Hay Fever (Nasal Allergies)

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DEFINITION 

• An allergic reaction of the nose
• An itchy nose and clear discharge is common

Symptoms

• Clear nasal discharge with sneezing, sniffing, and nasal itching.
• Eye allergies (itchy, red, watery and puffy) are commonly associated.
• Ear and sinus congestion may also be associated.
• A tickling, scratchy sensation in the back of the throat can be associated.
• Itchy ear canals, itchy skin, and hoarse voice are also seen.
• Symptoms occur during pollen season.
• Similar symptoms during the same month of the previous year.
• No fever.

Causes

• Hay fever is an allergic reaction of the nose and sinuses to an inhaled substance, usually a pollen.
• Grass, tree and ragweed are common pollens
• Allergens from cats and other animals

See More Appropriate Topic (instead of this one) If

• Doesn't look like hay fever, see COLDS.

WHEN TO CALL YOUR DOCTOR

Call Your Doctor Within 24 Hours (between 9am and 4pm) If

• You think your child needs to be seen.
• Lots of coughing.
• Sinus pain (around cheekbone or eyes) and not relieved by antihistamines

Call Your Doctor During Weekday Office Hours If

• You have other questions or concerns.
• Hay fever symptoms interfere with school or normal activities after taking antihistamines for 2 days.
• Diagnosis of hay fever has never been confirmed by your doctor.
• Year-round symptoms of nasal allergies.

Parent Care at Home If

• Hay fever and you don't think your child needs to be seen.

HOME CARE ADVICE FOR HAY FEVER

1. Antihistamines:  
   • Give antihistamines continuously during pollen season (continuously is the key to control).
   • Chlorpheniramine (e.g. chlortrimeton) products are effective and don't need a prescription (Any antihistamine you have will do, but some may cause more drowsiness).
   • See dosage chart for chlorpheniramine or benadryl
   • The bedtime dosage is especially important for healing the lining of the nose.
   • Long-acting products (less dosages per day) and combination antihistamine-decongestant products (less sedating) may be more helpful.
   • Loratadine: Newer antihistamine that causes less sedation (over-the-counter in 2003).
     • Dosage: 10 mg tablet once daily in morning (orally dissolving tablet also available)
     • Indication: weight over 66 pounds (30 kg) AND drowsiness interferes with school
     • Limitation: doesn't control hay fever as well as older antihistamines.
     • Cost: store brand usually costs half the Claritin brand
2. Eye Allergies:  
   • For eye symptoms, wash the pollen off the face and eyelids.
   • Then apply cold compresses.  
   • Antihistamine vasoconstrictor eye drops (no prescription needed)are sometimes needed, but oral antihistamines usually control eye symptoms.
3. Wash Off Pollen:  
   • Remove pollen from the nose with nasal washes (using warm tap water) whenever needed.  
   • Instill 2 or 3 nose drops in each nostril followed by blowing the nose.  Repeat until open.  
   • Remove pollen from the hair and skin with hair washing and a shower, especially before bedtime.
4. Expected Course:  Since pollen allergies recur each year, learn to control the symptoms.
5. Call Your Doctor If:
   • Symptoms aren't controlled in 2 days with continuous antihistamines
   • Your child becomes worse

And remember, contact your doctor is your child develops any of the "Call Your Doctor" symptoms.

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