Child protected from allergens by a protective bubble.

Is Your Child Destined for Allergies? Unveiling the Future of Allergic Rhinitis

Kai Mendoza in Health & Wellness November 2025 • 5 min read.

"Discover the rising trends of allergic rhinitis in children, explore key risk factors, and learn about innovative prevention and treatment strategies to safeguard your child's health."

In recent decades, there has been a noticeable surge in allergic disorders, mirroring the trends observed in autoimmune conditions. Conditions such as asthma, allergic rhinitis (AR), and allergic dermatitis have become increasingly common, alongside rising cases of anaphylaxis and food allergies. While these increases were initially documented in Western countries, developing nations are now exhibiting similar patterns as they adopt more Westernized lifestyles. This shift lends credence to the Hygiene Hypothesis, which suggests that a reduction in the diversity of the microbiome, particularly in the gut, plays a significant role in the development of these allergic conditions. However, these microbial changes alone do not fully explain the observed increases.

Allergic diseases are complex and varied, manifesting differently in different individuals. The classic progression from eczema to asthma and finally rhinitis only occurs in a small percentage of pediatric cases (around 10%). Some children may initially experience allergic rhinitis and later develop asthma without any skin-related issues. These variations suggest that there are multiple pathways through which a child can become sensitized, each influenced by a unique combination of genetic predispositions and environmental factors. These factors include the timing, intensity, and type of exposure, all of which contribute to the development of the allergic syndrome.

The rapid increase in allergic prevalence cannot be attributed solely to genetic changes, highlighting the importance of epigenetic factors. These factors regulate gene expression and help explain how environmental changes can lead to allergic conditions. It is likely that aspects of an altered environment—whether in utero or during early childhood (such as delivery method, pharmacotherapy, dietary changes, or school environment)—play a crucial role. Moreover, viral infections, though not fully understood, may also contribute to allergic problems, suggesting that future advances in virology could help identify specific viral triggers.

Unpacking the Rising Tide of Pediatric Allergic Rhinitis

Child protected from allergens by a protective bubble.

Allergic rhinitis (AR) is defined by the presence of at least two of the following symptoms: rhinorrhea, nasal congestion, sneezing, or pruritus. These symptoms arise from the formation of immunoglobulin E (IgE) antibodies in response to harmless environmental allergens, triggering both early- and late-phase immune responses. AR is associated with significant co-morbidities, including asthma, rhinosinusitis, conjunctivitis, sleep disorders, maxillofacial changes, and middle ear infections. A substantial proportion of asthma patients also have comorbid rhinitis; when rhinitis is absent (about 20% of cases), the asthma is typically neutrophilic.

Once a rare condition primarily seen in higher socioeconomic groups in 1800s England, AR now affects more than one in four people in the UK, particularly since the 1950s. In the United States, 60 million individuals are affected, representing 10 to 30% of adults and 40% of children. The International Study of Asthma and Allergies in Childhood (ISAAC) has shown that the highest rates occur in Westernized nations, though these differences are decreasing as developing countries urbanize.

Key risk factors identified in global investigations include:

Proximity to heavy traffic (e.g., lorries)
Parental smoking
Paracetamol usage
Antibiotic prescribing

Symptoms are commonly triggered by house dust mites, pollen, or pets, as well as non-allergenic factors like exercise, fumes, strong odors, and temperature fluctuations. The interplay of infections, indoor and outdoor air pollution, and dietary choices are significant factors. Research indicates that growing up on a farm can protect against AR by increasing microbial exposure and promoting a more diverse microbiome. Allergic disease prevalence is also linked to diet, both in utero and during early childhood, with high-lipid diets low in fresh produce and vitamins A and D increasing the risk.

Charting a Course Towards Allergy Prevention

Pediatric AR is likely to remain a significant challenge, particularly in Westernized societies. Implementing lifestyle changes such as reducing caesarean deliveries, promoting natural diets rich in fruits and vegetables, and increasing outdoor time could help reverse the increasing prevalence. Molecular allergological techniques promise more precise diagnoses and targeted immunotherapies. In the meantime, medication and saline irrigation remain the most accessible and cost-effective interventions.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.ijporl.2018.12.019, Alternate LINK

Title: Will Every Child Have Allergic Rhinitis Soon?

Subject: Otorhinolaryngology

Journal: International Journal of Pediatric Otorhinolaryngology

Publisher: Elsevier BV

Authors: Cemal Cingi, Nuray Bayar Muluk, Glenis K. Scadding

Published: 2019-03-01

Everything You Need To Know

What are the primary symptoms and related conditions associated with allergic rhinitis (AR)?

Allergic rhinitis (AR) is characterized by symptoms like rhinorrhea, nasal congestion, sneezing, or pruritus. These symptoms are triggered when immunoglobulin E (IgE) antibodies form in response to environmental allergens, leading to both early- and late-phase immune responses. Comorbidities associated with AR include asthma, rhinosinusitis, conjunctivitis, sleep disorders, maxillofacial changes, and middle ear infections. Approximately 20% of asthma cases occur without rhinitis, and these are typically neutrophilic.

How does the Hygiene Hypothesis explain the rise in allergic disorders like allergic rhinitis, and what evidence supports this theory?

The Hygiene Hypothesis suggests that a reduction in the diversity of the microbiome, particularly in the gut, plays a role in the development of allergic conditions. This theory is supported by the observation that as developing countries adopt more Westernized lifestyles, they are experiencing similar increases in allergic disorders that were initially documented in Western countries. However, microbial changes alone do not fully explain the observed increases, indicating other factors are also at play.

Besides genetics, what other factors are believed to significantly contribute to the development of allergic rhinitis in children?

While genetic factors contribute to the risk of developing allergic rhinitis, the rapid increase in prevalence highlights the importance of epigenetic factors. Epigenetic factors regulate gene expression and can explain how environmental changes—whether in utero or during early childhood (such as delivery method, pharmacotherapy, dietary changes, or school environment)—can lead to allergic conditions. Viral infections, though not fully understood, may also contribute.

What are the major risk factors and common triggers identified as contributing to the development and exacerbation of allergic rhinitis?

Several risk factors increase the likelihood of developing allergic rhinitis. These include proximity to heavy traffic, parental smoking, paracetamol usage, and antibiotic prescribing. Symptoms are often triggered by house dust mites, pollen, or pets, as well as non-allergenic factors such as exercise, fumes, strong odors, and temperature fluctuations. Diet, both in utero and during early childhood, also plays a role, with high-lipid diets low in fresh produce and vitamins A and D increasing the risk.

What preventative measures and interventions can be taken to reduce the prevalence and impact of pediatric allergic rhinitis?

To prevent pediatric allergic rhinitis, several lifestyle changes can be implemented, such as reducing caesarean deliveries, promoting natural diets rich in fruits and vegetables, and increasing outdoor time to promote a more diverse microbiome. Molecular allergological techniques may allow for more precise diagnoses and targeted immunotherapies. Currently, accessible and cost-effective interventions include medication and saline irrigation.