Treatment for Hay Fever in Children

Video Transcript

"Hi I'm Dr. David Hill and today we're going to be talking about treating hay fever in children. Now hay fever is this wonderful old word for what we now call allergic rhinitis, that's an allergy that affects the nose and causes a runny, drippy and, especially, an itchy nose. One of the ironies of the terms hay fever is allergies don't come with a fever, so if your child actually has a fever, he or she probably has a cold or even, perhaps, a sinus infection, depending on how long the fever has lasted. A fever that lasts more than three days or that comes on at the beginning of an illness, goes away and then returns after 24 hours all suggests a significant bacterial infection and your child should be seen by a doctor. If, on the other hand, your child does not have a fever and does have a runny nose usually with clear drainage, itching, a hallmark of allergic rhinitis is a little crease across the top of the nose from the child doing this with the hand and itching the nose. You may see dark circles under the child's eyes or even little tiny lines under the eyes from chronic inflammation and congestion. The eyes may water or itch as well, all these things suggest allergic rhinitis. Now some great treatments for allergic rhinitis are over-the-counter now, and these are antihistamines, including ones that don't make children sleepy or cranky, like some of the older antihistamines. Claritin or Loratadine, Zyrtec or Cetirizine are among the best known of this generation of antihistamines. Older antihistamines like Diphenhydramine or Benadryl don't seem to last as long and are more likely to make children sleepy, cranky or irritable. Now if those medicines aren't helping, there are other classes of prescription medicine that may do much more. The single most potent category of medicines are nasal corticosteroids. These are steroids that you squirt up in the child's nose. Now people think oh my child is never going to let me squirt something in his or her nose but these things don't hurt, they're not that uncomfortable and even young children often tolerate them well starting at about age two at the youngest. These medicines work on the allergic reaction at the beginning of the reaction and tend to be the most effective single class. There are also classes of medications that work at a different part of the allergic reaction. This most popular is Lofurlocast or Singulair and these can be a good add on especially for children who cough a lot. Now you can use any combination of these including all three classes of medication together in children who are difficult to treat. If none of those treatments are working it may be time to go for allergy testing. Allergy testing may help you determine what elements in the environment you might be able to get rid of such as getting rid of carpet and putting in hardwood floors or finding a good home for a cherished family pet who happens to make your child allergic. You may also find that allergy testing leads you to immunotherapy, the old allergy shots. Using immunotherapy you may be able to get rid of the allergies for a long time or even permanently. So talking about treating hay fever or allergic rhinitis in children, I'm Dr. David Hill."