When To Test Your Child For Seasonal Allergies

By Nicole Roder

It’s time to break out the tissues and Claritin again. Allergy season is coming. Allergic rhinitis, or hay fever, is common, ubiquitous, and downright miserable. It affects more than 19 million adults and 5 million children each year, according to the Centers for Disease Control and Prevention (CDC). And if recent trends in pollen counts continue, this spring allergy season is going to be a doozy.

Many people refer to hay fever as “seasonal allergies,” because it typically affects people at certain times of the year, namely spring and fall. However, it is possible to experience hay fever any time of year, especially if you are allergic to indoor allergens, like dust mites, pet dander, or mold and fungal spores.

Children can be especially vulnerable, particularly if you have a family history of allergies. And kids can develop allergies at any age. The sooner you and your pediatrician identify these allergies, the sooner you can begin treatment. Early treatment could minimize the symptoms and improve your child’s quality of life. So if you suspect that your child might suffer from seasonal allergies, read on for expert advice on when you should get them tested.

What are the symptoms of seasonal allergies?

Seasonal allergies come with a wide variety of symptoms, according to Jason Bellak, MD, a board-certified allergist and immunologist and vice president of the Oklahoma Institute of Allergy Asthma & Immunology. These symptoms can include the following:

• Itching

• Sneezing

• Runny nose

• Fatigue

• Cough

• Red eyes

• Tearing  

Is it allergies or a cold?

“Symptoms [of seasonal allergies] may be similar to viral colds,” says Dr. Bellak, “but colds may include fever/chills, productive cough, and off-colored nasal drainage. Colds typically are at their worst for the first two to four days and should be completely better by 10 to 14 days.” Seasonal allergies, on the other hand, will last for as long as the trigger is present in the environment.

Another surefire tell: If your child has similar symptoms every spring or fall, Dr. Bellak says that those are likely from allergies, and not a cold.

There is also a genetic component to seasonal allergies that you should consider. 

“Allergic diseases, including seasonal allergies, are more common in families with a history of allergic diseases,” says Dr. Bellak. “Several genes have been shown to be associated with allergic diseases, but there is much that is unknown.” 

So if you have seasonal allergies and your child usually starts sneezing and coughing every spring or fall, chances are, he or she has seasonal allergies, too. It might be time to see a specialist.

When to get your child tested

Many parents might think, “It seems obvious that my child has seasonal allergies. Can’t I just treat it with Claritin and forget about the testing?”

That might be a mistake. “Over-the-counter medications may treat the symptoms of allergies but do nothing to change the disease,” says Dr. Bellak.

Sometimes, seasonal allergies can lead to more serious health problems, such as asthma, eczema (atopic dermatitis), recurrent coughing and wheezing, snoring, or frequent ear, nose, and throat infections. Testing can be done at any age, and it will help your doctor identify your child’s allergen triggers so that you can treat the root cause of these health problems. 

So, when, exactly, should you get your child tested for seasonal allergies? The short answer is, when you and your child have had enough. According to Dr. Bellak, these are all signs that it might be time to get the test:

• Your child experiences symptoms every day 

• Allergy symptoms are keeping them from doing activities they enjoy 

• Their symptoms lead to missed school days

• You are making frequent visits to your pediatrician because of allergies

• You are concerned that your child might be allergic to your pet

• Over-the-counter medications are not working, or not working enough 

• Your child is experiencing troublesome side effects from allergy medications

• Over-the-counter medications are getting too expensive

• You have a desire for more natural treatment, such as immunotherapy  

What is the test like?

Allergy tests are easy and (usually) painless. “Testing for allergies is a simple, quick office procedure that starts without needles,” Dr. Bellak says. “Within 15 minutes, we know if you are allergic and what you are allergic to. By the end of the appointment, the patient has an individualized treatment plan.”

There are two common allergy skin tests that most allergists use, as well as a blood test option.

Skin prick test

If your child needs an allergy test, chances are your allergist will start with a skin prick test (SPT) on the child’s back. The doctor or nurse will use a device that pricks your child’s skin with lancets, or tiny needles. The lancets barely penetrate the skin and do not draw blood. They deposit a small amount of each suspected allergen, plus a control, in organized rows on the skin of your child’s back. 

After the initial “prick,” the doctor will watch the skin for signs of an allergic reaction. During allergy skin tests, your skin is exposed to suspected allergy-causing substances (allergens). Then, your provider observes the skin for signs of an allergic reaction. If a bump forms that is more than 3mm in diameter, that is a positive result for that allergen.

Intradermal skin test

Your doctor might recommend an Intradermal test (IDT) if he or she remains concerned about a specific allergen that tested negative on the SPT. In an IDT, the doctor or nurse will use a needle to deposit a small bubble of each allergen under the top layer of skin. It is relatively painless.

Blood test

Skin tests are the easiest, most effective diagnostic tools for allergies. They are also perfectly safe for most people. However, there are certain people who shouldn’t get skin tests. For example, people who have had severe allergic reactions in the past could have a life-threatening reaction to a skin test. People with severe eczema or psoriasis, or who are taking certain medications, should not have a skin test either, as the medications or skin conditions could interfere with test results.  

If your child can’t get a skin test for any of those reasons, your doctor might recommend a blood test.

The doctor or nurse will draw blood from your child’s arm, similar to any other blood test. The test will measure the amount of IgE (Immunoglobulin E) antibodies in your child’s blood. These are antibodies that your immune system produces if you have an allergy. 

Your child might start with a total IgE test, which measures the total number of IgE antibodies in the blood. If that number is high, that means that your child is allergic to something, but you still won’t know what. After a positive total IgE, your doctor might order another type of allergy blood test called a specific IgE. This test measures the level of IgE antibodies that respond to specific allergens.

What happens after the test?

Dr. Bellak emphasizes that testing and treatment planning for allergies should always be provided by a board-certified allergist who can provide complete care. These specialists will be familiar with the best treatments to meet your child’s needs. 

Fortunately, there is a treatment that has been proven to make positive changes in the allergy disease, rather than simply masking the symptoms. 

“The best treatment for allergies is immunotherapy,” says Dr. Bellak. “It is most often provided as subcutaneous injections of small, progressively increasing doses of what the patient is allergic to so they can build lasting tolerance. Immunotherapy has also been shown to improve eczema and asthma and may also prevent the development of other allergies and asthma.”

So before you reach for the Claritin, Zyrtec, Allegra, or Benadryl, schedule an appointment with an allergist who can test your child and get them on the road to a much more pleasant spring.