Definition
- There is a clear nasal discharge with sneezing, sniffling, and nasal itching
- Symptoms occur during pollen season
- Similar symptoms occurred during the same month of the year
- Previous confirmation of this diagnosis by a physician is helpful
- Itchy, watery eyes (eye allergies) are commonly associated
- Sinus or ear congestion is sometimes associated
Cause
Hay fever is an allergic reaction of the nose (and sinuses) to an inhaled substance. This allergic sensitivity is often inherited. During late April and May the most common offending pollen is usually grass. From late August to the first frost, the leading cause of hay fever is ragweed pollen. Although the inhaled substance usually is pollen, it can also be animal dander or other agents your child is allergic to. Hay fever is the most common allergy; more than 15% of the population has it.
Expected Course
This is a chronic condition that will probably recur every year, perhaps for a lifetime. Therefore it is important to learn how to control it.
Home Treatment
Oral Antihistamine Medicines. The best drug for hay fever is an antihistamine. It will relieve nose and eye symptoms. Check with your physician about the best choice for your child.
Symptoms clear up faster if antihistamines are given at the first sign of sneezing or sniffling. For children with occasional symptoms, antihistamines can be taken on days when symptoms are present or expected. For children with daily symptoms, the best control is attained if antihistamines are taken continuously throughout the pollen season.
The main side effect of antihistamines is drowsiness. If your child becomes drowsy, switch to a combination product that contains an antihistamine with a decongestant. If your child remains drowsy, continue the drug, but temporarily decrease the dosage. Tolerance of the regular dosage should occur in 1 to 2 weeks. Newer prescription antihistamines cause much less drowsiness and are approved by the Food and Drug Administration for use in children over age 6.
Nasal Sprays. Severe hay fever can now usually be controlled by new cromolyn or steroid nasal sprays rather than allergy shots. Since these sprays must be used when the nose is not dripping, antihistamines must be given first to stop the drainage.
Nasal sprays do not help eye symptoms. Therefore, they are usually used with oral antihistamines.
Pollen Removal to Decrease Symptoms of Hay Fever. Pollen tends to collect on the exposed body surfaces and especially in the hair. Shower your child and wash her hair every night before going to bed. Avoid handling pets that have been outside and are probably covered in pollen.
Prevention of Hay Fever Symptoms. Your child’s exposure to pollen can be reduced by not going on drives in the country, not sitting by an open car window on necessary drives, not being near someone cutting the grass during pollen season, staying indoors when it is windy or the pollen count is especially high, and closing the windows that face the prevailing winds. If your child’s hay fever is especially bad and you don’t have air-conditioning, you may wish to take her to an air-conditioned store or theater for a few hours. Avoid feather pillows, pets, farms, stables, and tobacco smoke if any of them seem to bring on symptoms of nasal allergy.
Eye Allergies Associated with Hay Fever. If your child also has itchy watery eyes, wash her face and eyelids to remove pollen. Then apply a cold compress to her eyelids for 10 minutes. An oral antihistamine will usually bring the eye symptoms under control. If not, instill drops of long-acting vasoconstrictor eye drops (a non-prescription item) every 8 to 12 hours for a few days. Ask your pharmacist for help in choosing a reliable product.
Common mistakes. Vasoconstrictive nose drops or nasal sprays usually do not help hay fever because they are washed out by nasal secretions as soon as they have been instilled. Also, when used for more than 5 days, they can irritate the nose and make it more congested.
Contact our office during regular hours if:
- symptoms aren’t controlled in 2 days with antihistamines
- your child develops sinus pain or pressure
- you have other concerns or questions
written by Barton Schmitt, MD and used with permission