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Is It a Cold or Allergies? How to Tell the Difference

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A change of seasons can cause sniffles, coughing and congestion that keep your child home from school or child care. How can you figure out whether they have a nasal allergy or the common cold?

It's not always easy to tell the difference between a cold and allergies, including seasonal allergic rhinitis or "hay fever." But knowing the key symptoms can help. And since most kids—including those with allergies!—will catch at least 6 colds every year, knowing how to "read" your child's symptoms is key.

Signs & symptoms of the common cold

Colds are caused by viruses. Rhinovirus is most commonly responsible, but there are many strains out there. If your child has a cold, you may notice them having a stuffy, runny nose, coughing, sore throat, fever occasionally, body aches and low energy.

Colds tend to go away, but allergies might not.

Generally, kids with colds will begin to feel better within 5 days and recover fully within 14 days. Allergy symptoms tend to stick around longer (generally more than 3 weeks), since they're caused by a specific substance (allergen) in the air your child breathes. Common allergens include mold, dust, pollen and animal dander.

Other telltales sign of a cold: fever & achiness.

While nasal allergies can be uncomfortable, typically don’t cause high temperatures or body aches like viral infections like colds often do. (Keep in mind, though, that kids with allergies may have dull headaches caused by sinus congestion.)

Signs that point to nasal allergies

Kids with nasal allergies are vulnerable to airborne triggers that may not affect everyone exposed. Signs that your child is experiencing allergies might include red, itchy, watery eyes; runny, itchy nose; persistent sneezing, sore throat, tightness in the chest, skin rash or irritation.

Itching is a red flag for allergies.

When reacting to an allergen like pollen, the body releases a chemical called histamine. Histamine can lead to inflammation and itching. If your child has a cold instead, you will probably not see the itchy, reddened eyes, nose and throat tickles or skin reactions common with allergies.

Clues in the achoos: what sneezing can tell you.

Sneezing is also less common with a cold, with longer pauses between each sneeze. With allergies, sneezing can be more frequent and come in rapid bursts.

Both colds and allergies can cause runny noses. But nasal drainage caused by allergies tends to be thinner and more watery, compared with nasal mucus from a cold.

Cold v. allergies: signs, symptoms & duration

Cold

Allergies

Duration (how long they last)

3 - 14 days

Usually 3 weeks or more

Runny nose

Often present

Often present

Stuffy nose

Often present

Often present

Aches & pains

Often present

Not typical

Sore throat

Often present

Not typical

Fever

Possible, though not always present

Not typical

Itchy watery eyes

Not typical

Often present

Mucus

Thick, transparent – light yellow secretion

Thin watery, transparent – white

Sneezing

Less prominent, longer rest period between sneezes

More prominent, in rapid succession

Cough

Usually wet

Usually dry


Managing your child's cold or allergies: what to keep in mind

Colds
Colds are contagious and may affect the whole family. Having a seasonal toolkit with safe, non-prescription remedies can help you feel prepared.

After a cold, make sure your child stays home until they're fever-free for 24 hours. If no fever is present, wait until symptoms are manageable. Make sure your child has enough energy to get through the day before returning to usual routines. (If you're giving your child a fever reducer such as acetaminophen or ibuprofen, wait until they're fever-free without medication before sending them to school, daycare, special events or play dates.)

Keep in mind that antibiotics don't treat colds. They're only good for bacterial infections, not viral infections like the common cold. However, if your child develops a secondary infection such as walking pneumonia or an ear infection, antibiotics may be needed. If you see new or worsening symptoms that won't go away, consult with your child's doctor.

Allergies

Allergies are non-contagious. Management includes using saline spray/sinus rinses to clean up the nasal passages, removing allergens and excess mucus. Over the counter medications such as fluticasone nasal spray, Azelastine nasal spray may help with nasal congestion.

Over-the-counter (OTC) antihistamines can also help with itching and other allergy symptoms. Nonsedating antihistamines including certirizine, fexofenadine and loratadine (such as Zyrtec, Allegra and Claritin) are preferable over diphenhydramine (Benadryl).

Kids may need allergy testing to pinpoint specific triggers. This may be the case if symptoms do not improve with OTC medicines or if there is a prolonged need for these medications. Your child may need to see a specialist who can determine the source of their symptoms and suggest how to treat them.

Remember

Whatever is causing your child's sniffles, sneezes and coughs, your pediatrician is ready to help. Your child's doctor understands the daily worries that affect you as a parent or caregiver. Both allergies and cold can affect the quality of life and overall health of the child and family.

Keeping a growing child healthy and safe is a full-time job! Our role is to support you through it all, so don't hesitate to reach out for the support you need.

More information

Last Updated
4/4/2025
Source
American Academy of Pediatrics Section on Allergy and Immunology (Copyright © 2025)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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