November 4, 2011
Dear Mayo Clinic:
My daughter, seven, has all the symptoms of allergies: watery eyes, runny nose and sneezing. Is it safe to give her an over-the-counter allergy medication, or should I first take her to see a doctor?
For mild allergy symptoms, over-the-counter antihistamine medication can be a safe and effective choice for children. Try an antihistamine, and if your daughter's symptoms fade, that may be all she needs. If her symptoms don't go away, though, consult with her primary care doctor or an allergy specialist before giving her any other medication.
Allergies are common, particularly in children. Some research suggests that as many as 15 to 20 percent of the population may have significant allergies. Because many children spend a lot of time outdoors, they may have more exposure to outdoor mold and pollen than adults, triggering more allergy symptoms. Children also are often fond of playing with pets such as cats and dogs, putting them in close contact with pet dander, another common allergy-causing substance (allergen).
In response to an allergen in the environment, such as pollen or pet dander, the body may produce histamine, which can cause itching, sneezing, a runny nose and watery eyes. In some people, allergies may also close up the air passages of the lungs, making breathing difficult. Antihistamine drugs decrease allergy symptoms of the nose and eyes by blocking the effects of histamine.
Over-the-counter antihistamine pills appropriate for a 7-year-old include fexofenadine (Allegra), loratadine (Claritin) and cetirizine (Zyrtec). These medications typically don't cause drowsiness and have a low risk of side effects. Taking the correct dose is important, so read the label carefully to find out what's right for your child.
Also, make sure that the medication contains only an antihistamine and is not combined with a decongestant. Oral decongestant medications may help in specific circumstances. But they are generally not recommended for prolonged use because they contain a mild stimulant that may cause headaches and sleep problems, especially in children.
If an oral antihistamine relieves your daughter's symptoms without side effects, and she only needs the medication occasionally, then a doctor's visit probably isn't necessary. If problems persist, however, then some investigation is appropriate.
When allergy symptoms don't go away with over-the-counter antihistamines, those symptoms could still be related to allergies but simply require a different type of treatment. Prescription medications may work better than the over-the-counter allergy medications. A primary care doctor or an allergy specialist can test your daughter to identify her allergies. That can help determine the best treatment options, as well as help her avoid the allergen that's causing the problem. For example, if tests show your daughter is allergic to tree or ragweed pollen or to cats, dust mites or mold, then your doctor can inform you how to reduce exposure to that specific allergen.
Another consideration is that your daughter's symptoms might not be related to allergies. For example, if she has nasal congestion throughout the year, rather than seasonally, or if her nasal passages seem to be blocked only on one side, that could signal a sinus problem, nasal polyps or a deviated septum.
An over-the-counter allergy medication that contains only an antihistamine is a reasonable first step to try to control your daughter's symptoms. If that doesn't give her enough relief, see a doctor. Effective allergy treatments are available. If her condition is not related to allergies, her doctor can help diagnose the underlying problem and create a treatment plan that fits her situation.
ā James Li, M.D., Ph.D., Allergic Diseases, Mayo Clinic, Rochester, Minn.