From Vincent Iannelli, M.D.,
Your Guide to Pediatrics.
FREE Newsletter. Sign Up Now!

About.com Health's Disease and Condition content is reviewed by Kate Grossman, MD

Q. My 9 year old has had a runny nose, sneezing and a cough for several weeks now. He doesn't have a fever and otherwise seems well. Does he just have a cold or could it be allergies?

A. It could very well be allergies. Although most people think of spring time as when most people have problems with allergies, depending on what you are allergic to, autumn can be just as bad.

Fall allergies are often triggered by ragweed and outdoor molds. Other triggers include certain plants that pollinate this time of year, including some weeds, trees and flowers, like sagebrush, Russian thistle and cedar elm.

And keep in mind that some children have allergies symptoms year round.

Still, autumn, with kids being back in school, is also a common time of year for cold viruses and other infections to be going around, so it also could just be a simple cold.

How do you tell the difference between a cold and allergies and does it really matter?

First off, it can matter and is important to tell the difference between a cold and allergies, since they are usually treated with different medications. While a cold may not need any treatment at all, or you might use a cold medication with a decongestant and cough suppressant, allergies can be treated with an antihistamine and/or nasal steroid. Also, if you go to your doctor with chronic cold symptoms, then you might be given antibiotics unnecessarily.

Although they have similar symptoms, such as a runny nose, watery eyes, sneezing, itchy throat, headache and a cough, there are some important clues that can help you tell if those symptoms are being caused by a cold virus or allergies, including that:

• although the runny nose from a cold will start off being clear, it often turns yellow or green after 3-5 days, while children with allergies will continue to have just a clear runny nose
• a child with a cold will usually get better in 10-14 days, while allergy symptoms might linger through the whole season until the first frost. Although it won't help you this year, if you notice that your child has a runny nose in Autumn and it doesn't finally go away until the weather gets cold and there is a freeze, that is a good sign that he has fall allergies and you will know what to do next year.
• children with a cold might also have a fever and muscle aches your child's symptoms change depending on the weather outside. For example, ragweed counts usually decrease after a heavy rain, so if your child's symptoms improve after it rains, he might be allergic to ragweed. Or if his symptoms are worse on days that are windy, that might also indicate an allergy since pollen counts are often higher on windy days.
• when children have a cold, other household contacts are usually sick too. If your child has been sick for a few weeks and no one else at home has caught it, that is a good sign that it is just allergies. But keep in mind that other family members might have similar symptoms just because they are all allergic to the same things, and so will have allergy symptoms at the same time of year. your child gets similar symptoms at this time of year. This isn't always helpful as you might not have noticed these seasonal patterns in younger children, and school age children and those in day care get sick a lot this time of year anyway.
• children with allergies will often have dark circles under their eyes, called allergic shiners. They might also have a small crease near the bottom of their nose (nasal crease) from pushing their nose up because it is itchy. Inside their nose, the mucosa will often be pale and swollen, while it is usually red and inflamed when you have a cold.

Avoiding Fall Allergies

Since pollens are peaking in the late morning and early afternoon (10am to 4pm), it can be helpful to keep your child indoors at this time. The early morning, between 5-10am is also a

bad time, as that is when the ragweed pollens are being dispersed into the air. Also, keep the windows of your house and car closed to minimize your child exposure to allergens (things he is allergic to), check pollen counts, and don't let your child outside when people are mowing their lawns.

If your child has been prescribed an allergy medication, such as an antihistamine like Claritin, Clarinex, Zyrtec, or Allergra, or a nasal steroid like Nasonex, Rhinocort Aqua, Flonase, or Nasacort AQ, you should start to give it to him just before the start of his allergy season to prevent any problems from beginning.

Allergy testing might also be helpful if you aren't sure what is triggering your child's allergy symptoms. If he is tested and it reveals an allergy to ragweed, then you won't be surprised when he begins getting allergy symptoms when the ragweed counts are high.