What is happening inside my child’s body? An allergy can do many things in the body. On the skin, it can cause a rash or hives. In the intestine, it can manifest as diarrhea. And in the nose and sinuses, it can result in classic bay fever, with watery eyes and a drippy nose.
Allergies are caused by an immune response to some irritant, such as pollen, food, perfume, animal dander, dust mites, or mold. When your child is exposed to the irritant, his body releases a chemical called histamine from special cells called mast cells. Histamines, along with other components of mast cells, cause tissues to become swollen and irritated and to release fluid. Mast cells are most numerous in the skin, mouth, nose, lungs, and intestinal tract, and histamine release in these parts of the body causes the wateriness associated with allergies.
What are the treatments?
The most common treatment for allergies is an antihistamine. This medicine blocks the histamines that are released from mast cells, aborting their ability to wreak havoc in the nose, eyes, lungs, and so on.
Antihistamines are available in a number of preparations. The over-the-counter brands include diphenhydramine (Benadryl) and loratadine (Claritin). Diphenhydramine appears in some combination medications as well. Antihistamines requiring a doc¬tor’s prescription include fexofenadine (Allegra), hydroxyzine (Atarax), and cetirizine (Zyrtec). Most of these are available in liquid form.
In some extreme cases, an antihistamine will not be sufficient to control the symptoms. When this happens, a corticosteroid may be used instead. Steroids are potent anti-inflammatory med¬ications that can quickly blunt allergic reactions. However, they tend to have more side effects than antihistamines, which is why they are not generally used as first-line drugs.
Steroids come in the form of nasal sprays, inhalants, syrups, tablets, and even injectables. Nasal sprays and inhalants work locally in the areas where they are received. Therefore, a nasal spray reduces nasal symptoms, while an inhalant targets the lungs and breathing. All of the other forms affect the entire body, exposing the child to higher doses and subsequently more side effects.
What are the possible complications?
The most severe manifestation of an allergic reaction is called anaphylaxis. This is a whole-body allergic reaction. It can be associated with hives, swelling (of the lips, mouth, or lung tis¬sue), low blood pressure, and even shock. These reactions range from mild to life threatening.
When an allergy causes an itchy rash, a toddler may scratch at the skin incessantly. This can cause bleeding and a secondary infection. Skin that is scratched repeatedly and is never given the chance to heal can scar.
Allergic reactions in the upper respiratory tract result in the pooling of mucus, which can lead to viral and bacterial infections. Sinus infections and ear infections are not uncommon conse¬quences of chronic allergies in toddlers.
