First Aid: Allergic Reactions (for Parents) — Nemours KidsHealth
First Aid: Allergic Reactions
- 1 First Aid: Allergic Reactions
- 2 What to Do When You Have an Allergic Reaction
- 2.1 1. What happens during an allergic reaction?
- 2.2 2. What should you do for throat swelling and difficulty breathing?
- 2.3 3. What can you do to relieve itching, redness or a rash?
- 2.4 4. What’s the best way to treat itching, sneezing and watery eyes?
- 2.5 5. What should you do when hives develop?
- 2.6 6. Can allergies occur unexpectedly?
- 2.7 7. What if you don’t know what’s causing your reaction?
- 3 What to do if a baby has an allergic reaction
- 4 Allergic Reactions at School
- 5 Make a Plan
- 6 Avoid Triggers
- 7 Safety First
- 8 Understanding a Mosquito Allergy
- 9 Symptoms, Diagnosis, and Treatments
- 10 Reactions to Mosquito Bites
- 11 Who Is at Risk
- 12 Diagnosis
- 13 Treatment
- 14 Prevention
- 15 When Is an Allergic Reaction an Emergency?
Allergic reactions can be triggered by foods, medicines, pets, insect stings, pollen, and other things. Most allergic reactions aren’t serious. But severe reactions can be life-threatening and need immediate medical care.
Signs and Symptoms
- skin redness
- slight swelling
- stuffy, runny nose
- itchy, watery eyes
- red bumps (hives) anywhere on the body
- swelling of the mouth or tongue
- trouble swallowing or speaking
- wheezing or trouble breathing
- belly pain, nausea, vomiting, or diarrhea
- dizziness or fainting
What to Do
- Contact a doctor if your child has an allergic reaction that is more than mild or concerns you.
- If the symptoms are mild, give an antihistamine by mouth such as diphenhydramine (such as Benadryl).
- If the symptoms are severe and you have injectable epinephrine (such as EpiPen), use it as directed right away and call 911 for emergency medical help.
Help kids avoid anything they’re allergic to, and keep an oral antihistamine available.
If your child has a severe allergy or has had a severe reaction, be sure the injectable epinephrine is on-hand at all times (including at school). You, your child (if old enough), and anyone who cares for your child know how to use it.
What to Do When You Have an Allergic Reaction
Pollen, dust, animal dander, nuts, shellfish and other foods — these can all cause an allergic reaction in susceptible people.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
The symptoms range from being mildly uncomfortable and annoying to serious and life-threatening. So it’s good to know what to do if you or someone you’re with has an allergic reaction.
You may need to act quickly.
Here, allergist and immunologist Bela Faltay, MD, answers common questions about allergic reactions and how to handle them:
1. What happens during an allergic reaction?
When you eat, breathe in or touch something you’re allergic to, your immune system produces histamines to deal with the bothersome substance (allergen).
This immune response can cause several symptoms, including:
- A rash
- Hives (large, pink bumps or swollen areas)
- Sneezing and watery eyes
- Swelling in the mouth or throat
- Rapid or difficult breathing
2. What should you do for throat swelling and difficulty breathing?
Call 911 immediately for medical help. Sometimes severe allergic reactions that cause you to struggle for breath can also create a sense of impending doom, says Dr. Faltay.
If the person who’s having an allergic reaction stops talking and simply stares, that’s a red flag as well.
“Calling 911 is better than driving to the emergency department,” he says. “Emergency medical technicians in an ambulance have protocols and access to treatments specifically for severe allergic reactions.”
3. What can you do to relieve itching, redness or a rash?
Wash the area with mild soap and lukewarm water. Apply hydrocortisone cream or lotion. Calamine lotion and cool compresses may also bring relief.
If you know what’s causing the reaction, stop using the product or wearing the item. Take off makeup or earrings if they’re the cause.
If you’re allergic to poison ivy, sumac or oak and have been exposed, wash clothing and other items that may have the irritant (an oily sap called urushiol) on them.
If your itchiness is severe, if your rash doesn’t go away, or if you see signs of infection, call your doctor.
4. What’s the best way to treat itching, sneezing and watery eyes?
When you have multiple allergic symptoms, an over-the-counter antihistamine such as loratadine (Claritin®) can treat them.
Dr. Faltay advises against using products that have a sedative effect, such as Benedryl®.
5. What should you do when hives develop?
The hives will subside in time. Meanwhile, it helps to apply cool compresses, to avoid hot showers and bath water, to wear loose clothing and to sleep in a cool room.
Be sure to work with your doctor to identify what’s triggering your hives.
6. Can allergies occur unexpectedly?
Yes. It’s important to know that some allergies are linked to others.
For example, if you’re allergic to latex, it’s possible that you’ll also react to avocados, kiwifruit and other tropical fruit. And if you’re allergic to birch pollen, it’s possible that you’ll react to apples or peaches as well.
It’s important to note that what seems like a food allergy can sometimes be food intolerance instead, notes Dr. Faltay.
7. What if you don’t know what’s causing your reaction?
Follow up with your doctor and ask about allergy testing, he advises. Testing can help pinpoint the cause of your reaction, and help you avoid triggers and future reactions.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
What to do if a baby has an allergic reaction
A baby can have an allergic reaction for a variety of reasons. An allergic reaction occurs when the body has an adverse response to a usually harmless substance, such as a soap or a specific food.
Babies have sensitive skin, which makes them more likely than adults to develop a rash. Even a slight irritation to a baby’s skin may be enough to trigger a rash.
Identifying the cause of the allergic reaction or sensitivity can help parents and caregivers to prevent and treat any future reactions.
Babies can have several different types of skin rash, which have a range of causes. Some allergic reactions can also lead to additional symptoms, such as nausea and vomiting.
Common types of allergic reactions in infants include the following:
Share on Pinterest Irritating fabrics, soaps, and heat can lead to eczema outbreaks in babies.
Eczema is one of the most common skin conditions in babies. There are different types of eczema, but atopic eczema is one of the most likely to affect babies and small children.
An eczema rash may consist of tiny red bumps, or it may look like scaly, dry skin.
Doctors do not know why some people develop eczema while others do not, but it may be due to a combination of genetic and environmental factors.
Common triggers of eczema outbreaks in babies include irritating fabrics, soaps, and heat.
An eczema rash may look slightly different in older infants. According to the National Eczema Association, babies younger than 6 months tend to develop eczema-type rashes on the scalp, face, and forehead.
In babies aged between 6 months and 1 year, the rash often appears on the knees and elbows.
Papular urticaria is a localized allergic reaction to a bug bite. Bites from various insects, including mosquitoes, mites, and bedbugs, can cause the reaction.
Although it usually affects children aged 2–6 years, papular urticaria can also occur in infants.
Papular urticaria resembles small clusters of red bumps or bug bites. Some of the bumps may be fluid-filled. Papular urticaria can last for several days or even weeks.
When the body is allergic to a substance, it releases a chemical called histamine that can lead to the development of hives and other allergy symptoms.
Hives are itchy, raised patches on the skin. They can range in size and shape but are usually pink or red with a thin red border.
Hives can develop anywhere on the body and often appear in clusters.
According to the American Academy of Allergy, Asthma & Immunology, about 6 percent of children aged 2 and under have food allergies.
Signs of a food allergy can include skin reactions and respiratory or intestinal symptoms, such as:
Occasionally, it is even possible for babies to have allergic reactions to foods before they start eating them. This is because they can develop allergies to the foods that the person who is breast-feeding them eats.
The foods that children are most likely to be allergic to are:
- milk and dairy products
Once they start eating solid foods, babies may show signs of additional allergies.
Doctors often recommend that parents and caregivers introduce new foods to a baby one at a time. This way, if an allergy does develop, it is easier to determine which food is responsible for the reaction.
Not all reactions in babies require treatment. For example, a mild rash is likely to fade within a few hours and may not trouble the baby in that time.
However, if the symptoms of a reaction are causing visible discomfort, treatment may be necessary.
The treatment can vary according to the type of rash or reaction. In general, the following treatments may help:
- Avoiding triggers: Soaps, detergents, and scented lotions can often irritate a baby’s skin, so it may be best to avoid using chemical cleaners and to choose hypoallergenic products instead.
- Washing with a fragrance-free cleanser: After using a mild, scent-free soap, pat the baby’s skin dry and avoid rubbing too hard, as this can irritate the skin.
- Applying a moisturizer: Using a hypoallergenic moisturizer after a baby’s bath can help to prevent dry skin. Moisturizers also provide a barrier to protect the skin from irritants.
- Using 1-percent hydrocortisone cream: Hydrocortisone cream can treat skin rashes relating to eczema or other allergic reactions. Although it is usually safe to use for infants for short periods, it is essential to speak to a doctor first.
- Considering scratch mitts: Scratch mitts prevent a baby from scratching a rash with their fingernails. Too much scratching can injure the skin and lead to an infection.
It is not possible to prevent all allergic reactions in babies, but there are steps that parents and caregivers can take to reduce the risk. These include:
- washing the baby’s clothes in hypoallergenic detergent
- using fragrance-free shampoo, lotions, and soap
- washing the baby’s bedding in hot water every week to reduce the chance of dust mites
- vacuuming frequently
- introducing new foods one at a time
If a baby has an allergic reaction after breast-feeding, it might be beneficial to keep a food diary to try to determine the underlying cause. Dairy is a very common culprit, especially before the infant reaches 1 year in age.
After identifying the allergen, it may help to avoid eating this food while breast-feeding. However, it is best to speak to a doctor before making changes to the diet.
Allergic Reactions at School
Many children have allergies. Most never have a dangerous allergic reaction called anaphylaxis. Still, it’s best to be prepared. To do that, you need a plan for when your child is at school.
An allergist can help. He can use blood and skin tests to find your child’s allergy triggers, review her treatments, decide if she should carry an epinephrine auto-injector, and show you both how to use it.
Make a Plan
Make sure everyone at school who’s around your child — teachers, aides, administrators — is trained to recognize an anaphylactic reaction and know what to do. They should not hesitate to use an epinephrine autoinjector, even if they are uncertain that the reaction is actually allergy related. Using the pen will do less harm than waiting.
Tell teachers, nurses, and other school staff about your childвЂ™s allergies. Work with the school and your allergist to create a detailed allergy plan. Many schools already have the outline in place. You just need to fill out the forms and have your doctor sign them.
A typical allergy plan includes:
- A description of the what causes the allergy, like peanuts or insect stings
- Your child’s symptoms
- The name of the medication to give for each symptom, and the correct dosage
- Who to call in case of an emergency
- What to do during after-school activities, field trips, on the school bus, and in the classroom
Keeping your child away from the things that trigger an allergic reaction is key. Try these simple steps.
- If your child has a food allergy, pack her food and tell her not to eat anything she didn’t bring to school.
- If sheвЂ™s allergic to bee stings, donвЂ™t dress her in bright clothes, which can attract bees. You may also want your child to use a bug spray.
- If sheвЂ™s allergic to nuts, ask the school to make the lunchroom or her classroom a nut-free zone.
Have her wear a medical alert bracelet or necklace. If you and your doctor think sheвЂ™s ready to carry an epinephrine auto-injector, make sure both she and her teacher or someone on the school staff know how to use it. Your doctor should show you how, and also tell you whether sheвЂ™ll need more than one shot. Your child should carry two shots just in case.
If your child has anaphylaxis and gets a shot of epinephrine, she will still need to get medical care right away. The shot won’t stop a reaction. It will only control the symptoms for a few minutes. That may give you extra time, but you or the school should call 911 right away and get your child to an emergency room, even if she seems OK after the shot.
As with any drug, epinephrine does expire. Look on the auto-injector for the expiration date.
James Sublett, MD, clinical professor and section chief of pediatric allergy, University of Louisville School of Medicine; managing partner, Family Allergy & Asthma, Louisville, Ky., and southern Indiana. Disclosures: Founder of AllergyZone LLC and speaks for GlaxoSmithKline and Merck.
Penn State: «Bee Sting Allergy.»
J. Allen Meadows, MD, public education committee chairman, American College of Allergy, Asthma & Immunology; allergist, Montgomery, Ala. Disclosures: Used to consult for Verus Pharmaceuticals, which makes Twinject.
Clark, A. Allergy, August 2009.
The Food Allergy and Anaphylaxis Network: «Food Allergy Action Plan,» «New Laws Passed in 2009!» «School Guidelines for Managing Students with Food Allergies.»
Krouse, J., ed. Managing the Allergic Patient, Saunders Elsevier, 2007.
Understanding a Mosquito Allergy
Symptoms, Diagnosis, and Treatments
Daniel More, MD, is a board-certified allergist and clinical immunologist with a background in internal medicine.
Smith Collection / Getty Images
Mosquito bites are annoying, but is it possible to have a mosquito allergy? To understand how you might be exposed to an allergen that triggers a reaction, let’s look at what happens when you get bit.
Mosquitoes are flying, biting insects that are closely related to flies and gnats. Only the female mosquito feeds on humans, and she needs a blood meal in order to produce eggs. During a feeding, the female mosquito bites the human skin and injects saliva. The saliva contains various proteins that prevent the blood from clotting, as well as proteins that keep the blood flowing into the mosquito’s mouth.
Reactions to Mosquito Bites
Many of the mosquito saliva proteins can cause immune reactions, including allergic reactions. Typically, however, most people have a variety of reactions to mosquito bites, and the symptoms change over time, depending on the number of bites a person receives. These reactions can include both immediate and delayed swelling, and itch around the bite area. These reactions tend to decrease in frequency after being bitten by mosquitoes over many years.
Generally, people with the above-described reactions are not diagnosed as being “mosquito allergic.» This term is reserved for people with more severe or unusual reactions, such as those described below.
More Severe Reactions to Mosquito Bites: «Skeeter Syndrome»
Reactions more severe than the typical itchy red bump experienced by most people as a result of a mosquito bite occur less commonly. These may result in blistering rashes, bruises, or large areas of swelling at the bite sites. People who experience extremely large areas of swelling after a mosquito bite (such as swelling of most of an arm or leg, for example) have been dubbed as having «Skeeter Syndrome.»
In rare situations, some people may experience anaphylaxis (the most serious type of allergic reaction) after being bitten by mosquitoes. Other people may have experienced whole body urticaria and angioedema (hives and swelling) or worsening of asthma symptoms after being bitten. Typically, these symptoms occur within minutes after a mosquito bite, compared to Skeeter Syndrome, which may take hours to occur.
Who Is at Risk
People who are at higher risk of developing an allergy to mosquito bites include:
- Those with frequent outdoor exposure, such as outdoor workers or frequent outdoor exercisers
- Those with low natural immunity to mosquitoes, such as young children and visitors to a new area where they have not been previously exposed to the type of mosquito present
- Those with certain immunodeficiencies, such as AIDS or certain cancers (such as leukemias and lymphomas)
The diagnosis of mosquito allergy is based on a positive skin test or RAST using mosquito whole-body extract. Testing for mosquito allergy should only be performed in people who have a history of reactions more severe than the typical small, red, itchy bumps experienced by most people. That said, commercially available allergy testing is apparently only able to identify 30% to 50% of those who have a true mosquito allergy.
The treatment of mosquito allergy falls into three different categories: the treatment of local reactions, the treatment of severe reactions (anaphylaxis,) and prevention. Let’s look at each of these separately:
Local Reactions: Most localized reactions can be treated with the use of topical corticosteroids, such as hydrocortisone cream, as well as with oral antihistamines. In fact, Zyrtec (cetirizine) has been shown to reduce local reactions to mosquito bites when taken before being bitten.
Some have suggested that those with mosquito allergy use Zyrtec on a daily basis during the summertime when mosquito bites are most likely to occur. Make sure to talk to your doctor before you make a regular practice of this, as any medication may have side effects.
Anaphylaxis: The treatment of anaphylaxis, which only rarely occurs as a result of a mosquito bite, should be treated in much the same way as anaphylaxis to insect stings. With severe reactions such as this, your pediatrician may recommend carrying an EpiPen as well as other measures to decrease the likelihood of a reaction. There is limited evidence suggesting that allergy shots may reduce severe reactions to mosquito bites, however, they are not a widely accepted treatment at this time.
The prevention of mosquito bites is the main goal for those with mosquito allergy. These measures include:
- Avoiding areas infested by mosquitoes (such as swamps and tall grassy areas).
- Removing or treating areas of standing water (empty out or treat swimming pools with chlorine).
- Wearing long-sleeved shirts and pants if exposure to areas containing mosquitoes is planned.
- Avoid cologne and scented lotions when going out-of-doors.
- Applying a commercially-available mosquito-repellant on exposed skin, such as those containing DEET (N, N-dimethyl-3-methyl-benzamide). DEET in concentrations of 10% to 30% can safely be used on the skin of children older than 2 months of age. Learn more about the best insect and mosquito repellents for kids (and adults).
- Treating clothing, camping tents and other fabric with permethrin (an insecticide), but do not apply directly to the skin.
- Also, since mosquitoes are attracted to body odor, skin temperature, and carbon dioxide production, the limitation of strenuous exercise and sweating when in areas infested by mosquitoes may reduce the number of bites.
A Word From Verywell
Thankfully, annoying and itchy reactions to a mosquito bite are much more common than a true mosquito allergy. Those who have a true allergy should see an allergist and talk about the best treatments for their particular symptoms. In particular, anyone who has a severe allergic reaction should be prepared to recognize anaphylaxis and consider allergy shots.
What we did not bring up here is a reason to protect yourself against mosquito bites whether or not you have an allergy. While malaria, yellow fever, and other mosquito-borne illnesses are uncommon in most developed countries, diseases such as West Nile virus (and its variants) may occur anywhere.
When Is an Allergic Reaction an Emergency?
Recognizing the symptoms of a severe allergic reaction and getting fast emergency treatment is crucial when dealing with anaphylaxis.
Recognizing the first signs of a serious, life-threatening allergic reaction (anaphylaxis) and taking immediate action with emergency medication can be the difference between life and death. If you or a loved one, especially a child, has a severe allergic reaction, every second counts.
«The biggest mistake is not treating a severe allergic reaction,” says Scott H. Sicherer, MD, an Elliot and Roslyn Jaffe professor of pediatrics, allergy and immunology and the chief of the division of allergy and immunology in the department of pediatrics at Mount Sinai Hospital in New York City and author of Food Allergies: A Complete Guide for Eating When Your Life Depends on It. “The people who die from anaphylaxis are those who had a delay in treatment.»
That’s why it’s critical for people with severe allergies to know the symptoms of anaphylaxis and be prepared with an emergency action plan.
How to Identify Anaphylaxis
The signs and symptoms of anaphylaxis can vary greatly from person to person as well as from time to time in the same person. Also, they may develop very quickly — within seconds of exposure to an allergen — or evolve over an hour or so.
The most common signs and symptoms of an allergic reaction include:
- Cough, difficulty or irregular breathing, wheezing, itchy throat or mouth, and difficulty swallowing
- Nausea, vomiting, abdominal pain, and diarrhea
- Itchiness, red bumps or welts on the skin (hives), and skin redness
- Dizziness, lightheadedness, heart palpitations, chest discomfort or tightness, mental confusion, weakness, lower blood pressure, rapid pulse, loss of consciousness, and fainting
Anaphylaxis Symptoms and Diagnosis
Allergies or COVID-19? Here’s How to Tell the Difference
An allergic reaction becomes more serious and is considered a medical emergency when any of the signs or symptoms are particularly severe, such as loss of consciousness or difficulty breathing, or if different parts or systems of the body are involved, such as having the combination of hives and vomiting, Dr. Sicherer says.
How to Treat Anaphylaxis
As soon as anaphylaxis is detected, call 9-1-1 immediately and administer epinephrine if available. Try to keep the person as calm as possible.
If he or she has been diagnosed with a severe allergy, emergency medicine should be on hand. “The only treatment is injectable epinephrine,” says Robert Wood, MD, a professor of pediatrics and the chief of the division of pediatric allergy and immunology at Johns Hopkins Children’s Center in Baltimore, Md. “The most common misconception is that epinephrine is dangerous, which isn’t the case. Some doctors will often warn people not to give epinephrine until the last resort, but people with a severe allergic reaction need to take it sooner rather than later.”
People who have severe allergies may be told by their doctor to take a dose of epinephrine even before serious symptoms develop. «For example, if someone has a severe peanut allergy and they know they ate peanut, you could reasonably give the epinephrine before symptoms occur or if there were only mild ones,” Sicherer says.
While waiting for medical assistance to arrive, follow these potentially life-saving tips:
- Avoid giving any oral allergy medicine and any liquids if the person is having trouble breathing.
- If the allergic reaction is from a bee sting, scrape the stinger off with a credit card or fingernail. Do not use tweezers, which will release more venom into the sting site.
- To help prevent shock, have the person lie flat with his or her feet elevated about 12 inches and cover him or her with a blanket or jacket. Do not put the person in this position if it causes discomfort or if a neck, back, or leg injury is suspected.
Everything You Need to Know About Managing Hives in Kids
At the Emergency Room
Treating anaphylaxis doesn’t end with injecting epinephrine, even if the person feels better. The next step is seeking medical care at an emergency room (ER).
“The reason you must go to the ER is because you’re having a serious allergic reaction, and even if you feel better after taking epinephrine, the symptoms can still come back,» Sicherer says.
In fact, sometimes a person may get better after a severe allergic reaction but then have symptoms come back even stronger several hours later, which is called biphasic anaphylaxis, he adds. “You should go to the ER and stay there for at least four hours to make sure the symptoms are under control,» Sicherer says. Medical personnel will monitor you and give additional medications if needed.