Hives (also known as urticaria) are slightly raised, itchy red welts or blotches that tend to appear suddenly. A welt can stand alone or in clusters, and can be smaller than a thumbprint or bigger than the palm of your hand. They can appear anywhere on the body, and can disappear in one place only to show up in another, lasting anywhere from a couple minutes to several days. Hives are considered acute when they last for less than a day to up to six weeks; chronic hives can occur for months at a time.
Affecting an estimated 3 percent of preschool-age kids and 2 percent of older children, hives are produced when an irritant causes our body to produce histamine, which can leak from the blood vessels and pool underneath the skin, leading to welts. For many kids, that histamine release is triggered by allergies to things like nuts, shellfish, eggs, berries, milk, certain antibiotics, or insect bites, but others can get blotchy from exposure to sun, a sudden blast of cold air or exposure to cold water, viral infections, or stress.
A doctor will examine the rash and ask about your child’s diet, habits and family history of allergies to diagnose hives.
Once you know what brought on an episode of hives, you can talk to your doctor about ways to avoid the triggers. It might require eliminating some foods from your child’s diet, switching medications, using insect repellent, wearing sun-protective clothing, or avoiding sudden cold temperatures.
For an acute attack of hives, an over-the-counter oral antihistamine like Benadryl (diphenhydramine) or Zyrtec (cetirizine) can bring down swelling and reduce itching. If these make your child too drowsy, you can also try the non-sedating antihistamines like Claritin or Alavert (loratadine). Applying 1% hydrocortisone cream to itchy welts can also be soothing.
Ask a doctor or a pediatric psychologist about relaxation exercises if your child’s hives tend to be brought on by stress.
“My five-year-old breaks out in hives fairly regularly. I keep liquid Benadryl and hydrocortisone cream handy at all times. As soon as the hives come on, if we are home, I put her into a cool bath, then we apply cream and take a 1/2 dose of Benadryl. If we are not home, the cream is in my purse and ready to apply.” —Paige Shoven, mom to Elizabeth, 8, and Kara, 5