Urticaria (Hives) in Children

Hives (urticaria) is a sudden outbreak of red, itchy, and swollen areas on the skin. This condition often happens as an allergic reaction from eating certain foods or taking certain medicines. In some cases the cause is not known. Hives can vary in size from one-half inch to several inches in size. Hives can show up all over the body or just on one part of the body.

Causes of hives in children include food, medicines, and other triggers. Common causes include:   

• Peanuts
• Eggs
• Shellfish
• Penicillin
• Sulfa
• Anticonvulsant medicines
• Phenobarbital
• Aspirin

Other types of hives include:

• Dermatographism. These hives are caused by scratching the skin, constant stroking of the skin, or wearing tight-fitting clothes that rub the skin.
• Cold-induced hives. These hives are caused by exposure to cold air or water.
• Exercise-induced urticaria. These allergic hives occur because of physical activity. 
• Solar hives. These hives are caused by exposure to sunlight or light bulb light.
• Chronic hives. These are hives that come back with no known cause.

Anyone can get hives. But children with allergies are at a greater risk.

These are the most common signs of hives in children:

• Itchy, pink, or red swollen areas on the skin
• Hives can appear alone, in a group, or over a large part of the body
• Hives can go away within 24 hours in one spot but may come back in another spot

Hives can be diagnosed by your child’s healthcare provider. Your child will first complete a full health history and physical exam.

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

The best treatment is for your child to stay away from known triggers. If the hives were caused by a medicine, your child should strictly stay away from that medicine.

Your child’s healthcare provider may also prescribe:

• Antihistamines, such as diphenhydramine or hydroxyzine
• Other antihistamines that won’t make your child drowsy, such as cetirizine or loratadine

If your child is having trouble breathing, the healthcare provider might use a shot of epinephrine. This helps decrease the swelling and itching. Your child’s provider may show you how to use an emergency kit that has epinephrine. This can be kept near your child in case of future episodes. Discuss this with your child’s provider.

If your child’s symptoms get worse or he or she has new symptoms, talk with your child’s healthcare provider.

• Hives is a problem in which red, itchy, and swollen areas show up on the skin.
• Causes of hives include food, medicines, and other triggers.
• Treatment includes antihistamines and a shot of epinephrine, if breathing is difficult.
• Staying away from known triggers of hives is important.

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.
• Before your visit, write down questions you want answered.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
• Ask if your child’s condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if your child does not take the medicine or have the test or procedure.
• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.