Sniffling, coughing and rashes that itch are common in childhood. But if these symptoms last longer than the length of the common cold, 10-14 days, they may really be signs of allergies, asthma, hives or eczema. About 35 million Americans suffer from allergies, and most start in childhood. Allergies tend to run in families, although anyone can develop them.

Some people have only mild symptoms, and over-the-counter allergy medications work well. For others, the allergy symptoms are severe and keep them from attending work, school, and living life as they would like.

An allergy is an over-reaction of the body’s immune system to something in the environment called an allergen. The allergen usually enters the body through contact with the skin, through the nose into the lung or by mouth. Once the immune system is sensitive to the allergen, symptoms will develop when contact is made with the substance. The most common allergens are house dust, dust mites, mold, grass, tree, and ragweed/weed pollen, pet dander and foods such as milk, egg, wheat, peanut, tree nuts, soy, fish, and shellfish (seafood).

“Hayfever” or allergic rhinitis can cause itchy eyes, a scratchy throat, or a runny or stuffy nose with sneezing and coughing. These symptoms may cause ear infections, difficulty hearing and sinus infections.

Allergies may cause asthma symptoms as well. Asthma is characterized by wheezing, coughing and shortness of breath when climbing stairs, laughing or crying. About 70 percent of those with asthma also have allergies. 

Hives are raised welts on the skin that frequently itch and may be present for six to eight weeks. These typically are not caused by allergies, but may be brought on by a viral illness, drugs (antibiotics) and, in certain cases, food allergies.

Eczema is a disease of the skin that usually starts in infancy with a raised, red itchy rash on the face, the folds of the elbows or behind the knees. The rashes can be anywhere on the body. Food allergies can trigger the skin symptoms, but there may be no allergy involved. 

Contact dermatitis is an inflammation of the skin at the place where contact was made with a substance. This can range from a simple mild rash with itching brought about by sitting in the grass that disappears in 20-30 minutes, to poison ivy, which lasts for a week or more with intense itching. Plants, metal, fabric (wool) and cosmetics are common causes of contact dermatitis.

Food allergies are more common in young children under age 3. Most outgrow their allergy by the time they enter kindergarten. Symptoms of a food allergy may include hives, coughing, vomiting, colic, belly pain, diarrhea, or swelling of the face and mouth. The most common food allergens include milk, fish, shellfish, tree nuts, peanuts, soy, wheat and eggs. Avoiding the food that causes symptoms is the best treatment. If your child has a severe reaction to a food item and has difficulty breathing, or swelling of the face, lips or tongue, call 9-1-1 immediately. Your child could be experiencing a life-threatening anaphylactic reaction, which requires immediate medical intervention. Once the emergency has been resolved, the child should then be followed up by a board-certified allergist for further treatment. The allergist will assist you in identifying the allergen and developing a nutrition plan. Kids with severe food allergies will be prescribed an epinephrine auto injection device (such as the EpiPen® or EpiPen Jr®) and should wear a medical alert bracelet to notify others of their allergies.

Family history and a physical exam provide information about allergic conditions. Keep track of the time of year symptoms occur, how severe they are and how long they last. How your child is growing also is important, as well as how often he or she needs to be home from school or you or another caregiver must be absent from work to provide care for him or her.

Allergy testing is usually done with skin tests. The liquid form of the allergen is placed on the skin and gently pricked, so the special cells under the skin can react if you are allergic. The skin turning red and itchy within 20 to 30 minutes indicates a positive test result. A blood test also can be performed. Your physician will discuss with you the best method for your child.

The best treatment for allergies is to avoid them altogether. This is possible for certain allergens such as feathers, a certain food or an animal. It is difficult to avoid dust, tree and weed pollen. Other things can increase nasal stuffiness and congestion such as cigarette smoke, wood smoke, perfumes, cleaning products, or scented candles and lotions. HEPA filters on the furnace help filter out the allergens, as does keeping windows closed in high-allergy seasons like spring and fall. Air conditioning is highly recommended.

Medications for allergies consist of antihistamines and decongestants, which are sold in pharmacies. If those are not helpful in managing symptoms, the child should see his primary care physician or an allergist for further evaluation. If the symptoms are so severe that medications provide only partial relief, allergy shots may be helpful.

Be sure to educate everyone who cares for your child about his or her allergies. This includes teachers, sitters, daycare providers, grandparents, etc. They need to know what to do in case of an emergency, or how to give special medications if needed.

The good news is that help is available and symptoms usually improve with treatment. Most children with allergies live their lives just like any other child. It is important for symptoms to be controlled, so they can participate in normal activities with their friends.

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