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Is It a Cold or Is It an Allergy?

Deborah Elbaum, M.D.
March 3, 2009

Figuring out how to help your child

When my daughter developed a cough that seemed to last forever, my husband and I were baffled. Was it a remnant of her most recent cold, or was she developing an allergy to dust mites hiding in her bedroom? Should we continue asking our pediatrician about the cough, or was it time to make an appointment with an allergist?

No one enjoys being uncomfortable. Using an over-the-counter (OTC) medicine to help alleviate cold symptoms such as nasal congestion may seem like an easy solution, but determining the underlying cause of symptoms is very important, as colds and allergies are managed differently.

Causes of common cold

  • Cold symptoms can be caused by many types of viruses. People get infected either by breathing in germs or by direct contact with someone or something with germs on it.

Causes of allergies

  • Allergies involve a person's immune system over-reacting to a usually harmless protein such as pollen (from grasses, weeds or trees), mold, animals (for example, cat saliva or dog dander), insects (for example, dust mites, cockroaches or stinging insects), foods, medications or latex. Allergies tend to run in families and are not contagious.

Similar symptoms

  • Both colds and allergies (especially allergic rhinitis or "hay fever") can manifest as a runny nose, nasal congestion, sneezing, coughing and fatigue.
  • With colds, a yellow nasal discharge, muscle aches, sore throat, watery eyes and fever can also occur.
  • With allergies, a clear nasal discharge and itchy eyes often occur. No fever or muscle aches should be present.

Timing of colds and allergies

  • Colds can occur year round. They can last as long as 10-14 days.
  • Allergies can be bothersome seasonally or perennially. For example, a person allergic to ragweed will be symptomatic for a few months. In contrast, someone with a dust mite allergy might exhibit symptoms year round. >> When Spring Allergies Strike

Treating a cold

  • Common colds caused by viruses have no cure; resting and drinking fluids are recommended. Depending on your age, symptoms and health history, your health care provider may also suggest OTC medications such as decongestants, pain relievers or nasal sprays.
  • Cautions: The FDA recently recommended that OTC cold and cough medicines not be given to children under the age of 2 because of potentially life-threatening side effects. In addition, overuse of OTC decongestant nasal sprays can cause increased nasal stuffiness.
  • For infants, saline spray and a bulb syringe can help loosen and remove mucus from the nose. A humidifier can also help soothe nasal passages.
  • Avoiding close contact with contagious people and washing hands frequently can help prevent future infections.

Treating allergies

  • Avoiding or eliminating your specific allergens as much as possible is key. Undergoing allergy testing can help determine what these may be. In some cases, prevention measures can be as simple as dehumidifying a damp space to decrease mold growth. Some allergens, however, such as trees in the environment, may be harder to avoid.
  • To help alleviate symptoms, both prescription and OTC medications are available, including antihistamines, decongestants, eye drops, steroid nasal sprays and leukotriene modifiers. Leukotriene modifiers come in a pill form. They reduce inflammation and symptoms by blocking the action of certain chemicals.
  • Your health care provider can work with you to create a plan for your specific allergies, outlining which medications to use during the different times of the year. Environmental allergies differ depending on your geographic location and the humidity level.
  • Allergy shots (or immunotherapy), which are done in an allergist's office, can also help reduce symptoms. This process of desensitization is especially helpful for allergies to pollen, dust, mold, cats, dogs or stinging insects.

When to call your health care provider

  • People suffering from both colds and allergies can develop complications such as asthma or secondary infections, including ear or sinus infections. Treating these may require antibiotics or other medications.
  • If you develop any concerning symptoms, you should inform your health care provider. In addition, inform him or her if the following occur: persistent fever or cough, difficulty breathing, chest pain, severe ear or throat pain, dehydration or persistent sinus congestion.
  • If your allergies interfere with your daily activities, or the medications you currently use are not sufficiently effective, you can consider making an appointment with an allergist.
  • What if a person has both a chronic allergy and an acute cold? Sometimes, it takes time to clarify a situation. You might treat symptoms as a cold, but after about two weeks, it is time to see a health care provider or allergist. They may recommend trying allergy or asthma medications to see if the symptoms then resolve.

After many months, we took our daughter to an allergist who diagnosed her with asthma and started her on maintenance medications. Following his advice, we put mattress and pillow protectors on the bed, and removed the thick carpeting in her bedroom. Her nagging cough cleared up within a few weeks.

Here's a quick reference list to help you determine your cold or allergy course of action -- and when to head to the doctor's office.


  • Runny nose
  • Nasal congestion
  • Sneezing
  • Coughing
  • Fatigue
  • Yellow nasal discharge
  • Muscle aches
  • Sore throat
  • Watery eyes


  • Runny nose
  • Nasal Congestion
  • Sneezing
  • Coughing
  • Fatigue
  • Clear nasal discharge
  • Itchy eyes

When to call the doctor

  • Persistent fever
  • Persistent cough
  • Difficulty breathing or wheezing
  • Chest pain
  • Severe ear pain
  • Severe throat pain
  • Dehydration
  • Persistent sinus pain or headaches
  • Any other symptoms that concern you

When to make an appointment with an allergist

  • Allergies interfere with daily activities
  • Current medications are not effective
  • You want to explore getting allergy shots

Helpful links for more information

  • American Academy of Allergy, Asthma & Immunology
  • American Academy of Pediatrics
  • National Institute of Allergy and Infectious Diseases (NIH)

  • Deborah Elbaum received her M.D. from the University of Pennsylvania School of Medicine and has written on food allergies and asthma for educational publications. She lives in Massachusetts and has three

    * This article is for general informational purposes only. It is not intended nor implied to be providing medical advice and is not a substitute for such advice. The reader should always consult a health care provider concerning any medical condition or treatment plan. Neither Care.com nor the author assumes any responsibility or liability with respect to use of any information contained herein. children.


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