, reducing exposure to them can help reduce symptoms.
Some practical steps to help prevent allergy symptoms
Keep windows closed on high‑pollen days and use air conditioning if possible to improve indoor air quality.
Wash hands and face after outdoor play during pollen season or after playing with a furry pet.
Change clothes and shower after spending time outdoors during pollen season.
Use mattress and pillow covers designed to block dust mites and wash bedding regularly in hot water.
Keep indoor humidity low.
Vacuum regularly using a HEPA‑filter vacuum if available.
For food allergies, avoidance should be strict. Read food labels carefully, and keep foods containing the allergen away from your child.
Allergy medications and treatment for children
Talk with your pediatrician before starting allergy medicines. Treatment fo allergies depends on the allergy type. For example, for environmental allergies, children may benefit from antihistamines, nasal sprays or eye drops. For asthma, children may need treatment with inhaler medicines.
Children with anaphylactic food allergies will need a prescription for epinephrine and a written emergency action plan.
Some children with ongoing allergy symptoms may also benefit from specialized treatments, like immunotherapy (e.g., allergy shots), which teaches the immune system to tolerate the allergic trigger.
When should my child see an allergist?
Your pediatrician may recommend a referral to a board‑certified allergist if:
Symptoms are severe, ongoing, or hard to control (for example, severe environmental allergy symptoms or frequent asthma flare-ups)
The trigger of symptoms is not clear
There is concern for food allergy, medication allergy, insect sting allergy, anaphylaxis or any other allergy concerns
An allergist can:
Help diagnose allergic conditions
Perform allergy testing when appropriate and identify allergy triggers
Recommend specific avoidance strategies
Create a personalized treatment and safety plan
Remember
Your pediatrician is the best place to start when managing your child's allergy symptoms. If you have concerns about symptoms, triggers, or treatment options, don't hesitate to ask. Sometimes, managing allergies may also require a partnership with an allergist.
More information
About Dr. Gabryszewski
Stanislaw J. Gabryszewski, MD, PhD, FAAP, is a member of the American Academy of Pediatrics Section on Allergy & Immunology and Section on Infectious Diseases. He is an Assistant Professor, University of Pennsylvania Perelman School of Medicine and an Attending Physician in the Division of Allergy & Immunology at Children's Hospital of Philadelphia.
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