Parents often ask me whether their children's constantly runny noses are the result of allergies, sinus infections, or of one cold after another.

Allergies:

• Allergies typically feature a clear nasal discharge with sneezing.
• There may be itchy, watery eyes and/or a dry cough.
• Often parents notice a "rabbit nose" -- a child crinkling her nose to relieve the itchy sensation inside.
• The "allergic salute" -- rubbing the nose with the hand, sometimes leaving a horizontal crease on the nose -- is another common sign.
• "Allergic shiners" -- dark circles under the eyes -- have long been associated with allergies, but are less predictive than the other symptoms.
• Often, “triggers” may be identified, such as symptoms after exposure to dust or animals
• Often there is a family history of allergies

Colds:

• Colds will often begin with a clear nasal discharge, but after several days it usually turns creamy, yellow, or green for a time.
• Symptoms typically start suddenly and resolve within 7 to14 days.
• Sneezes tend to be more productive, and coughs sound wetter than with allergies.
• If the eyes are involved, one or both of them usually turn pink, with a discharge that matches that in the nose.
• A fever may be present.
• Often people in close contact with the child have similar symptoms

Sinus Infections:

• A sinus infection in a child often begins like a cold but lasts for greater than 10 to 14 days with no period of improvement.
• Sometimes a sinus infection begins with a high fever (>103 F), facial swelling, or facial pain.

Since children with allergies often get more colds, sinus infections, and ear infections than their counterparts, it can be difficult to tease apart what is going on. The experience of other family members offers a big clue. Allergies often run in families. Eczema and asthma are also more common in allergic families.