Your Guide to Hives: Identify, Treat and Prevent Urticaria in Children

When you find hives on your child, you may worry about their cause. Does your child have a serious allergy to a certain food or chemical? Is he or she on the verge of a viral infection? These reddish or pinkish raised bumps (sometimes with a white center) can have a variety of – mostly mild – causes, from allergies and illnesses to stress and weather. They are often very itchy.

How common are hives in children, and what causes them?

Urticaria, also known as hives, are very common in children – affecting up to 25 percent of kids at least once. When a child is exposed to a specific trigger – an allergen, infection, extreme temperature or a period of high stress – mast cells release histamine, which causes fluid to leak from small blood vessels under his or her skin. This results in red or pink patches and itching. If you’re not sure whether your child has these or a different type of rash, you can see a picture of hives here.

Here are some common hive triggers:

• Bug bites or stings
• Contact with certain chemicals (soaps, detergents, lotions, etc.)
• Exposure to pets or other animals
• Food allergies, especially to fruits, milk, tree nuts and shellfish (occasionally accompanied by serious allergy symptoms)
• Pollen
• Viral infections (usually harmless)

Less common triggers include:

• Anxiety or stress
• Bacterial infections (like Strep)
• Exercise
• Exposure to cold temperatures
• Medication allergies (very rare)
• Sun exposure

Should I handle hives at home or seek treatment?

If your child has a small patch of hives – and is showing no other symptoms – the hives are probably an allergic reaction to something like plant pollen, pet saliva or a minor chemical irritant. Wash your child’s skin, and offer ice cubes or a cold pack to ease itching. The hives should subside within a few hours.
If the hives are more widespread or very itchy – as long as they’re not accompanied by other symptoms and your child is over the age of 1 – give your child a dose of Benadryl every four to six hours until the hives have subsided.

Call your child’s doctor by the next day if:

• Your child has developed a fever or joint pain.
• The hives have spread all over his or her body.
• The hives are keeping your child from normal activities.
• Hives appeared after your child ate a certain non-high-risk food (like fruit) or took an over-the-counter medication, but he or she is experiencing no other symptoms.
• The hives are causing swelling around your child’s eyes or mouth.

Call the doctor immediately or go to the ER if:

• Your child is under a year old and has hives all over his/her body.
• Your child looks or acts very sick.
• The hives started after he or she took a prescription medication.
• The hives erupted after he or she ate a high-risk food, such as nuts, shellfish, fish or eggs.
• You feel your child’s hives are severe and need to be seen immediately.

Call 9-1-1 now if your child has hives and:

• Your child has a hoarse voice or cough.
• He or she is wheezing or having trouble breathing.
• Your child is drooling, having trouble swallowing or is slurring his or her speech.
• He or she has been exposed to a known allergen.
• Your child feels dizzy or faint or has lost consciousness.
• You have reason to believe your child is experiencing a life-threatening emergency.

When will hives go away?

Most cases of hives are not serious, and your child should start to look less blotchy and feel less itchy within a few hours to a few days. Of course, if you have any concerns, it’s a good idea to call your child’s doctor.

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