Asthma and allergies are two of the most common chronic conditions among children. And because both conditions involve a child’s airway, some symptoms can be similar – which can make it difficult to tell if your child has asthma, allergies or both, when symptoms flare up.

So, what makes these two conditions different? How can you tell the difference between asthma and allergy symptoms? Knowing the differences can help you treat your child’s symptoms and prevent flare-ups so they can enjoy a full and active life.

The difference between asthma and allergies in children

Childhood asthma is a chronic lung disease

Childhood asthma occurs in about 10% of children. Asthma involves inflammation and swelling of the bronchial tubes, which carry air to the lungs. Children often have asthma attacks or flare-ups during allergy season, after they exercise or even when they breathe in cold air.

Asthma is also a major cause of childhood disability. It can limit a child’s ability to learn, play and even sleep. Children miss about 13 million school days each year because of asthma and it’s a leading cause of emergency room visits for kiddos.

Asthma symptoms in kids

Common childhood asthma symptoms can happen every day, once a week or less frequently, and include:

• Wheezing or noisy breathing
• Coughing (often at night or with exercise)
• Trouble breathing or shortness of breath
• Tightness in the chest

Allergies are an immune system response

Seasonal allergies – which are often called hay fever or allergic rhinitis – are the most common types of allergies. Pollens, grasses and outdoor mold are the big seasonal allergy causes. Other environmental allergens include dust, mold and pet dander.

Allergies are triggered when your immune system detects something it thinks is harmful. And the symptoms you experience are your immune system’s way of fighting the invaders.

Allergy symptoms in kids

Many of the most common seasonal allergy symptoms in kids are the same as those in adults:

• Itchy, watery or red eyes
• Runny or stuffy nose
• Sneezing
• Dry cough
• Scratchy or sore throat (rarely)

Allergy symptoms in kids can be similar to common illnesses. Check out any of the links below to see how symptoms are similar and different:

• Cold vs. allergy symptoms
• COVID-19 vs. allergy symptoms

Can allergies cause asthma attacks?

There are different types of asthma, including allergic and non-allergic, but there can be both allergic and non-allergic triggers.

Intrinsic vs. extrinsic asthma

Allergic asthma, which is also called extrinsic asthma or allergy-induced asthma, is caused by allergens. So, allergic asthma is often triggered during spring, fall and summer allergy seasons. But it can really flare up any time, since other environmental allergens are present year-round. Between 80-90% of children with asthma have allergy triggers, compared to 50% of adults.

Non-allergic asthma, or intrinsic asthma, can have a wide range of triggers, including respiratory infections, exercise, smoke exposure or even stress. In this category, infections are especially common triggers for allergies in children.

How do I know if my child has asthma or allergies (or both)?

A primary care doctor, or an allergy and asthma specialist, can provide an official diagnosis.

If your child has new symptoms, start by making an appointment with their primary care doctor or clinician. The doctor will likely conduct a clinical exam and also talk with you about your child’s:

• Type, severity and frequency of asthma or allergy symptoms
• Medical history, specifically any prior treatment for similar symptoms
• Family medical history

From there, they’ll work with you to develop a treatment plan, which may include connecting you with an allergy and asthma specialist. If allergies are suspected, a skin test may be recommended to determine which allergens cause a reaction.

A skin test involves scratching the skin and applying solutions containing different types of allergens. If your child has a reaction to any of the allergens, a hive or welt will appear at the site of the scratch. Blood tests may also be run to determine allergies.

Helping your child manage their asthma or allergies

How to help kids manage asthma

Controlling a child’s asthma is essential to helping them live a healthy, active life. Here’s what you can do to help manage your child’s asthma.

• Make sure any asthma medications are taken as prescribed – Most kids with asthma will take some type of medication to help control their condition. Some are daily medicines to help prevent their airways from becoming irritated, others may only need quick-relief medications (like an inhaler) for flare-ups.
• Schedule regular doctor visits – Regularly scheduled visits help make sure your child’s asthma medications are well managed, and also provide an opportunity for you to get the latest information on asthma treatments. Unless your child’s doctor suggests more frequent visits, your child should see them once every six months.
• Complete a yearly Asthma Control Test – Filling out this annual questionnaire helps your doctor understand how your child’s asthma symptoms have been over the past 12 months, as well as how many emergency room visits have happened due to asthma. This helps them adjust your child’s treatment and asthma management plan (AMP).
• Create and regularly update an AMP – With the help of your child’s doctor, you’ll create an asthma management plan and update it at every visit. The plan helps you know your child’s asthma triggers and medications, how to control symptoms and when to call the doctor. You can also share it with school professionals and caregivers.
• Get your child an annual flu shot – It’s especially important for kids with asthma to get a flu shot in early fall, before the flu season begins. Having asthma puts your child at risk for developing severe complications from the flu.
• Take regular spirometry tests – A spirometry test involves breathing into a tube that’s attached to a machine that measures asthma factors. Your child can have this yearly test in their doctor or clinician’s office starting at ages 5 to 7.

How can I help my child with allergies?

Children with allergies have the same allergy treatment options as adults. For starters, over-the-counter children’s alleergy medicines like antihistamines, decongestants and nasal steroid sprays can be extremely helpful. Just make sure you talk with your child’s doctor first.

With consistent use, these medications can help relieve symptoms and keep them under control. You can also use natural remedies such as sinus rinses as alternatives or in combination with medications.

Depending on how serious your child’s allergies are – and whether they also have asthma – your doctor may recommend prescription medications or allergy shots.

Whether it’s asthma, allergies or both, these conditions can be managed

With the right care and treatment plan, you can help your child manage their asthma, allergies or both so they can live a happy, healthy life.

If your child has never been diagnosed with asthma, allergies – or is starting to show new symptoms – make a primary care appointment. There are many conditions that look similar and your doctor can help demine if your child’s symptoms are related to asthma, allergies or COVID-19, or something else.

With in-person and video visit options, you can choose the appointment type that’s most convenient for you.

If your child has been diagnosed with asthma, allergies or both, you can schedule a visit with an allergy and asthma specialist without a referral.