July 19, 2021

Is It Allergies Or Something Else?

With executive orders in several states, it’s becoming more common that no jurisdiction can require a person to wear a mask or face covering. As students return to school (for many it’s the first time in over a year due to remote learning), will more students be at the nurse’s office?


What should parents be on the lookout for this school year, symptom-wise?

I think you will see the natural return of the usual fall viral illnesses and allergies. If schools keep policies of removing a student with COVID-19 symptoms, we will likely see more students missing school. While some COVID-19 symptoms like fever and loss of smell are more classic for COVID-19, less common symptoms like headache, runny or stuffy nose can mimic allergies or common non-COVID19 viral illnesses.


Runny nose, congestion… how do I know the difference between allergy symptoms and other illnesses?

If these are the only symptoms you may not be able to distinguish the difference. Certainly, fever, loss of smell, and body aches do not occur in most individuals with seasonal allergies. The more common symptoms of allergies are clear runny nose, sneezing, and eye itching and watering. Further, most allergies respond to common allergy medications such as oral antihistamines and nasal corticosteroids while COVID-19 does not.


Do masks help prevent symptoms from seasonal allergies?

I think the verdict is still out. Certainly, a mask acts as a barrier and may lessen the pollen going into the nose and respiratory track but does not protect the eyes. Despite the last year with having a mask mandate, I evaluated many children and adults who still suffered from their allergies.


What allergy meds and treatments are the most effective?

I think it is always important to ensure a person is using medication in the correct way. If simple allergy medications such as OTC oral antihistamines (e.g., loratadine, cetirizine, fexofenadine)and nasal sprays (e.g., azelastine, fluticasone) control a person’s symptoms it is very likely environmental allergies. However, we know that at least 20-30%of individuals with allergies are not well-controlled with usual OTC or prescription allergy medications. Whether it is a patient whose allergy medications work but they feel like a “walking pharmacy” or have trouble with remembering their medications (compliance) or experience side effects, patients often want to know what their allergies are.


How can a person know what their allergies are?

There are two ways to test for allergies – a skin test or a blood test. Both provide good answers but generally the skin test, which is usually performed by an allergist, is more sensitive in pick up a person’s allergies. An allergist can then use the results of that allergy test to take a person’s treatment beyond medication to what is called immunotherapy.


Is there a permanent solution to kick seasonal allergies?

Unlike medications which just treat the allergy symptoms, immunotherapy is a tried-and-true way to “kick” most individual’s allergies for good. Immunotherapy involves giving a person either a drop under the tongue or a shot in the arm on a regular basis to retrain their immune system to stop misbehaving every time it is exposed to that allergy immunotherapy is individualized to the patient’s allergies and will dramatically reduce a person’s allergy symptoms and allergy medication use. Over a period of time, immunotherapy  can actually “cure” most patient’s allergies. It takes time but it is a worthwhile alternative for the majority of patients.


Most importantly, if you suspect allergies may be the cause of your child's symptoms, please come in for a consult or testing appointment!

About The Author:

Kirk Waibel, MD