Urticaria/Hives in Children

What is urticaria?

Urticaria, or hives, is a condition in which red, itchy, and swollen areas appear on the skin--usually as an allergic reaction from eating certain foods or taking certain medications, though sometimes the cause may be unknown. Hives can vary in size from one-half inch to several inches in size. Hives can appear all over the body or be limited to one part of the body.

What foods commonly cause hives?

• Peanuts

• Eggs

• Shellfish

What medications commonly cause hives?

• Penicillin

• Sulfa

• Anticonvulsant drugs

• Phenobarbital

• Aspirin

Other causes of hives

The following are other possible causes of hives:

• Dermatographism--hives caused by scratching the skin, continual stroking of the skin, or wearing tight-fitting clothes that rub the skin.

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

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

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

• Chronic urticaria--recurrent hives with no known cause.

How are hives diagnosed?

A diagnosis of hives is usually made based on a complete medical history and physical examination.

Treatment for hives

Avoidance of the allergen is the best treatment for hives. If the hives were caused by a medication, strict avoidance is necessary.

Specific treatment for hives will be determined by your child's doctor based on:

• Your child's age, overall health, and medical history

• Extent of the reaction

• Your child's tolerance for specific medications, procedures, or therapies

• Expectations for the course of the reaction

• Your opinion or preference

Your child's doctor may also prescribe the following medications:

• Antihistamines--these help to decrease histamine release which may help to decrease the symptoms of urticaria. Some examples are diphenhydramine (Benadryl) or hydroxyzine (Atarax). These medications may make your child drowsy.

• Nonsedating antihistamines--work similar to antihistamines but without the side effect of making your child drowsy. These might include cetirizine (Zyrtec) or loratadine (Claritin).

If your child is having difficulty breathing, your child's doctor might use an injection of epinephrine to help decrease the swelling and the itching. Your child's doctor may instruct you on the use of an emergency kit that contains epinephrine to have near your child in case of future episodes. Discuss this with your child's doctor.