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When Your Child Has Hives (Urticaria) or Angioedema

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 occur 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 medications, including antibiotics, aspirin, and ibuprofen

  • Extreme heat or cold

  • Emotional stress

  • Exercise

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 doctor can diagnose hives by looking at your child’s skin and taking a complete health history. The doctor may also perform skin tests. These look for foods or other substances to which your child may be sensitive. 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 containing diphenhydramine.

  • To relieve itching and swelling, apply calamine lotion, 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 doctor 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 4–6 hours for several days. Some antihistamines may make your child drowsy. Some work faster than others. Ask your child’s doctor which antihistamine to use.

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

Angioedema is a type of allergic reaction that sometimes occurs 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 doctor, dentist, and pharmacist about any allergies your child has to medications. Keep a list of alternate medications handy.

 

Call 911 or emergency services 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

 

 

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