If your child develops symptoms of seasonal nasal allergies, his or her physician will prescribe medications, such as oral antihistamines or intranasal steroids, for the symptoms. If these medications are effective, and do not result in any unwanted side effects, they can be used safely on a seasonal basis for many years. Because seasonal nasal symptoms are almost always related to an outdoor pollen or mold, there is no need to do allergy testing unless your child stops responding to the medications or develops side effects.
At that point, if your child is 5 years of age or older, he or she should be referred to an allergist for allergy testing in order to precisely identify which seasonal allergens are causing the symptoms in preparation for allergy immunotherapy. Allergy testing to foods should only be included if the child also has symptoms directly related to eating.
If your child has yearround nasal symptoms particularly if they are older than 2 years of age, allergy testing should be performed in order to confirm a diagnosis of allergic rhinitis and determine whether there is an allergen that can be actively avoided. The patient’s environmental history will guide the testing; for example, the doctor will ascertain whether there is a pet in the house. The allergens most often included are house dust mites, animal danders, cockroaches, and both indoor and outdoor molds. This initial testing need not be extensive and can be performed as either an allergy skin or blood test. Some primary care physicians are comfortable in performing a screening allergy blood test and are prepared to make recommendations regarding allergen avoidance based upon these results.
If the primary care doctor is not inclined toward ordering the appropriate blood tests or devising programs of environmental control, your child may be referred to an allergist at this point. Other situations in which your child should be referred to an allergist include the development of other related diseases, particularly bronchial asthma, recurrent or chronic sinusitis, or recurrent or persistent middle ear disease in association with their rhinitis. In addition, another concern is the development of oral abnormalities caused by chronic mouth breathing.