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Spring Allergies: A Q&A with Our Top Expert

How to handle the runny nose, itchy eyes, and sinus pain of spring allergies

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Allergies that lead to chronic sinusitis and possibly swollen tonsils and adenoids also need to be addressed. In my experience, if you treat the sinus infections and the tonsil and adenoid infections aggressively with antibiotics and even sometimes steroids and irrigation, typically both will shrink and you will spare your child having to have an operation.

Q: What’s the first step for parents who think their child may have allergies?

A: Start by making an appointment to see a board-certified sinus and allergy specialist. Saline irrigation is the easiest treatment, either with a neti pot, squeeze bottle, or irrigating system. Antihistamines are also very helpful. But, if possible, parents can also take up the carpeting in their child’s room and replace with wood, linoleum, or tile floors. Also, remove dust-catching drapes from their children’s room. If their kids have been outside and rolling around in the grass, take their clothes off before they reach their bedroom, and give them a bath. Certainly use air conditioners and purifiers. And, again, be sure to clean the filters.

Q: What about decongestants? Parents have so many concerns about medicating their children. What does the research show about what’s safe -- and not safe -- to give children with allergies?

A: There are now new warnings on decongestants, and since long-term usage may cause problems, even heart problems, I recommend parents use decongestants very sparingly because they can have significant side effects.

As far as antihistamines go, several on the market are nonsedating and don’t cause fatigue; I think those are good for children. They can play an important role in controlling allergy symptoms. I think allergy shots are great for kids. You’re going to need a commitment -- even a year, maybe two or three -- and you’ll need to be followed closely by an allergy specialist. I’ve seen kids do very well. When they’re first allergic, they’re miserable. But two or three years later, they are feeling terrific and come allergy season, they’re just not feeling it. Again, getting to the problem early helps thwart allergies.

The benefits are there for adults, too. There are drawbacks -- some people don’t have the time for the weekly shots; others are afraid of needles. In Europe, doctors are giving drops under the tongue, but that’s not FDA-approved here yet, even though several studies do show they are effective.

Q: One of the toughest situations that comes up when kids are diagnosed with allergies is the recommendation to reduce exposure to allergens by giving away the family cat or dog. What is your position on this?

A: It’s a question of working with people’s lifestyles. If you take 10 people who are avid golfers and tell them they have to quit because of their allergies, 10 out of 10 are going to tell you to take a walk.

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