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: Allergy Signs in Children

DEAR DR.PAUL: I have been told that my daughter has "allergic shiners" and asked to keep. I am concerned about the dark circles under her eyes. Can you give me more information? Thank you.

DR.PAUL ANSWERS: A very good question! Actually I often see children in the mall or parks, and I notice that they have certain features that suggest they have allergies. When I ask their parents if their child is allergic, they confirm that their son or daughter has allergies and wonder how I knew. So yes, there are some facial features that suggest a child may have allergies, more specifically that the child is atopic. "Atopic" means that he or she is prone to certain allergic conditions including nasal allergies, food allergies, hay fever, eczema and asthma.

So what are these "allergic signs"? They are referred to as an "allergic or atopic facies" and yes one sign is the dark circles under the eyes or as you called them "allergic shiners'. Often parents tell me that their child is said not to be getting enough sleep because of the dark circles under their eyes. Yet in reality, this is a part of the allergic look and not due to sleep deprivation. Allergic "shiners," are thought to be caused by increased blood flow near the sinuses.

Another sign we see around the eyes is less obvious. Children with allergies or an atopic tendency tend to have an extra skin fold or line under their lower eyelids. These folds or lines are called Denni-Morgan lines named after the doctors who first noticed the relationship between this extra fold of skin and allergic tendency. Another sign of allergies, more specifically nasal allergies, is the allergic salute. Children with nasal allergies, often have an itchy nose, among other symptoms. So as a result, their hand seems to always be scratching their nose as if they are saluting. Frequent throat clearing or hoarseness can be another feature of an allergy as well.

One thing I tell parents is that just because a child has atopic facies, it does not automatically mean the child will develop allergies or related atopic conditions. Indeed, some children may have allergic shiners or an extra lower eye lid skin fold, and have no allergic signs or symptoms at all. Speaking of an allergic or atopic tendency, I want to talk a bit about how allergies are inherited. We do know that allergies tend to run in the family. More specifically, if one parent has an allergic tendency, then there is about a 40% chance that their child will inherit the allergic tendency. If both parents are allergic, then the chance jumps to 75%. Again, even if one inherits the tendency, they may not necessarily develop allergies during their lifetime. Why some kids who inherit the tendency develop allergies awhile others don't, is not well understood. Also we do not understand why some children show signs of allergies at a very early age, while others only develop their first allergic symptoms well into adulthood.

The information provided in this site is designed to be an educational aid only. It is not intended to replace the advice and care of your child's physician, nor is it intended to be used for medical diagnosis or treatment. If you suspect that your child has a medical condition, always consult a physician.

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