Allergic Rhinitis is a reaction that occurs in the nose when airborne irritants (allergens) trigger the release of histamine. Histamine causes inflammation and fluid production in the fragile linings of nasal passages, sinuses and eyelids.
Allergic rhinitis is one type of rhinitis and is uncommon in children younger than 3 years of age. However, prevalence increases with age. There is usually a family history of allergic rhinitis. Other types of rhinitis include viral rhinitis (associated with upper respiratory infections) and vaso-motor rhinitis.
This disease affects up to 20 percent of children and 15 to 30 percent of adolescents. It is estimated that 75 percent of children with asthma also have allergic rhinitis.
The two categories of allergic rhinitis include:
The most common causes of allergic rhinitis include the following:
The following are the most common symptoms of both types of allergic rhinitis. However, each child may experience symptoms differently. Symptoms may include:
Children with perennial allergic rhinitis may also have the following:
The symptoms of allergic rhinitis may resemble other conditions or medical problems. Always consult your child's physician for a diagnosis.
Typically, the diagnosis is made by your child's physician based on a thorough medical history and physical examination. In addition to the above symptoms, your child's physician may find, upon physical examination, dark circles under the eyes, creases under the eyes and swollen tissue inside the nose.
Avoidance of the allergens that are causing the problem is the best treatment. The specific treatment for this condition depends on many factors and is tailored for each child. Please discuss your child's condition, treatment options and your preferences with your child's physician or healthcare provider.
Treatment may include:
Antihistamines help to decrease the release of histamine, possibly decreasing the symptoms of itching, sneezing or runny nose. Some examples of antihistamines are diphenhydramine (BENADRYL) or hydroxyzine (Atarax). These medications may cause drowsiness. Consult your child's physician to determine the proper dosage for your child.
Nonsedating antihistamines work like antihistamines but without the side effect of drowsiness. Nonsedating antihistamines may include cetirizine (ZYRTEC) or loratadine (CLARITIN). Consult your child's physician to determine the proper dosage for your child.
Anti-inflammatory nasal sprays help to decrease the swelling in the nose. Consult your child's physician to determine the proper dosage for your child.
Corticosteroid nasal sprays also help to decrease the swelling in the nose. Corticosteroid nasal sprays work best when used before the symptoms start, but can also be used during a flare-up. Consult your child's physician to determine the proper dosage for your child.
Decongestants help by making the blood vessels in the nose smaller, thus, decreasing congestion. Decongestants can be purchased either over-the-counter or by prescription. Consult your child's physician to determine the proper dosage for your child.
If your child does not respond to avoidance of suspected allergens, or to the above medications, your child's physician may refer you to an allergist for testing. The allergist then may recommend immunotherapy based on the findings. Immunotherapy usually involves a three to five year course of repeated injections of specific allergens to decrease the reaction to these allergens when your child comes into contact with them. Consult your child's physician for more information.
Preventive measures for avoiding allergic rhinitis include:
Reviewed by: Steven D. Handler, MD, MBE
Date: April 2009