Asthma or allergies? CA pediatrician shares how to spot difference in kids
AI-generated summary reviewed by our newsroom.
- Persistent cough and chest tightness may indicate asthma over seasonal allergies
- Allergy diagnosis often starts with blood testing and may require specialist input
- Children with eczema may have higher risk of allergies or asthma due to inflammation
It’s that time of year: the grasses are still long from winter rain and the winds are blowing pollen and dust into the air, but is your child’s runny nose and cough a symptom of seasonal allergies — or asthma?
Dr. Sasha Szytel, a general pediatrician at Bravo Pediatrics in San Luis Obispo, said that while asthma and allergies share some characteristics, there are some distinct differences to tell them apart, and one is typically more common than the other.
“In our area, because we have such amazing plant life, we tend to see more people with environmental allergies than we do with asthma,” Szytel said.
Seasonal allergies usually present “daytime symptoms,” as a result of kids spending summer days outside being exposed to pollen and grasses, Szytel said.
Allergies usually do not affect young infants under a year old, though.
“I always think of allergies as something that tends to build more over time,” Szytel said.
Asthma, though it operates through the same mechanism as allergies, presents differently in the body.
The main indicator that your child’s symptoms may be asthma instead of allergies is a persistent cough, Szytel said.
“Kids with allergies can have a cough, but it’s one of many symptoms, and the cough usually isn’t their main complaint,” she said.
When kids with asthma get sick with a cold or upper respiratory infection, they’ll often hold onto their cough longer than other kids, she said.
“They often will complain of like a tightness in the chest or a difficulty catching their breath,” she said. “Sometimes their coughs will last for several weeks. That can be a bit of a tip off for asthma.”
When should I get my child tested for allergies and asthma?
Szytel said that often allergies can be treated at home with over-the-counter long-lasting antihistamines like Claritin or Zyrtec, which help relieve symptoms within a few hours. She typically does not recommend shorter-acting sedatives like Benadryl.
But sometimes further medical intervention and testing is recommended.
For allergies, the first step would be to conduct a regional blood panel, which tests for about 25 different local plants, molds, pets and other common allergens through a blood sample.
“It’s not perfect, but it’s a really helpful guide,” Szytel said.
For more severe cases of allergies, they would refer a child to an allergy specialist who can do skin testing. In that test, the doctor injects a small amount of an allergen into the skin on the back and observes for an immediate or delayed response.
Testing for allergies can be helpful to know exactly what you’re child is allergic to, so as to know how to best minimize exposure at home. Some allergies, such as grasses and pollen, can be minimized by showering after being outdoors, but others, like pets and dust mites, might be harder to identify and mitigate without specific testing.
For asthma, Szytel usually recommends testing.
“If you have a child who just seems to cough quite a bit or when they have a cold, it’s always good to get them evaluated for asthma,” she said.
The best testing for asthma is a spirometry, which requires kids to breath in and out of a specialized tub that measures their lung volume, capacity and ability to exhale. However, it is difficult to get younger children to cooperate with the test.
“When they come into the office, we listen to their lungs, and a lot of times we can hear that they’re wheezing, and that’s kind of the hallmark of asthma,” Szytel said.
She also said family history of asthma can be a likely indicator.
Sometimes, completing a trail of asthma medication and seeing if that helps relieve symptoms can help.
Treatment, such as inhalers, are not always permanent, too.
“A lot of kids with asthma do get better over the years, as they have maybe fewer and fewer colds to trigger their asthma,” Syztel said.
Whether or not your child’s symptom amount to asthma, its better to be safe than sorry, Syztel said.
“If there’s any doubt, it’s always good to check in with their pediatrician, especially if you suspect asthma,” she said. “The concern there is untreated asthma over time can lead to some scarring in the lung because of the inflammation.”
She also recommended for any kids with asthma to make sure they get their flu vaccine. Flu vaccines usually become available by Sept. 1 and are offered for children over 3 years old at the SLO County Public Health Department, local pharmacies or your child’s doctors office.
Can eczema be related to my child’s allergies or asthma?
The other chronic condition that falls within the same category is eczema.
“Allergies, asthma and eczema all have a very similar mechanism of inflammation in the body,” Szytel said. “They just affect different body parts.”
For this reason, Szytel said its good to be on the lookout for allergies and/or asthma if your child has persistent, reoccurring and difficult-to-treat eczema. Usually this is only for only children, however, as eczema is fairly common in young infants under age one.
Again, family history can be a strong indicator.
“This is really common for us to hear, in a child with eczema or or asthma, that mom or dad or both had asthma as a child,” she said.
