How to tell the difference between cold and allergy in children? Both colds and allergies can cause similar symptoms in children, including runny nose, sneezing, and stuffy nose. These similarities often confuse parents and make accurate diagnosis difficult. However, there are key differences in the cause, type of symptoms, time of occurrence and their duration, knowing which these two conditions can be distinguished from each other. Understanding these differences is important to providing your child with appropriate and timely care. ### The main reason **cold** The common cold is a viral infection caused by different types of viruses, the most common of which are rhinoviruses. These viruses are transmitted through respiratory droplets in the air or direct contact with contaminated surfaces. Cold is a contagious disease and can spread from person to person. **allergy** An allergy, unlike a cold, is an overreaction of the body's immune system to harmless substances in the environment, which are called allergens. These substances can include plant pollen, dust mites, pet dander, mold and even some foods. When faced with an allergen, the body mistakenly considers it a threat and releases histamine and other inflammatory substances to defend itself. Allergy is a non-infectious reaction and is caused by individual sensitivity. ### Types of symptoms and their severity Diagnosis can be a bit complicated based on the type and severity of symptoms, but with close attention to detail, the differences can be seen: #### **Running** nose In a cold, the runny nose is usually clear at first and can then thicken and become cloudy, yellow, or green. But in allergies, the runny nose is usually clear and watery, like water. #### sneezing Children with colds may sneeze occasionally, but usually not a lot and in a row. While in allergies, the sneezes are very frequent, in a row and explosive, as if the child cannot stop them. #### Nasal congestion Nasal congestion is common in both cases. In a cold, nasal congestion becomes annoying especially at night. In allergies, nasal congestion can be chronic and long-term and even cause sleep problems. #### Cough A cough in a cold can be dry or phlegmatic and is usually caused by pharyngeal secretions or lung irritation. In allergies, the cough is often dry and irritating, mostly due to post-pharyngeal secretions (PND) that irritate the throat. #### itching This is one of the most important distinguishing marks. In a cold, itching (especially itching of the nose, eyes, ears, and throat) is usually absent. But in allergies, itching in these areas is very common and specific, and the child may rub his nose frequently or rub his eyes. #### Redness and watery eyes With a cold, redness or watery eyes are less common, unless there is a concomitant eye infection. But in allergy, the eyes are often red, watery and very itchy. #### Sore throat Sore throat is common in colds and often appears at the beginning of the disease. In allergies, sore throats are less common, but may be caused by irritation from secretions in the back of the throat. In allergies, itchy throat is more common than sore throat. #### Fever Fever never occurs in allergy. A fever, especially in young children or in cases of more severe infections, is a telltale sign of a cold or other infection. #### Body pain and fatigue Body aches and fatigue are common in colds, especially the flu. But in allergies, the child usually does not have body pain, unless he has not slept well due to severe allergy symptoms and fatigue is caused by insomnia. #### Gastrointestinal symptoms Gastrointestinal symptoms such as diarrhea or vomiting may occur with some types of cold or flu viruses, but are usually not present with allergies. ### Occurrence time and duration **cold** Onset: Cold symptoms usually begin with symptoms such as a sore throat or itchy throat, followed by a runny nose, sneezing, and coughing. Duration: Symptoms usually peak within 7 to 10 days and then gradually improve. A cough may persist for several weeks after other symptoms have improved. Seasons: Colds can occur in all seasons of the year, but it is more common in colder seasons such as autumn and winter due to the gathering of people in closed spaces. **allergy** Onset: Allergy symptoms usually begin suddenly and upon exposure to allergens. For example, a child who is allergic to pollen may experience sneezing and a runny nose immediately after playing outdoors. Duration: As long as the child is exposed to the allergen, the symptoms continue. Allergies can be seasonal (such as pollen allergies that are active during certain seasons of the year) or chronic (such as dust mite or pet dander allergies that are present year-round). Seasons: depends on the type of allergen; For example, pollen allergies are common in spring and summer, while dust mite allergies occur year-round. ### Response to treatment and family history #### Response to treatment Colds: There is no cure for the virus itself, but symptoms can be relieved with antipyretics, pain relievers, and adequate fluids. Antibiotics are ineffective against viruses and should not be used for colds. Allergy: Allergy symptoms are controlled with anti-allergy medications (antihistamines), nasal sprays containing corticosteroids, and in more severe cases, immunotherapy (allergy shots). Avoiding allergens is also a key and effective solution. #### Family history Colds: It is not related to family history of allergies or similar diseases. Allergies: It is very common for a child with allergies to have a history of allergies, asthma or eczema in the family. This is an important genetic factor. When should we see a doctor? Despite these differences, diagnosis is sometimes still difficult, especially in infants and young children who cannot articulate their symptoms clearly. In the following cases, consultation with the best pediatrician in Tehran is necessary: - High fever or persistent fever that does not improve. Shortness of breath, wheezing, or a severe cough that is bothersome or doesn't respond to home remedies. - Ear pain or ear infection symptoms such as ear pulling or extreme restlessness. - Severe or unusual symptoms that are worrisome. - Failure to improve symptoms after 10 to 14 days, because colds usually improve during this period of time, and the persistence of symptoms may be a sign of an allergy or complication. - Strong suspicion of allergy, especially if symptoms are seasonal or accompanied by severe itching in the eyes, nose, or throat. If the child has a history of asthma or other chronic breathing problems, because even a simple cold can aggravate asthma symptoms. #### Summary While colds and allergies can both be uncomfortable, they are completely different in their causes and treatment approaches. By paying attention to the symptoms, their onset and duration, parents can distinguish between the two to a great extent. However, in any case of doubt or concern, especially if the child's symptoms are severe or long-term, it is the best course of action to refer to the best pediatrician in Tehran for accurate diagnosis and appropriate treatment. The doctor can determine the main cause by examining and, if necessary, additional tests, and provide the necessary guidance so that your child feels better as soon as possible.