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Urticaria (Hives) in Children

What is urticaria in children?

Urticaria, or hives, is a problem in which red, itchy, and swollen areas show up on the skin. It can happen as an allergic reaction from eating certain foods or taking certain medicines. Though, sometimes the cause may be unknown. 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.

What causes urticaria?

Causes of urticaria in children include food, medicines, and other triggers. These causes include:

  • Peanuts

  • Eggs

  • Shellfish

  • Penicillin

  • Sulfa

  • Anticonvulsant drugs

  • Phenobarbital

  • Aspirin

However, the most common cause of urticaria in children is virus-induced and happens when your child is sick or shortly after an illness. These hives are not due to allergies.
Other types of hives include:

  • Dermatographism. These hives are caused by scratching the skin, continual 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 are brought on by physical activity.

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

  • Chronic urticaria. These are hives that come back with no known cause.

Who is at risk for urticaria?

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

What are the symptoms of urticaria in children?

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 area of the body

  • Hives can go away within 24 hours in one spot but may come back in another spot

How is urticaria in children diagnosed?

Hives can be diagnosed by your child’s healthcare provider. He or she will first complete a full medical history and physical exam.

How is urticaria in children treated?

Your child’s healthcare provider will figure out the best treatment for your child based on:

  • How old your child is

  • His or her overall health and medical history

  • How sick he or she is

  • How well your child can handle specific medicines, procedures, or therapies

  • How long the condition is expected to last

  • Your opinion or preference

The best treatment is for your child to avoid known triggers. If the hives were caused by a medicine, your child should strictly avoid 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, your child’s healthcare provider might use a shot of epinephrine to help decrease the swelling and the itching. Your child’s provider may show you how to use an emergency kit that has epinephrine to keep near your child in case of future episodes. Discuss this with your child’s provider.

When should I call my child’s healthcare provider?

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

Key points about urticaria in children

  • Urticaria, or hives, is a problem in which red, itchy, and swollen areas show up on the skin.

  • Most uticaria in children are caused by viral acute illnesses. Other causes of urticaria include food, medicines, and other triggers.

  • Treatment of urticaria includes antihistamines and a shot of epinephrine, if breathing is difficult.

  • Avoiding known triggers of urticaria is important.

Medical Reviewers:

  • Blavias Allen, J., DO
  • Brown, Kim, APRN
  • Kirsi Järvinen-Seppo, M.D., Ph.D.