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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.