Allergy Symptoms in Children

Young girl blowing her nose outside
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Allergic rhinitis causes allergy symptoms in children, which include itchy eyes, sneezing, and a clear, runny nose. This condition, which is also called hay fever, happens when the body's immune system reacts to something in the environment. Being able to distinguish between allergy and cold symptoms in kids can help you provide effective treatment for your child.

Allergy treatments are readily available as more and more allergy medications are available over the counter without a prescription. These include Allegra (fexofenadine), Astepro (azelastine), Claritin (loratadine), and Zyrtec (cetirizine).

While treating for allergies if your child actually has a cold won't do harm, it won't relieve their symptoms either. So, it's important to be able to tell the difference. When in doubt, be sure to consult a pediatrician.

Symptoms of Allergies in Children

Allergy symptoms may vary quite a bit among children. Typically, they include the common symptoms that adults experience, including sneezing, head congestion, and watery, itchy eyes. But symptoms may depend on the type of allergen your child reacts to, such as from a pet, mold, or pollen. While there are many types of allergies kids can have, the most common is allergic rhinitis.

Symptoms of allergic rhinitis may include:

  • Itchy nose
  • Nasal stuffiness
  • Nose rubbing
  • Red eyes, with tearing and itching
  • Runny nose with clear discharge
  • Sensation of itchiness or tingling in the mouth or throat
  • Sneezing
  • Snorting
  • Stuffy nose (congestion)
  • Symptoms that persist more than a week or so
  • Throat clearing

As allergies worsen or linger, children may also develop a sore throat, headaches, and coughing. Additionally, their allergies may interfere with their sleep, leading to daytime irritability. These children may also experience focus issues at school and just generally feel out of sorts. It is these allergy symptoms that are often confused with a cold or sinus infection, as many parents assume that allergies shouldn't get "so bad" or impact behavior.

Chronic Allergies

Some children develop year-round allergy symptoms. Essentially, their immune systems get triggered and stay in a heightened state, continuing to produce the more common allergy symptoms as well as other less common symptoms.

Children with chronic allergies may have dark circles under their eyes (allergic shiners) and may have a crease near the bottom of their nose (allergic crease) from rubbing their nose so much (allergic salute). They may also develop mouth-breathing (due to chronic congestion) and chronic ear problems like inflammation and infection.

Ear infections often result from chronic allergies due to inflammation that causes a build-up of fluid and infection in the ear canal. This can present as a feeling of stuffiness and/or pain in the ears and can impact hearing and the development of speech in babies and young children. Antibiotics may be needed to clear the infection.

Common Co-Occurring Conditions

Untreated or uncontrolled allergies can also trigger or exacerbate other commonly co-occurring conditions in children and vice versa.


If a child also has asthma, uncontrolled allergies may also trigger asthma symptoms, leading to coughing, wheezing, and trouble breathing. If your child has allergies and asthma, keeping their allergy symptoms under control can also help manage their asthma symptoms.

Skin Irritation

Various skin conditions, such as eczema and atopic dermatitis, are often exacerbated and/or triggered when a child also has untreated allergies. The heightened immune response is thought to make the skin more reactive.

Preventative care, such as keeping skin clean and well moisturized and following any doctor prescribed skin treatments (like hydrocortisone for eczema), can help keep skin issues from becoming aggravated during allergy outbreaks.

It's also worth noting that children who show signs of atopic dermatitis as babies may be more likely to develop allergic rhinitis (as well as asthma) later on in childhood. This progression of symptoms is often referred to as the atopic march.

Oral Allergy Syndrome

Another common comorbidity with hay fever is oral allergy syndrome (OAS). Children with OAS experience allergic reactions in their mouth, throat, and lips when they eat triggering foods. Typically, this is experienced as itchiness. These children are also more likely to develop allergic rhinitis later in life.

Cold vs. Allergy Symptoms

Although a clear runny nose, congestion, and sneezing are all classic allergy symptoms, it's important to keep in mind that they are also common cold symptoms.

A tell-tale sign of allergies, however, is that they always occur during a certain time of the year and they persist as long as the trigger allergen is blooming or present in the child's environment. In addition, you can suspect allergies if your child gets symptoms after being around an outdoor allergy trigger such as pollen or grass or an indoor allergy trigger such as dust mites, pet dander, or mold.

But sometimes, that runny nose is a sign of a cold. Since cold and allergy symptoms can be so similar, it can help to tell the two apart by thinking about a few questions:

  • Does allergy medicine decrease their symptoms? If so, it's likely allergies.
  • Has your child been exposed to something that typically triggers their allergies, such as a cat or dog? If yes, it's probably allergies.
  • Is your child in one of their typical allergy seasons? If so, then allergies may be to blame.
  • Is their runny nose clear or does it appear more green or yellow? Green or yellow nasal discharge is more likely with a cold and does not typically occur with allergies alone.
  • Do they have a fever? The presence of fever, while not always among cold symptoms, points to an infection rather than allergies.
  • Have they been around anyone else who has a cold? In this case, a cold may be the culprit.

If their allergy medicines aren't working, everyone around them has a cold, and they haven't been around their usual allergy triggers, then your child may just have a cold.

When to See the Doctor

It's always advisable to check in with a pediatrician any time your child shows new symptoms. But it's especially important when their symptoms persist or the over-the-counter or prescription treatments you are using are not adequately managing their discomfort. In those cases, a trip to the doctor can ensure you have the correct diagnosis and provide the most effective treatment options.

A Word From Verywell

Once you know how to recognize your child's allergy symptoms, you will be better able to offer them relief. If you're ever unsure if your child is experiencing symptoms of a cold, allergies, or something else, contact a pediatrician who can provide a thorough evaluation and appropriate treatment plan.

6 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. American Academy of Pediatrics. AAP allergy tips.

  2. American College of Allergy, Asthma, and Immunology. Children and Allergies.

  3. American Academy of Pediatrics. Seasonal allergies in children.

  4. Salah S, Taieb C, Demessant AL, Haftek M. Prevalence of skin reactions and self-reported allergies in 5 countries with their social impact measured through quality of life impairmentInt J Environ Res Public Health. 2021;18(9):4501. doi:10.3390/ijerph18094501

  5. Bantz SK, Zhu Z, Zheng T. The atopic march: Progression from atopic dermatitis to allergic rhinitis and asthmaJ Clin Cell Immunol. 2014;5(2):202. doi:10.4172/2155-9899.1000202

  6. American Academy of Allergy, Asthma, and Immunology. Oral allergy syndrome.

Additional Reading
  • Adkinson. Middleton's Allergy: Principles and Practice, 6th ed.

  • Kliegman. Nelson Textbook of Pediatrics, 18th ed.

By Vincent Iannelli, MD
Vincent Iannelli, MD, is a board-certified pediatrician and fellow of the American Academy of Pediatrics. Dr. Iannelli has cared for children for more than 20 years.