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Hives

May 17, 2016

What are hives?
Hives are a very itchy rash usually caused by an allergic reaction. Hives look like raised pink spots with pale centers on the skin. The spots range from 1/2 inch to several inches wide (hives often look like mosquito bites). The spots may be different shapes. The spots rapidly and repeatedly change in location, size, and shape. Giant hives are called angioedema.

What is the cause?
Widespread hives are an allergic reaction to a food, medicine, viral infection, insect bite, and other substances. Often the cause is not found. Hives on just one part of the body (localized) are usually due to skin contact with plants, pollen, food, or pet saliva. Localized hives are not caused by drugs, infections, or swallowed foods. Hives are not contagious.
Rarely, hives may also be caused by:

  • exposure to cold air or water
  • exposure to sunlight
  • becoming overheated from exercise or a hot shower

How long do they last?
More than 10% of children get hives. Most children who develop hives have them only once. The hives come and go for 3 or 4 days and then mysteriously disappear.
Large swellings are common around the eyes, lips, and genitals if hives occur there.

Some young children become sensitized to mosquito or flea bites. They develop big hives (called papular urticaria) at the sites of old and new bites. These hives may last for months.

How can I take care of my child?
The best drug for hives is an antihistamine. An antihistamine won’t cure the hives, but it will reduce their number and relieve itching.

Benadryl (diphenhydramine) is the most commonly used drug for hives, and is available without a prescription. The main side effect of this drug is drowsiness in some people. Other antihistamines (for example, store brands of any drug for hay fever) will also help. When you give Benadryl, give it 3 to 4 times a day until the hives are gone for 12 hours. Use the dosage given on the product.

Use the drug recommended by your child’s healthcare provider.

For flare-ups of itching, give your child a cool bath without soap for 10 minutes. (Caution: avoid any chill). Put a cold washcloth or ice cube on itchy areas for 10 minutes. Avoid heat or rubbing.

Avoid anything you think might have caused the hives. For hives triggered by pollen or animal contact, take a cool shower or bath. For localized hives, wash the allergic substance of the skin with soap and water. Localized hives usually disappear in a few hours and don’t need Benadryl. Avoid heat or rubbing, which makes hives worse.

Many parents wait to give the antihistamine until new hives have appeared. This means your child will become itchy again. The purpose of the medicine is to keep your child comfortable until the hives go away. Therefore, give the medicine regularly until you are sure the hives are completely gone. Hives are not contagious and your child can be with other children.

When should I call my child’s healthcare provider?

Call IMMEDIATELY if:

  • Breathing or swallowing becomes difficult.
  • Your child starts acting very sick.

Call during office hours if:

  • Most of the itch is not relieved after your child has been taking an antihistamine for 24 hours.
  • The hives last more than 1 week.
  • You have other concerns or questions.

Disclaimer

Written by Barton D. Schmitt, MD, author of “My Child Is Sick”, American Academy of Pediatrics Books.

Pediatric Advisor 2012.1 published by RelayHealth.

Last modified: 2011-06-29 Last reviewed: 2011-06-06

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

© 2012 RelayHealth and/or its affiliates. All rights reserved.

Merck does not endorse and is not responsible for the accuracy of the content, or for practices or standards of non-Merck sources. Please read our Terms of Use for more information.

Copyright © 2012 Merck Sharp & Dohme Corp., a subsidiary of Merck & Co. Inc. All rights reserved.

The Lancet® is a registered trademark of Elsevier Properties S.A. used under license.

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