Is It Allergy, or a Cold?

The common cold (caused by the Rhinovirus) can frequently present in a similar fashion to an attack of allergy. The patient can have sneezing, runny nose, profuse post-nasal drainage, and fatigue. Typically this occurs without a fever leading the parent to believe that something must have triggered an allergy attack. The two can be difficult to tell apart as the drainage from both is often clear to slightly colored.

In reality, the common cold will typically last for only 3-5 days and will clear with only symptomatic treatment. The use of the newer allergy antihistamines (Claritin, etc.) will not treat the symptoms of the cold, and this may be one of the ways to differentiate the two diseases. Common treatment is the use of OTC cold and cough preparations, which have a bit of a sedating and drying effect, the use of analgesics such as Tylenol, and the aggressive use of nasal saline spray. Nasal steroid sprays have been shown to be helpful in the prevention of acute sinusitis, and it certainly does not hurt to continue their use. It is NOT recommended to treat nasal drainage of a short duration without complications with antibiotics. The use of some OTC remedies such as Zinc lozenges has been propagated but there is not a lot of scientific proof to support this. However, if they taste good and you have a sore throat, they are a good option if you can spare the loose change.

When does the common cold become a problem?

When symptoms are lasting more than a week and secondary infections are developing, it is time to see the doctor. A cold that leads to worsening congestion and thicker drainage has possibly developed into a sinus infection, and the patient should be evaluated if this occurs. Ear infections can also develop and if a child is having the onset of ear pain, they need to be evaluated. Also, the most common infectious cause of asthma flare ups in the pre-teen to teen years is the Rhinovirus. With this in mind, if a patient has asthma, the use of preventative medications should be encouraged during these times, and bronchodilators should be used at the first sign of cough or lower respiratory problems.

Winter is also a time to turn on the furnace, and this can lead to more dust in the environment. Proper control of the HVAC system can prevent the irritation form this. One other important point about the use of heat and the cold winter months is that the humidity in the air is very low. This can lead to nasal irritation and bleeding. Resist the effort to use a room humidifier as this can increase the dust mite and mold growth in a bedroom rather quickly. Instead, use topical nasal saline spray and increase the humidifier on the furnace to keep the indoor humidity to 40-50%.

Following these simple measures and using some measured restraint can keep the cold and winter allergy problems from becoming more than a nuisance.

Written by Allergy Care physician, Mark Corbett, M.D.