I don’t think  my child has  seasonal  allergies, but  I wonder: How  can I tell the  differences between allergies and a cold?


Head colds and allergies often display similar symptoms, such as a stuffy nose and possibly runny eyes, sneezing, and headaches. Distinguishing between the two is important when it comes to ensuring your child is properly treated and, therefore, feeling his or her best. 


Common distinguishers 


Whereas allergy symptoms sometimes last for weeks or even months, cold symptoms tend to get better gradually, usually in a week to 10 days. Cold symptoms that appear unchanged after a number of weeks could be a sign of allergies. While paying attention to duration is important, there are some distinguishing symptoms: Colds are often associated with fever initially; allergies are often associated with itchiness in the eyes and nose. Colds are often contagious, so consider whether family members or your child’s friends or classmates have had similar symptoms.


 Lasting symptoms could also be due to a bacterial or viral infection, such as a sinus infection that often comes with headaches and yellow drainage from the nose. The diagnosis of a viral infection does not, however, exclude the possibility of allergies: Underlying allergies can aggravate symptoms of a viral infection and vice versa.  


Pay attention to timing 


Identifying the time of year in which your child’s symptoms began can provide an important clue, as the start of symptoms during a season change could be a sign of allergies. Keep in mind that different types of pollens emerge at different stages throughout the spring (certain tree pollens emerge in early and mid-spring, with grass pollens often coming out in June). If similar symptoms recur in successive years, then allergies must be considered as the cause.


 While timing can be a helpful indicator, it will not provide the full answer. For example, the onset of symptoms in the fall could be the sign of ragweed allergies, but these symptoms could also be from the common rhinovirus that often spreads through student bodies at the start of the school year. 


When to see an allergist 


While exceptions are possible, children often do not develop seasonal allergies until around age 5. If you suspect that your child has allergies, you should contact your pediatrician about the ongoing symptoms. Your pediatrician might recommend trying a non-drowsy, over-the-counter allergy medication. Note that if such a medication helps, it is still not conclusive that your child suffers from allergies — many allergy medications also mitigate cold symptoms by reducing nasal discharge.


 If your child’s symptoms continue despite the use of an over-the-counter antihistamine, or if other signs point to allergies as the culprit, your pediatrician will likely refer you to an allergist. Seeing an allergist is especially important if your child’s quality of life is being affected by the symptoms, such as his or her ability to sleep, focus in school, and enjoy activities with friends and family. A visit to an allergist may also evaluate whether your child suffers from asthma, which is commonly associated with allergies.


 In discussing medications with an allergist, you may also learn of ways in which you can make your home more allergy-safe if needed, especially because underlying indoor allergies can aggravate seasonal symptoms.


 There are a number of effective allergy medications out there in addition to antihistamines, so getting the right diagnosis and finding the right medication for your child are important. Identifying the cause of allergy symptoms is a main objective of the allergist so that you can take the right steps to improve your child’s health — whether that means finding the best medication, altering your environment, or both.  


John L. Ohman, Jr., MD, is Chief of the Division of Allergy at Tufts Medical Center, and a professor at Tufts University School of Medicine.