March, April and May are riddled with airborne allergens here in the Richmond area. It is primarily tree pollen but others, such as grass pollens, may be present as well. Because this is also the tail-end of cold and flu season, many are left wondering whether their runny noses and cough are due to allergies or a cold. While not every person presents with “textbook symptoms,” the following general guidelines can help inform the likelihood your child’s (or your own) symptoms are due a non-contagious condition like allergic rhinitis, or a potentially contagious upper respiratory viral infection.
| Symptom | Seasonal Allergies | Cold Virus |
| Congestion | Yes | Yes |
| Runny Nose | Yes, starts clear, stays clear | Yes, starts clear, then turns yellow/green as illness progresses |
| Cough | Yes, typically wet/productive but may start out dry | Yes, can be dry, wet/productive, and/or barky |
| Sneezing | Yes | No |
| Pink Eye | Possible, eyes also itchy and with increased tears, may have clear/honey-color crusting in morning, more commonly both eyes equally | Possible, not typically itchy, discharge is thicker and more yellow/green, thick/gooey discharge on eyelashes in morning, usually starts in one eye and moves to other |
| Throat symptoms | Itchy, sometimes sore, may have feeling of post-nasal drip mucous in throat | Soreness, not itchy, may have feeling of post-nasal drip mucous in throat |
| Wheezing | Possible for those with allergy-induced asthma | Possible for those with asthma, viral-induced wheezing, or reactive airway disease |
Your description of your child’s symptoms provides us with much of the information we need to start formulating a diagnosis, but the symptoms don’t always tell the whole story. When we examine your child, we’re looking for additional clues to differentiate these two similar conditions. Individuals suffering from seasonal allergies have a pale and swollen lining to the inside of the nose. By contrast, the inside lining of our nose is typically carnation pink in color. Those with cold viruses have red, angry-appearing nasal lining. Additionally, dark circles under the eyes (sometimes referred to as “allergic shiners”) can be more indicative of seasonal allergies. Another differentiator is the back wall of the throat. Those suffering from seasonal allergies will often have a cobblestone road (think Cary Street in Shockoe Slip) appearance.
With the help of reported symptoms and physical exam findings, your PAR provider can shed a lot of light on the cause of your child’s symptoms. Based on the most likely diagnosis, we will make recommendations for interventions that can improve their symptoms and provide guidance on contagiousness.
You can read more about Seasonal Allergies at https://parpeds.com/library/seasonal-allergies/
For cold symptom management recommendations, visit https://parpeds.com/library/coughs-colds-and-congestion/