If you or your child is sniffling, coughing and sneezing, you might just chalk it up to a common cold. But it could also be an allergy. Hay fever can appear even in people who’ve never had it before, especially kids. So how do you know what you’re dealing with? Here’s how to tell and get the right relief.
The signs of a cold are well-known: sniffling and sneezing, coughing, a sore throat. But allergies can produce similar symptoms – even in someone who’s never had them before.
While new seasonal allergies are more common in children, they can come on at any age. When that happens, pollen, grass or other irritants may suddenly start to aggravate your body. Every time you breathe them in, the immune system produces antibodies known as histamines, which cause allergy symptoms.
Possible reasons include a family history of allergies (of any kind, even food), or an intolerance to a substance that builds over time until your body identifies it as a threat.
Each year, 10% of kids and 8% of adults are affected by respiratory allergies (otherwise known as allergic rhinitis or hay fever), according to a 2009 report by the Centers for Disease Control and Prevention’s National Center for Health Statistics. Meanwhile, about 25% of Americans catch at least one cold per year.
So how can you tell whether to avoid allergens, or – in the case of an infectious cold virus – avoid other people?
“There are a few ways to tell the difference,” says Michael J. Welch, M.D., co-director of the Allergy and Asthma Medical Group and Research Center in San Diego and author of American Academy of Pediatrics Guide to Your Child's Allergies and Asthma (Villard Books).
Find out what your symptoms mean – and get the best treatments for each condition.
Symptom #1: A runny nose
Getting the sniffles is a major sign of either a cold or allergies. To tell which one, check the color of the mucus being produced, Welch advises.
It’s a cold: “If it’s thick and yellow or green, it means you’re dealing with some type of infection, not allergies,” he says.
It’s an allergy: “The mucus produced by allergies is clear and watery, as is the discharge from the eyes,” notes Welch.
With kids, there’s another clear sign that you’re dealing with an allergy, says Paul Ehrlich, M.D., a partner in Allergy and Asthma Associates of Murray Hill in New York City and author of Asthma Allergies Children: A Parent's Guide (Third Avenue Books).
He calls it “the allergic salute”: They rub the nose to tackle the itch, and then push up on it to wipe away runniness.
Get relief: If the signs all point to allergies, try an over-the-counter (OTC) antihistamine, which blocks the body’s production of the immune compounds and reduces your symptoms. Sleepiness is a potential side effect, although “nonsedating” varieties minimize it.
If it looks like you’re dealing with the common cold, try a decongestant medication or nasal spray.
“My preference is the [decongestant nasal spray] because you don’t get any side effects,” says Welch. “It’s not pleasant but it really works.”
Nose sprays have a reputation for causing “rebound” symptoms with long-term use, but they’re fine for 3-5 days, Welch says.
Oral decongestants often contain pseudoephedrine, “a cousin of amphetamines,” Welch says. It can have a stimulating effect, so you may end up feeling jittery with an increased pulse and trouble sleeping.
You can also try a nasal rinse or neti pot, which both use a drug-free saline solution.
Don’t give decongestants or antihistamines to kids under 3, Welch advises – instead, consult your pediatrician.
“For [babies or toddlers], you can suck out the mucus with a bulb syringe,” he says.
Symptom #2: Itchy eyes and sneezing
Sneezing is another common symptom that could signal either a cold or allergies.
It’s a cold: Random sneezing – particularly when accompanied by a sore throat – is usually a sign that you’ve picked up a cold virus.
It’s an allergy: If you sneeze while cutting the grass, walking through a park or gardening, the likely culprit is pollen.
Sneezing 5-6 times in a row is another indication, Ehrlich says.
Itching is caused by histamines released during an allergic reaction – so itchy eyes mean “you generally don’t have a cold,” he says.
Get relief: Oral or nasal decongestants can sometimes help.
If you have hay fever (a seasonal allergy to pollens and grasses), avoid going out in the early morning hours, late afternoon or early evening, because that’s when pollen is most prevalent, Erlich says.
Antihistamine eye drops may relieve itchy eyes. Over-the-counter products with ingredients such as ketotifen fumarate (Alaway, Zaditor) significantly decrease allergic symptoms in adults and older children, according to studies at Harvard Medical School’s Schepens Eye Research Institute.
But check the label to make sure a product is child-safe and find out how long it can be used without a doctor’s OK.
Symptom #3: Coughing or trouble breathing
A dry and unproductive cough (where nothing comes up) can be associated with a cold or allergies. But other kinds can indicate what you’re dealing with.
It’s a cold: A wet cough – one that brings mucus up from the lungs – usually accompanies a cold, the flu or even bronchitis (inflammation of the air passages).
If you or (more likely) your child has a harsh, “barking” cough, it may signal croup, a swelling in the throat usually triggered by a cold virus. It’s contagious but rarely serious, and usually goes away after a few days of rest.
It’s an allergy: Wheezing could suggest asthma – which is often associated with allergies, Welch says.
“Short-term wheezing can sometimes occur in [someone] who doesn’t have asthma, but it’s usually mild and doesn’t last more than a few days.”
A family history of allergies makes that more likely.
“If these things persist and there's no history, it's really up to a doctor to distinguish [if it’s asthma],” Welch says.
Get relief: Welch suggests using a cough medicine that contains guaifenesin, an expectorant drug that thins mucus and makes coughing easier.
Some formulas may also contain a cough suppressant, such as dextromethorphan.
Symptom #4: Achiness or fever
It’s a cold: “Achiness usually suggests a viral infection, like a cold or flu,” Welch says. If you have a fever, it’s also likely you’re dealing with an infection.
It’s an allergy: “In general, [aches and fever] aren’t part of having allergies,” Welch says.
Get relief: A fever brought on by a cold isn’t likely to be as high as one caused by the flu. Pain relievers such as ibuprofen and aspirin can help.
But don’t give aspirin to kids under 12, because it can significantly raise their risk of Reye’s syndrome, a rare but potentially fatal condition.
A new report from the American Academy of Pediatrics recommends calling the doctor about a fever if:
A baby younger than 3 months old has a fever of 100.4° F or higher.
An infant between 3 and 6 months old has a fever of 101.5° F or higher.
An older child has a fever of 103° F or higher.
A child of any age has a fever accompanied by lethargy, headache, skin rash, trouble breathing or dehydration.
Symptom #5: Sore throat
An irritated throat could mean a cold or allergies – or something else.
It’s a cold: Sore throats are a common symptom of colds, flu, strep throat, and a variety of other viral and bacterial infections, which a doctor would have to diagnose.
Call your doctor if the sore throat is accompanied by a fever, there are white patches on the throat, or it lasts for several days.
It’s an allergy: Your throat may also bother you when you have allergies, especially if you’re experiencing a postnasal drip.
Get relief: Traditional treatments are the best, according to the National Institutes of Health: Drink hot tea with lemon or honey, drink cold liquids, gargle with salt water, or take an over-the-counter pain reliever.
Adults and older kids can also suck on throat lozenges, but they’re a choking hazard for young children.
When to See the Doctor:
A doctor can’t do much for a cold – you just have to ride it out. (Unless you have severe symptoms, such as a high fever, that could signal something more serious.)
But if you have persistent allergy symptoms that don’t improve, consider getting help. Welch recommends using OTC allergy medications and identifying and avoiding your triggers.
If that doesn’t work, you should see an allergy specialist, Ehrlich says – especially if your symptoms interfere with sleep, your ability to go to work or your child can't go to school.
“An allergist can better give you an idea of what to do,” he says.
What’s Your Allergy IQ?
Ignorance may be bliss, but not when it comes to a stuffy, sneezy, scratchy problem like allergies. Maybe you suffer from seasonal allergies. Or perhaps the bed bugs really are biting. Do you know what’s making you itch?
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