When Your Child Has Hives (Urticaria) or Angioedema

October 08, 2017

When Your Child Has Hives (Urticaria) or Angioedema

Hand and forearm with hives.Hives (also called urticaria) are raised, red, itchy bumps on the skin. The bumps come and go for a few days and then disappear completely. Although hives can be uncomfortable, they won’t harm your child or leave scars. Sometimes your child may have severe swelling around the lips or eyes. This is a more serious skin reaction called angioedema. It can happen with hives or on its own.

What causes hives?

Hives often develop when cells in your child’s skin release a chemical called histamine during an allergic reaction. The histamine produces swelling, redness, and itching. Here are some of the most common causes:

  • Foods, such as peanuts, shellfish, tree nuts, eggs, and milk, and food additives, such as monosodium glutamate (MSG) and artificial colorings.

  • Viral infections

  • Prescription and over-the-counter medicines. These include antibiotics (penicillin), sulfa, anticonvulsant drugs, phenobarbital, aspirin, and ibuprofen.

  • Extreme heat or cold:

    • Cold-induced hives. These hives are caused by exposure to cold air or water.

    • Solar hives. These hives are caused by exposure to sunlight or light bulb light.

  • Emotional stress

  • Dematographism. These hives are cause by scratching the skin, continual striking of the skin, or wearing tight-fitting clothes that rub the skin.

  • Chronic urticaria. These are hives that keep coming back and with no known cause.

  • Exercise-induced urticaria. These allergic symptoms are brought on by physical activity.

What do hives look like?

Hives are itchy bumps that can vary in color from pink to deep red. They come in different sizes and sometimes spread to form large patches of swollen skin. Hives can appear on one part of the body and disappear on another in a matter of hours. Each hive lasts less than a day, but new hives may keep forming for days or even weeks.

How are hives diagnosed?

Your child’s healthcare provider can diagnose hives by looking at your child’s skin and taking a complete health history. He or she may also do skin tests. These look for foods or other substances that your child may be sensitive to. Blood tests may be done to rule out causes of hives not related to allergies. In most cases, the cause of hives is never found.

How are hives treated?

For mild symptoms:

  • Give your child an oral over-the-counter antihistamine that has diphenhydramine. Talk about this with your child's healthcare provider

  • To relieve itching and swelling, apply calamine lotion or cool compresses, or have your child soak in a cool bath. (Adding 2 cups of ground oatmeal to the tub may make your child more comfortable).

For more severe symptoms, your child’s healthcare provider may prescribe:

  • A prescription or over-the-counter oral antihistamine to block the chemical in the body that causes allergic reactions. Your child is likely to take it every 4 to 6 hours for several days. Some antihistamines may make your child drowsy. Some work faster than others. Ask your child’s healthcare provider which antihistamine to use and the correct dose to give your child.

  • An oral steroid to relieve severe swelling of the throat and airways. It’s usually taken for 3 to 5 days.

  • Epinephrine (adrenaline) to use in an emergency to stop a severe allergic reaction. If swelling affects your child’s breathing, get emergency care RIGHT AWAY. Your child is likely to need an injection of epinephrine to stop the allergic response.


Angioedema is a type of allergic reaction that sometimes happens along with hives. It causes swelling deep in the skin, especially around the lips and eyes. Swelling can make it hard to breathe. If this happens, seek medical care right away.

Preventing hives

To help prevent hives, avoid any substances your child is sensitive to:

  • If your child has food allergies: Read labels carefully, and use caution in restaurants.

  • Tell your child’s healthcare provider, dentist, and pharmacist about any allergies your child has to medicines. Keep a list of alternate medicines handy.

Call 911

Call 911 right away if your child has hives and any of the following: 

  • Wheezing, or trouble breathing or swallowing

  • Swelling of the lips, tongue, or throat

  • Dizziness

  • Loss of consciousness


October 08, 2017

Reviewed By:  

Bass, Pat F. III, MD, MPH,Blaivas, Allen J., DO