To donate, visit www. This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts.
Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout. The Royal Children's Hospital Melbourne. Hives Hives are slightly raised, red patches of skin called wheals or welts. Signs and symptoms of hives If your child has hives, they may have raised round wheals that look like mosquito bites.
Hives are normally very itchy, but can also sting. A single wheal often lasts several hours before fading without trace. The wheals appear in batches or clusters. New batches may develop as old areas fade away.
Often the wheals join together to form larger swellings. The area of affected skin can vary in size from quite small to as large as a dinner plate.
Depending on the trigger, hives usually settle over hours. When there is no identifiable cause idiopathic urticaria , hives will usually go away within a few days, but may last weeks. Hives can look or feel unpleasant, but usually they are harmless. Anaphylaxis Sometimes children have a more serious allergic reaction known as anaphylaxis.
Hives only, without other features described above, is not anaphylaxis. What causes hives? Care at home Most of the time, hives as the only symptom can be safely managed at home, without the need to see a doctor. When to see a doctor If your child continues to have hives for more than six weeks, take them to see your GP. Sometimes, a skin biopsy or blood tests are done to confirm that you had an allergic reaction, and to test for the substance that caused the allergic response.
However, specific allergy testing is not useful in most cases of hives. Treatment may not be needed if the hives are mild. They may disappear on their own. To reduce itching and swelling:. If your reaction is severe, especially if the swelling involves your throat, you may need an emergency shot of epinephrine adrenaline or steroids.
Hives in the throat can block your airway, making it difficult to breathe. When the condition lasts longer than 6 weeks, it is called chronic hives. Usually no cause can be found. Most chronic hives resolve on their own in less than 1 year. Call your provider if the hives are severe, uncomfortable, and do not respond to self-care measures. Dinulos JGH. Urticaria, angioedema, and pruritus. In: Dinulos JGH, ed. Habif's Clinical Dermatology. Philadelphia, PA: Elsevier; chap 6.
Erythema and urticaria. Andrews' Diseases of the Skin: Clinical Dermatology. Philadelphia, PA: Elsevier; chap 7. Editorial team. Hives Urticaria - hives; Wheals. Causes When you have an allergic reaction to a substance, your body releases histamine and other chemicals into the blood. Many substances can trigger hives, including: Animal dander especially cats Insect bites Medicines Pollen Shellfish, fish, nuts, eggs, milk, and other foods Hives may also develop as a result of: Emotional stress Extreme cold or sun exposure Excessive perspiration Illness, including lupus , other autoimmune diseases , and leukemia Infections such as mononucleosis Exercise Exposure to water Often, the cause of hives is not known.
Symptoms Symptoms of hives may include any of the following: Itching. Swelling of the surface of the skin into red- or skin-colored welts called wheals with clearly defined edges. Wheals may get bigger, spread, and join together to form larger areas of flat, raised skin. Wheals often change shape, disappear, and reappear within minutes or hours.
It is unusual for a wheal to last more than 48 hours. Dermatographism, or skin writing, is a type of hives. It is caused by pressure on the skin and results in immediate hives in the area that has been pressed on or scratched. Exams and Tests Your health care provider can tell if you have hives by looking at your skin.
Treatment Treatment may not be needed if the hives are mild. To reduce itching and swelling: Do not take hot baths or showers. Hives can be treated depending on the severity and causes of the condition. Many cases of hives are harmless and often resolve on their own. To relieve the itching associated with hives, it is often helpful to place a cool cloth on the affected area, or to take a cool shower. Taking a cool bath with baking soda or uncooked oatmeal may also provide relief.
Many cases of mild hives can be relieved this way. Patients experiencing hives should avoid hot baths or showers, as well as tight-fitting or rough, scratchy clothing, as these may further irritate the skin. A medical professional can recommend an antihistamine to help alleviate symptoms, which will reduce swelling, redness, and itching. Certain over-the-counter antihistamine medications include loratadine Claritin , fexofenadine Allegra , hydroxyzine Atarax, Vistaril , cetirizine Zyrtec , or diphenhydramine Benadryl.
Prescription antihistamines include cyproheptadine Periactin , levocetirizine Xyzal , and combined H2 blocker antihistamines — ranitidine Zantac and cimetidine Tagamet. You may also be prescribed corticosteroids such as prednisone or Medrol , to reduce symptoms. Dapsone is an antibacterial medication that can also be used to treat hives. Autoimmune drugs can also be used to calm an overactive immune system, if the previously mentioned medications do not help to clear symptoms of hives.
Another drug used for the treatment of hives includes montelukast Singulair. Ultraviolet radiation treatment has also resulted in successful treatment of hives in some patients. Patients with hereditary angioedema may also be prescribed blood protein controllers , which can help regulate levels of blood proteins to provide symptom relief.
Patients with chronic hives may be treated with a combination of medications. Omalizumab Xolair is a biologic drug that is directed against the IgE receptor in human mast cells, which has been approved to treat chronic hives in patients older than 12 years of age.
For more severe episodes of hives, you may be prescribed epinephrine adrenaline , or given an emergency injection of the medication in the emergency room. Patients with a history of hives often carry an EpiPen with epinephrine for such situations.
You should contact a medical provider if your hives are causing you severe discomfort. If you have tried several self-care measures, and your hives still persist, a medical professional can help you manage your symptoms. If a current medication you are taking is causing you to experience hives, consult your doctor right away, as you may need to stop taking the medication.
If you have chronic hives, speaking with a medical provider can help manage your symptoms. Chronic hives may also be associated with thyroid disease, hormonal problems, or even cancer.
Your medical provider can help assess your condition. Patients experiencing a severe allergic reaction should seek immediate emergency care. Signs of a serious allergic reaction during an episode of hives include:. Tongue swelling. Face swelling. Difficulty breathing. Tightness in your throat. This page offers general health information to facilitate discussion with your telehealth provider.
You must not rely on the information on our website as an alternative to medical advice from your doctor or other professional healthcare provider. Hives are a common, often allergic, reaction to an offending substance or trigger.
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