Is it a Cold or Allergies?

Everything’s blooming, and symptoms that seem cold-like are easy to confuse with allergies. They look the same, but don’t act the same. Both share the runny nose, watery eyes, sneezing, itchy throat, headache and cough, but they have different causes and different treatments and it’s important to know the difference.

Last week I saw a mom and her adorable 8-year-old daughter. Mom was worried because daughter had missed a lot of school and was feeling rundown and under the weather. “She’s had this cold for weeks”, she told me. “It gets better and worse, but never goes away”.

I took one look and knew that Daughter had allergies. We discussed the different causes and treatments and it made all the difference. But how do you know? How can you identify what’s a cold and what’s an allergy?

* Colds are caused by a virus and may come with a fever. Allergies are caused by the body’s immune reaction to something in the environment.

* A cold lasts 10-14 days, and symptoms get worse before they get better and gradually go away. Allergies wax and wane and may be the worst on clear, breezy days when pollen is blown around. They may improve right after a rain when the air’s been washed clean. Allergies can happen any time of year, not just spring and fall, especially in a warm climate.

* Colds are very contagious, so if a member of the family catches one it’s likely to spread around. Allergies may affect one or more members of the family but you can’t “catch” them.

* Children with allergies often have other signs, like dark circles under their eyes called allergic shiners, a small crease near the bottom of their nose called the nasal crease (from pushing their nose up because it’s itchy). The inside surface of the nose will often be pale and swollen, while it is usually red and inflamed when you have a cold. Allergy testing may help, but is often inconclusive.

* A cold needs no treatment, except possibly a decongestant or cough medicine before bed for older kiddos (NOT recommended for children under 4), lots of fluids, and my favorite — chicken soup. Avoid asking your doc to prescribe antibiotics, they won’t help.

*Allergies are often treated with antihistamines or nasal steroid sprays that should be given when the child has symptoms. They can be helpful to keep kiddos comfortable, sleeping well, and able to go to school.

When in doubt, have your family doctor take a look. The symptoms of colds AND allergies can be annoying, but neither are serious. Take advantage of the many ways you can make kiddo more comfortable.

Ah Choo!

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Rachel Zahn, MD is a pediatrician turned health writer who had three kids during medical school and pediatric training—crazy, huh?

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