Central Ohio physicians offer tips on allergy testing and treatment.
Allergy symptoms can make a person of any age or size feel miserable—perhaps none more so than children. Left untreated, allergies can make a child feel sick, exhausted and, in rare instances, at risk for life-threatening reactions.
We asked several Central Ohio allergy specialists how parents can effectively diagnose, minimize and treat children's allergies—whether they're caused by pollen, animals or another trigger.
Signs and Symptoms
“An allergy is an overreactive immune response to an otherwise harmless substance,” said Dr. David Hauswirth, an allergist with Ohio ENT & Allergy Physicians. In addition to symptoms such as sneezing, a runny nose and itchy and watery eyes, environmental allergies (such as pollen, grasses, mold, dust mites or animals) can cause a cough, throat-clearing, throat drainage and dark circles under the eyes known colloquially as “allergic shiners.”
“Histamine, one of the chemicals released as part of the allergic cascade … causes itching and other symptoms such as runny nose, congestion and rashes,” said Dr. David Stukus, associate professor of pediatrics and a pediatric allergist at Nationwide Children's Hospital.
Though seasonal, environmental and pet allergies cause discomfort, serious or life-threatening reactions are “exceptionally unlikely,” according to Stukus, though asthma sufferers carry a somewhat increased risk.
Seeing the Doctor
Many parents assume that an otolaryngologist (an ear, nose and throat doctor) should be the first stop. However, Dr. Mitchell Grayson, chief of allergy and immunology at Nationwide Children's Hospital, recommends starting with your pediatrician.
“If they have relatively mild symptoms, there are things your child's pediatrician can prescribe, or even over-the-counter options,” Grayson said. “If [those options don't] work, you have food allergies and/or asthma, or you have concerns about identifying the exact allergen, go to an allergist. We're the ones who will do skin testing. We can also do allergy shots, whereas an ENT doesn't usually do that.”
Many parents wonder if (and when) their child should be tested for allergies. “If someone's not had any symptoms, then there is zero reason to do any testing for allergies. We unfortunately get a lot of false positive results, which can lead to overdiagnosis,” Stukus said.
Children can be tested at any age, and the procedure is generally covered by insurance. Pediatric patients are usually tested for specific allergens, rather than a full spectrum. “It feels like pushing your fingernail into skin; it doesn't draw blood or puncture skin, and is really not uncomfortable,” Hauswirth said.
Treatment and Tips
If allergies are confirmed, the doctor will create a personalized treatment plan. For less-severe allergies, this may include prescription medication or over-the-counter options such as cetirizine (more commonly known by the brand name Zyrtec) or fexofenadine (used in Allegra and other products). These don't cross the blood-brain barrier and don't cause drowsiness, doctors said. Nasal corticosteroids may be used in tandem, but be advised they don't take effect for up to five days.
Allergy shots can help those don't respond to medications. They work by exposing patients to small doses of allergens, building up their tolerance over time.
While some children can “outgrow” allergies, doctors advise against trying to wait it out. Hauswirth tells parents to seek treatment “if you're leaving the park early, missing activities, if it affects children's schoolwork, relationships, sleep, or if they don't want to go outside or to games or practices because they're miserable. We have so many readily available and really good treatments for allergies today, there's no reason not to get help.”