Spotting an allergic child A good allergy doctor can usually spot an allergic or potentially allergic child or young adult without doing any allergy tests. Dr Adrian Morris explains how.

In this article

Appearance Allergic shiners Dennie-Morgan lines Long face syndrome

Nasal salute Facial tics Keratosis pilaris Atopic eczema

Conjunctivitis Glue ear Postnasal drip

Children with allergies tend to have an unhealthy-looking pale complexion called 'white dermatographism' and are often small for their age.

Particular features, listed below, may indicate how prone your child is to allergies.

Allergic children and adults have typical darkening around the eyes called allergic shiners. This blue discoloration is caused by congested veins and looks like smudged mascara.

Young children with nasal and chest allergies have characteristic Dennie-Morgan lines. These are crease-like wrinkles that form under the lower eyelid folds.

Children with asthma and nasal allergies have so-called long face syndrome: a high-arched palate and protruding upper teeth. This develops after years of constant nasal blockage.

The nasal mucous membranes (turbinates) swell from irritation, so much so that the nasal passages become completely blocked. These children are forced to breathe through their mouths, which also affects tooth growth.

Intense nasal itching leads to the 'nasal salute' - the child tends to rub their nose with the palm of the hand, usually in an upward direction. This constant rubbing leads to a crease or wrinkle across the bridge of the nose.

Children with nasal allergies tend to pull funny faces, as their noses are always itching. They may then go on to develop uncontrollable facial tics or twitches and constantly sniff, making strange noises.

Teachers often complain they're being naughty and fooling around, when the real cause is an untreated nasal allergy.

Children with allergies, and potential eczema sufferers, have characteristic dryness and roughness of the skin, particularly on the cheeks, upper arms and chest. This dryness is called xerosis and usually has a sandpaper-like texture called keratosis pilaris, which reduces the skin barrier to irritants and infection.

Atopic eczema may develop as a consequence of dry skin, especially in the elbow and knee joints of children. Children with eczema constantly fidget and scratch, leading to a misdiagnosis of being hyperactive, when in fact it's their itchy skin distracting them.

With chronic eye allergies, the inner parts of the eyelids develop a swollen, cobblestone-like appearance from allergic conjunctivitis.

Children also tend to rub away the outer third of their eyebrows.

Children with nasal allergies may develop glue ear, when mucous becomes trapped behind the eardrum in the middle ear. This results in temporary deafness, discomfort and a poor attention span.

Children may experience a constant postnasal drip and repeated sore throats from allergic mucous building up and being discharged into the throat. Serious nasal allergies also reduce children's senses of taste and smell.

This article was last medically reviewed by Dr Adrian Morris in September 2007.
First published in September 1999.

Thanks to Royal Brompton & Harefield NHS Trust for allowing BBC Health to take photos.