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    Ragweed Allergy Options for Children: Ease the Sneeze

    Majed Koleilat, MD Allergy and Immunology, Deaconess Clinic 01/18/2016
    Ragweed is a pervasive flowering plant that is nearly inescapable and the cause of allergies worldwide.  Allergens and ragweed specifically can be especially dangerous for children.  Allergic symptoms can manifest differently in children, and since children spend more time outside, they are therefore subject to more ragweed exposure. 

    Common symptoms of ragweed allergies in children are itchy eyes, swollen eyes, runny or stuff nose, throat irritation and hives.  More severe cases may present as asthma symptoms like wheezing, coughing and difficulty breathing. 

    Ragweed allergies are typically diagnosed with skin and/or blood testing.  Treatment options for children are somewhat more difficult because complications are more likely to arise and compliance can be low.  However, help is available. 

    Anti-histamines – Most are available over-the-counter but require daily administration and may cause drowsiness.  This route does not directly address the cause of allergy but rather manages the process of the allergic response.  Anti-histamines are most effective when started before ragweed season begins. 
    Decongestants - As an “as needed” medication, decongestants do not directly address the ragweed allergy but provide temporary relief.  They are available as liquids, pills or nasal sprays.  Decongestants may cause hyperactivity in children.  Nasal decongestant sprays may lead to dependency and increased need for the nose spray (especially oxymetazoline).

    Corticosteroids – Available as nasal sprays, corticosteroids reduce nasal/sinus inflammation and provide ragweed symptom relief.  Corticosteroid sprays have a “building” effect and need to be administered consistently before children feel symptom alleviation. 

    Subcutaneous Immunotherapy – Long considered the “gold standard” for allergy treatment, allergy shots have historically been the only treatment available to mitigate the allergic response by changing/modifying the disease process as opposed to simple symptom treatment.  Allergy shots are quite effective but there are several major drawbacks.  Injections are administered in a physician’s office and the child must remain in the office for 30 minutes post-injection to be monitored for significant reactions.  Additionally, it can take up to a year for a child to feel symptomatic relief.
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