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Allergies and "Allergic Shiners"

Hi Again,

I was also asked by Jennifer, one of our Moms here at Meyer Pediatrics, about allergic shiners, those dark and puffy circles under kid’s eyes that are often mistakenly thought to be due to lack of sleep. The’re not related to sleep at all. They are a sign of allergies, as are the creases under the eyes called Denny’s Lines and the raised pink bumps on the back wall of the throat called cobblestoning. If one parent has allergies, each child has about a 50% chance of having allergies (although what your child is allergic to is NOT inherited; that they have to do for themselves. Just because you are allergic to penicillin does not mean that your child is, or even ever will be). If both parents have allergies, then each child has about a 75% chance of having allergies.

I’m often asked when, or even if, a child should be tested for allergies. My short answer is that I would go through the relative trauma of skin testing (far more accurate than blood testing) only if the child’s life is being changed by the allergies. If they can’t go to a friends house because the friend has a dog, that may be a good reason to investigate.

There won’t be just one or 2 things that your child is allergic to and therefore you could just avoid. It likely will be a dozen or more things. In most cases, you could just treat the allergies and skip the whole testing phase. Obviously, if you think that your child has had a serious reaction to something, or perhaps may even have had a potentially fatal reaction to something such as having had difficulty breathing after eating shellfish, then of course you would want to have this checked by an allergist so that you can know for sure.

It depends on the child, but I often find that for kids with significant allergies it usually takes a combination of Singulair (a prescription medication for airway inflammation) plus an allergy nasal spray such as Omnaris or Nasonex or Nasocort, plus a once-a-day, non-sedating antihistamine (such as Allegra or Clarinex) to control the allergy symptoms well. One or two of those medications just doesn’t seem to work as well, in my experience.

I know that most parents don’t like the idea of their children taking mutliple medications, and I do prefer just letting the child live with mild symptoms, but if we’ve made the decision to treat allergies with medication, I think we might as well do it the right way. Go for the win.

As a preventative, Singulair once a day can often be used as a maintenance plan during the time of year when your child is most symptomatic, with antihistamines used on an “as needed” basis. When your child is fully symptomatic, however, you’re going to want to do everything, or nothing at all, in my opinion.

I hope that this little overview answered some of your questions about allergies. If not, or if there are other topics that you’d like to see me address, write me here at Dr. Ted’s Blog and I’ll try to get something written as soon as possible.