Allergic Rhinitis: All About Nasal Allergies in Children

Suddenly your child's nose starts running like a faucet. They're sneezing and rubbing their red-rimmed eyes. You might wonder if they've caught a cold. But these same symptoms might point to allergic rhinitis—an allergy that targets your child's nose.

Here's what you need to know about allergic rhinitis and how to work with your child's health care team to keep them comfortable when symptoms flare up.

What is allergic rhinitis?

Understanding what's happening inside your child's nose and body starts with the two basic forms of allergic rhinitis.

Types of allergic rhinitis: seasonal (hay fever) & year‑round

• Seasonal allergic rhinitis affects kids in spring, summer or early fall when outdoor pollen from trees, grasses and plants or mold spores fill the air. Hay fever is another term for warm-weather allergies (even though hay is rarely the cause and fevers don't happen).
  
  
• With perennial allergic rhinitis, kids can develop symptoms throughout the year. They react whenever they encounter certain triggers (allergens). Common perennial triggers include dust mites, mold, furry animals, cockroaches and more.

What causes these allergies in children?

Allergies happen when a child's immune system reacts strongly to something that gets inside their bodies. These allergens don't bother all kids, but your child's system sees them as a threat. Their body reacts by trying to cleanse away irritants and protect delicate tissues, like the lining of the nose.

Kids with seasonal or perennial (year-round) nasal allergies may experience:

• A runny, drippy nose

• Sneezing and sniffling
  

• Red, watery, itchy eyes

• Swollen nasal passages

• Dark under-eye circles (sometimes called "allergy shiners")
  

Nasal stuffiness and swelling might lead to:

• Difficulty sleeping (because it's hard to breathe through your nose)

• Drowsiness and low energy from poor sleep

• Trouble thinking clearly and making choices

• Struggles with school, sports and community activities
  

Does allergic rhinitis run in families?

Some families are more vulnerable to allergies than others. Studies show that kids have a 30% to 50% higher chance of developing allergies if one birth parent has them too. The odds jump to 60% - 80% when both birth parents have allergies. This explains why whole families might sniffle and sneeze from spring through early fall or feel terrible when they vacation in a damp, dusty lakeside cabin.

Could my child have a cold rather than allergies?

Here are key differences between allergic rhinitis and the common cold that may help you figure out what's happening.

• Colds are caused by viruses that your child picks up from being around other people. But no one can "catch" your child's allergic rhinitis, since it doesn't spread contagious germs.

• Allergies flare up the moment your child encounters an allergy trigger. Colds develop gradually over several days.

• If your child has a cold, the mucus from their nose will often be thick and cloudy, even yellowish-green. With allergies, the mucus is thin and clear.

• Colds trigger body aches and fever. Kids with allergies do not develop achiness or run a temperature.

• Allergies often cause itchy, red, watery eyes—a symptom rarely seen with colds.

• Colds usually last 3 to 10 days, gradually clearing up on their own. Allergies can last for weeks or months or even flare up throughout the year.
  

Do kids with allergic rhinitis need special tests?

Some nasal allergies can be diagnosed and treated based on your child's symptoms. For example, if they sneeze, sniffle and rub their eyes whenever they pet the neighbor's cat, then pet dander is the likeliest cause.

If it's not clear what's causing your child's allergies, allergy testing—along with tracking when symptoms happen—can help identify the trigger.

Knowing they react to mold, for example, helps you limit the time they spend in basements, attics, crawl spaces, or even musty antique stores.

How can I help my child feel better?

The first step is to partner with your pediatrician to create a care plan focused on your child's symptoms and triggers. Here are suggestions to discuss with your child's doctor.

Tips for controlling seasonal allergies

• Keep windows closed during peak pollen and mold seasons, which start in spring and continue through early fall.

• Monitor outdoor pollen counts and keep your child indoors on high-pollen days. Indoor spaces like gyms, trampoline parks, public pools and skating rinks can keep them active when the air is more likely to trigger symptoms.

• Use air conditioning and filtering systems to control allergens inside your home and car.

• Help your child learn to keep their hands away from their eyes, nose and mouth. Touching these areas helps pollen find an easy way inside.

• Encourage them to wear sunglasses outside to block pollen from the eye area.

• If your child is sensitive to mold, use a dehumidifier to keep moisture levels low, especially in sleeping spaces.

• Use saline sprays to cleanse your child's nasal passages and reduce swelling. These safe, drug-free treatments come in many forms, from simple spray bottles to specialized misting systems. Ask your pediatrician for suggestions.
  

Medicines for seasonal allergies

• Antihistamines ease the body's reaction to pollen, mold and other seasonal allergens. Ask your pediatrician about over-the-counter formulas—liquid, capsules or nasal sprays—made especially for children. Prescription antihistamines may also be an option, depending on your child's age and symptoms.
  
  
• Steroid nasal sprays ease the swelling inside your child's nose and sinuses. These can help your child breathe more easily and may improve sleep. Several brands of nasal spray are approved for use in children as young as 2 years old. Using the spray the right way and taking it regularly during allergy season helps it work best.
  
  
• Decongestants can comfort drippy little noses by reducing mucus flow and swelling. They should be used carefully, though, since studies show that congestion can come back worse ("rebound") after a course of decongestants. Always talk with your child's doctor for guidance on the correct use of these medicines.

Tips for controlling year-round (perennial) allergies

• First, know your child's triggers. Testing can show whether they're allergic to pets and other furry animals, mold, dust, cockroaches or other allergens. (Keep in mind that children can have more than one trigger, too.)

• Learn more about how triggers work. For example, if your child is allergic to pet dander, you'll need to do more than keep them from cuddling with the family dog or cat. Dander is made of tiny flecks of skin that settle in rugs, bedding, soft furniture and mix with household dust. Regular cleaning and laundering can reduce allergy flare-ups.

• Kids with mold allergies will benefit from cool, dry indoor air that keeps mold from forming. Portable dehumidifiers can help, especially in bedrooms and other sleep spaces. If you can, add air filtration and dehumidifying systems to your home's heating and cooling system to reduce allergens.

• Dust mites are a common allergy trigger. These nearly-invisible creatures feed on skin flakes found in household dust, which is why they're often found in bedding, soft furniture and pillows. This article offers helpful tips for dust mite control in bedrooms and beyond.

• Cockroach allergies don't mean your house is dirty. These bugs can be found in almost any indoor space, from homes to schools, community centers and more. They thrive year-round in warmer climates, making them hard to eliminate. Kids react to the droppings and body parts cockroaches leave behind, not the bugs themselves. Learn more here and how to prevent flare-ups in kids with cockroach allergies.
  

Treatment for year-round nasal allergies

• Drug-free saline rinses and sprays can be used daily to clear allergens out of your child's nose and sinuses. Many kids do well with this daily practice.
  
  
• Steroid nasal sprays can help children with more severe allergies. These are typically used daily to provide steady control of allergy symptoms. Your pediatrician may recommend these even if your child's allergies are mild, because perennial allergy triggers can be found nearly anywhere. For many kids and teens, these sprays are essential for good sleep, clear thinking and school success.
  
  
• Non-drowsy antihistamines and less commonly decongestants may play a part in your child's care plan, too. Your pediatrician will talk with you about your child's symptoms, habits and activities, and may recommend a pediatric allergist or immunologist. Working together, you can create a care plan that addresses your child's symptoms and unique needs.
  

• What to know about the "allergic march," a known pathway to allergies

• Nose allergies & hay fever (Symptom Checker)
  

• How are allergies and asthma linked?

• Do kids need nutritional supplements for strong immunity?