Allergic Rhinitis

What are the symptoms of allergic rhinitis?

Each child may experience symptoms of allergic rhinitis differently, but common symptoms include:

• sneezing
• congestion
• runny nose
• itchy nose, throat, eyes, and ears
• nosebleeds
• clear drainage from the nose

Symptoms of perennial allergic rhinitis may also include the following:

• recurrent ear infections
• snoring
• mouth breathing
• fatigue
• poor performance in school
• "allergic salute" — when a child rubs his hand upward across the bridge of the nose while sniffing

The symptoms of allergic rhinitis may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.

You can help your child avoid allergic rhinitis by:

• using air conditioning, instead of open windows, during pollen season
• avoiding areas where there is heavy dust, mites, or molds
• avoiding pets

What causes allergic rhinitis?

Allergic rhinitis is almost always inherited. The most common causes of allergic rhinitis are:

• pollen
• dust mites
• mold
• animal dander

How is allergic rhinitis diagnosed?

If your child has been experiencing any combination of the above symptoms, schedule an appointment with a physician. A doctor will conduct a physical exam and look for:

• dark circles under the eyes
• creases under the eyes
• swollen tissue inside the nose

How do we treat allergic rhinitis?

Treatments for allergic rhinitis vary depending on your child's age, overall health, medical history, extent of the reaction, and tolerance for specific medications, procedures, or therapies.

Be sure to check with your doctor before administering any treatment to your child.

Standard treatment for allergic rhinitis:

• Avoidance of the allergen: Simply avoiding the allergens causing the problem is the best treatment.
• Over-the-counter antihistamines: Antihistamines, like Benadryl or Atarax, help decrease the release of histamine, possibly decreasing the symptoms of itching, sneezing, or runny nose. These can cause drowsiness.
• Non-sedating prescription antihistamines: Will not cause drowsiness, and can include cetirizine (Zyrtec), loratadine (Claritin), or fexofenadine (Allegra).
• Anti-inflammatory nasal sprays: Can help decrease the swelling in the nose.
• Corticosteroid nasal sprays: Can help decrease the swelling in the nose. They work best before symptoms start, but can also be used during a flare-up.
• Decongestants: Help by making the blood vessels in the nose smaller, thus decreasing congestion. Available either over-the-counter or by prescription.

If your child doesn't respond to avoidance or to the above medications, an allergist may recommend allergy shots or immunotherapy. Immunotherapy usually involves a three to five year course of repeated injections of specific allergens. This will help decrease your child's reaction to these allergens.

How we care for allergic rhinitis

At Boston Children's, allergy disorders are tackled by a team approach, coordinating care with immunotherapy, behavior modification, and investigational therapies. In addition, we offer numerous workshops and one-on-one consultations to help you and your child learn to live with chronic rhinitis. Boston Children's is widely recognized as one of the world leaders in allergy and immunology treatment and research.