Treatment for a Child's Allergy to Dust or Pollen

How to avoid allergens?

Stay away from a substance that causes an allergic reaction. Here are some tips for staying away from allergens:

• Stay indoors with the windows closed when the pollen count is high and on windy days.

• Become familiar with your city’s Air Quality Index (AQI). The AQI uses a scale of 0 to 500 to measure the level of air pollution. The higher the number, the higher the level of air pollution, and the greater the health risk.

• Control dust in the home, especially in your child's room.

  • When possible, remove wall-to-wall carpet, window blinds, and down-filled blankets or pillows.

  • Wash bedding, curtains, and clothing often. Use hot water. This helps get rid of dust mites.

  • Put dust mite covers on pillows and mattresses.

• Use air conditioning instead of opening the windows, if you can.

• Put a dehumidifier in damp areas of the home. Clean it often.

• After playing outside on days when the pollen count is high, have your child take a shower. They should also wash their hair and change clothes. 

• Take vacations in places where pollen is not as common, such as near the ocean.

Your child's doctor will also have other suggestions.

Medicine as treatment for allergy

Many medicines are available for children who have allergies. The American Academy of Pediatrics (AAP) advises against some over-the-counter medicines (OTC) for babies and young children. Talk with your child's doctor before you give your child any OTC medicines.

What are antihistamines?

Antihistamines are used to ease or prevent symptoms of hay fever (allergic rhinitis) and other allergies. They prevent the effects of histamine. The body makes it during an allergic reaction. Newer types of antihistamines cause less drowsiness than older ones. Ask your child's doctor which antihistamine you should give your child. They come in tablet, capsule, liquid, or injection form. They are available both OTC and by prescription.

What are decongestants?

Decongestants treat nasal congestion and other symptoms of colds and allergies. They cause the blood vessels to narrow. This clears up nasal congestion. Decongestants are available both OTC and by prescription. The most often used forms are liquids, tablets, nasal sprays, and nose drops. The AAP does not recommend oral decongestants for children. They can cause a faster heart rate, hyperactivity, anxiousness, and problems sleeping. Nasal spray or nose drops should be used for only a short time. Regular use of them in any form can cause symptoms to get worse. That's because the body becomes dependent on the medicine.

What are nasal steroids?

Nasal steroids control swelling (inflammation) in the nose caused by allergies. They take a few days to work. They are used daily on a regular schedule, not on an as-needed schedule. Many nasal steroids are now sold OTC. These medicines are generally safe and not habit-forming. Talk about these medicines with your child's doctor before using them.

What is allergy immunotherapy?

When staying away from allergens and taking daily medicine doesn't work, allergy immunotherapy may be a treatment choice. Allergy immunotherapy improves a person's tolerance of the allergen and reduces symptoms. There are two types of allergy immunotherapy: allergy shots and sublingual (under the tongue) immunotherapy.

• Allergy shots. This is the most common form of allergy immunotherapy. It's given as small injections under the skin. Allergy shots work well for people with allergies to pollen, pets, dust, and stinging insects, and for people with allergic asthma. The shots contain a small amount of the allergen. Over many months, the allergen dose is slowly increased. Injection schedules vary. But they start weekly while the doses are increased. Then they are given every other week and finally once a month. There is a small risk of severe allergic reaction.

• Sublingual immunotherapy (SLIT). This treatment is approved for children with allergies to grass and ragweed. SLIT is given by tablet that dissolves under the tongue, usually daily. Ask your child's doctor if this treatment is right for your child. It's rare for SLIT to cause a severe allergic reaction.

Most children improve with allergy shots. It often takes 12 to 18 months before you will see a definite easing of allergy symptoms. In some children, symptoms get better in as soon as 6 to 8 months. After 5 years, most children can stop the treatment and still feel the benefits.

Immunotherapy is only part of the treatment plan for allergic children. It takes time for this treatment to work. So your child will need to keep taking the allergy medicines as prescribed by their doctor. It's also important to keep removing allergens, such as dust mites, from your child's environment.

Are there side effects to immunotherapy?

There are two types of reactions to immunotherapy: local and body-wide (systemic). The local reaction is redness and swelling at the injection site or locally in the mouth with SLIT. If this keeps happening or is very uncomfortable, then the extract strength or schedule is changed.

A systemic reaction may affect the whole body. Symptoms may include nasal congestion, sneezing, hives, swelling, wheezing, and low blood pressure. These reactions can be serious and even life-threatening. In rare cases, this can lead to death. If a systemic reaction occurs, your child may keep taking shots, but the dosage will be lower. Discuss with your child's doctor what to do in an emergency. The doctor may recommend that you carry epinephrine medicine while your child gets immunotherapy.

If you have any questions about immunotherapy, talk with your child's doctor.