Patient Care

Allergic Rhinoconjunctivitis (Children)

What is Allergic Rhinoconjunctivitis?

Allergic Rhinoconjunctivitis, which is caused by an allergen, refers to nose and eye problems that occur at least once a week. When only the nose is affected, it is called allergic rhinitis. It is also known as hay fever, “sinus” or “sensitive nose”. When only the eyes are affected, it is called allergic conjunctivitis.

Allergies, particularly in children, are increasing around the world especially in developed countries. The prevalence of allergic rhinoconjunctivitis in Singaporean children up to 2 years old is estimated to be as high as 42%.1

Most allergies are due to a combination of genetic and environmental factors. This means that there is often a family member with asthma, allergic rhinoconjunctivitis or eczema.

House dust mite allergens are the most common triggers for Allergic Rhinoconjunctivitis in Singapore. House dust mites are microscopic creatures that reside in homes. Other triggers include pollen, which is most common in temperate climate, and animal dander (a combination of dead skin cells and hair or feathers). Food is rarely a trigger for isolated Allergic Rhinoconjunctivitis symptoms.

What are the signs & symptoms of Allergic Rhinoconjunctivitis?

Children with Allergic Rhinoconjunctivitis are prone to:

  • Sneezing
  • Itching of the nose
  • Running or congestion of the nose
  • Swelling or itching of the eyes

These symptoms tend to occur weekly in the morning and evening but can last the whole day. When the nose problems are significant, some of these children develop prolonged cough as well. Many parents are worried that prolonged cough will develop into asthma. This is untrue. A child with asthma can indeed have a prolonged cough but prolonged cough does not cause asthma to develop later on. Allergic Rhinoconjunctivitis and asthma can and often do co-exist so it is not uncommon that someone with Allergic Rhinoconjunctivitis may be later diagnosed with asthma.

What are the treatment options for Allergic Rhinoconjunctivitis?

Treatment can begin with skin prick testing for outdoor allergens such as house dust mites, food and drugs to identify the cause. Blood tests can also be done.

Like most allergies, treatment will consist of allergen avoidance and the use of medications.

Antihistamines are safe and effective even in very young children.

Topical steroids such as nasal sprays are also safe options. As they require a longer time to work, and need to be used regularly over days to weeks to reap the benefits. They are particularly helpful in reducing nasal blockage or congestion.

Please consult a doctor for a proper diagnosis before administering medication.

Caring for children with Allergic Rhinoconjunctivitis?

If your child is allergic to house dust mite allergens, wash your beddings (bed sheets, pillowcases and covers) in hot water that is 60°C weekly or fortnightly. Minimise the use of carpets, soft toys or thick curtains. The house should be kept dust-free by damp cleaning. Vacuum only when your child is not at home and let the air settle for about 2 hours before allowing him or her to enter the room. Mite-proof mattresses and pillow covers may be helpful but are expensive.

If your child is allergic to pet allergens, avoidance of the animal is recommended. However, it is advisable to have a proper allergy test and consultation with your doctor before doing so. If avoidance of the pet is not possible, reduce exposure by preventing it from entering your child's bedroom.

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