Child Allergies: Answers to FAQs by Dr. Ryan Duncan

At the Academy, we are committed to being more than just the best preschools in Greater Nashville. We also want to be a resource for our families by partnering with other local businesses and experts in the community to educate and inform parents on issues that are important to your child’s health and development. This month we are partnering with Dr. Ryan Duncan of ENT of Cool Springs.


Introducing Dr. Ryan Duncan

Ryan Duncan, M.D. graduated from Auburn University in 1998 and received his M.D. from the University of Alabama-Birmingham in 2002. He has been practicing in Middle Tennessee since August of 2007, and is currently the founder and medical director of ENT Specialists of Cool Springs and The Tennessee Sinus and Surgery Center.

Allergy Signs and Symptoms

Is your child struggling with allergies? Here are some of the common symptoms of children who suffer from allergic disease:

  • Sinus and Nasal symptoms: nasal stuffiness, drainage, sinus infections
  • Sneezing and itching: typical ‘hay fever’ symptoms
  • Asthma: wheezing and coughing, chest tightness
  • Eczema: skin irritation or rashes

Frequently Asked Questions

What can cause allergies?

  • Seasonal symptoms: trees, weeds, grasses. This type of allergic problem typically occurs in school age children.
  • Year round symptoms: molds, dust mite, animal dander. This can occur at almost any age.
  • Food: milk, wheat, peanut, shellfish, corn, soy, egg.  This can cause a variety of symptoms from nasal and throat symptoms, to bowel, and constitutional symptoms.

child allergies

How do we determine what your child is allergic to?
A careful history and physical exam can give us a lot of clues as to what may be the offending culprit.  For children under the age of 7, we typically choose to allergy test with a blood sample.  This can show us moderate to severe types of reactions to certain allergens.  Skin testing, which is typically done on older children, is the preferred method of testing because it is generally more sensitive in picking up reactions.

What is the best treatment once you know what your child is allergic to?

Treatment for allergies generally come in three categories:

  • Avoidance or Environmental Control (More detail below)
  • Medications (More detail below)
  • Immunotherapy (More detail below)

Many patients require a combination of these three treatment methods to achieve optimal control of their symptoms.

Detailed Information on Types of Treatment

Environmental Control
If your child can avoid the things you are allergic to, then their symptoms can be minimized.  Modifications in your home to decrease dust mites, animal dander, or mold can all be effective. For many allergy sufferers, however, it is very difficult to completely control the environment, especially when they are outside of their own home.

Allergy medications won’t cure your child’s nasal allergies. They will, however, relieve and sometimes prevent allergy symptoms. There are a variety of options ranging from over the counter to prescription medications and nasal sprays.  For many children with nasal allergies, the combination of avoiding allergens and taking allergy medication is enough to control allergy symptoms.

  • Antihistamines –Taken by mouth, they can help with itchy watery eyes, runny nose and sneezing, as well as itchy skin and hives. Some types cause drowsiness.
  • Nasal Corticosteroids – Highly effective for allergy symptom control and widely used to stop chronic symptoms. Safe to use in children over long periods of time. Must be used daily for maximal effectiveness. –
  • Singulair (Montelukast) – This drug works by blocking certain natural substances (leukotrienes) that may cause or worsen asthma and allergies. It helps make breathing easier by reducing swelling (inflammation) in the airways.

Immunotherapy is the only method that treats the underlying allergic disease.  It is an excellent form of treatment for children who have tried medications or environmental control and are not getting enough relief from their symptoms.  It requires frequent, regular exposure to very small amounts of  allergen(s) over the course of several  years.   Immunotherapy comes in two forms:  subcutaneous, also called SCIT or ‘allergy shots’, and sublingual also known as  SLIT or ‘allergy drops’.

Injection immunotherapy is an effective treatment, but for many kids this is a difficult form of treatment due to the need for weekly shots. Sublingual immunotherapy, or allergy drops, is an off-label use of the same antigens used in allergy shots. Due to the better safety profile of allergy drops, more allergic individuals can benefit from a treatment approach that addresses the cause of the allergies.

There are many benefits to consider with allergy drop treatment including reduced time spent for physician visits, the convenience of taking immunotherapy at home or on the go, the ability to treat a broader array of allergic patients and conditions, and the reduced need for allergy medications.

ENT of Cool Springs

For more information or to talk to Dr. Ryan Duncan about testing your child for allergies please visit or contact ENT of Cool Springs at the information listed below.

ENT of Cool Springs | TN Sinus and Snoring Center
Cool Springs Professional Plaza
2001 Mallory Lane, Suite 202
Franklin, Tennessee 37067

(615) 973-6096