Nasal Allergies (Hay Fever)
Hay Fever is an allergic reaction of the nose and sinuses to an inhaled substance, usually pollen. Symptoms include a runny or itchy nose, itchy or watery eyes and sneezing. Fever and sore throat do not occur with hay fever - these symptoms are more likely a result of an underlying infection or illness.
Symptom Management
Antihistamines:
- Antihistamines are the drug of choice for nasal allergies. They may reduce runny nose, nasal itching and sneezing.
- Benadryl is very effective and available over-the-counter (OTC). It needs to be given every 6 to 8 hours to be most effective. Benadryl is approved over age 1 for allergic symptoms. Before administering this medication, please review our medication dosing guides.
- Long-acting antihistamines (e.g., Zyrtec or Claritin products) that last 18 to 24 hours are now available OTC and approved for ages 2 and up.
- The key to hay symptom control is to give antihistamines every day during pollen season.
Loratadine (Claritin) or Cetirizine (Zyrtec) Options:
- These medications cause less sedation than older antihistamines (ie., Benadryl) AND are longer acting (lasts up to 24 hours).
- Dosage:
- Ages 2-5 years: Give 2.5 mg of liquid syrup
- Ages 6-11 years: Give 5 mg chewable tablet once daily in the morning.
- Ages 12+ years: Give 10 mg tablet once daily in the morning.
Eye Allergy Treatment:
- Wash the allergic substance off the face and eyelids, then apply cold compresses.
- Usually an oral antihistamine will adequately control the allergic symptoms of the eye.
- If the eyes remain itchy and poorly controlled, buy some OTC antihistamine eye drops.
- Ketotifen Eye Drops (First Choice):
- Common brand names are Zaditor or Alaway.
- They are approved for ages 3 and older.
- Instill 1 drop every 12 hours.
- For severe allergies, the continuous use of ketotifen eye drops on a daily basis during pollen season gives the best control.
- Antihistamine/Vasoconstrictive Eye Drops (Second Choice):
- Common brand names are Naphcon-A, Opcon-A, Visine-A
- They are approved for ages 6 and older.
- Instill 1 drop every 8 hours as necessary.
- Avoid vasoconstrictor eye drops without an antihistamine in them, as they only treat the eye redness and not the cause of irritation. Avoid continuous use for over 5 days.
Nasal Saline to Wash Out Pollen:
- Use saline nose drops or spray. This helps to wash out pollen or to loosen up dried mucus. If you don’t have saline, you can use a few drops of bottled water or clean tap water. Teens can just splash a little clean tap water up the nose and then blow.
- Step 1: Instill 3 drops per nostril.
- Step 2: Blow each nostril separately while closing off the other nostril.
- Step 3: Repeat nose drops and blowing until the discharge is clear.
- Do a nasal saline rinse whenever your child cannot breathe through the nose or it’s very itchy.
- Saline nose sprays can be purchased OTC or made at home using ½ teaspoon of table salt to 1 cup of warm water. Use bottled or boiled water to make saline nose drops.
- Another option is to use a warm shower to loosen the mucus. Breathe in the moist air, then blow each nostril.
Wash Pollen Off Body:
Remove pollen from the hair and skin with hair washing and a shower, especially before bedtime.
Expected Course
Since pollen allergies recur each year, learn to control the symptoms.
When to Call the Office
- Symptoms aren’t controlled in 2 days with continuous antihistamines.
- Your child becomes worse.
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The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.