Hives in Children: Symptoms, Causes, Treatment

What are the symptoms of hives in children?

Hives, also known as urticaria, can affect children and present with various symptoms. The primary symptoms include:

1. Raised, Red or Skin-Colored Welts: These welts, or wheals, can appear anywhere on the body. They can vary in size and may merge to form larger areas of swelling.
2. Itching: The affected areas are often intensely itchy. The itching can range from mild to severe and can cause significant discomfort.
3. Swelling: In addition to the raised welts, there may be swelling around the eyes, lips, hands, feet, or throat, known as angioedema. This swelling can sometimes be painful.
4. Shape and Size Variability: The welts can change shape, move around, disappear, and reappear over short periods.
5. Blanching: When pressed, the center of a hive might turn white. This is called blanching and is a common characteristic of hives.
6. Rapid Onset and Resolution: Hives can appear suddenly and often resolve on their own within 24 hours, although new hives may continue to appear as old ones fade.

In more severe cases, especially if there is significant swelling in the throat or difficulty breathing, immediate medical attention is required as this could indicate a more serious allergic reaction (anaphylaxis).

If hives persist for more than six weeks, they are considered chronic, and it’s advisable to consult a healthcare provider for further evaluation and management.

What are the possible causes of hives in children?

Hives in children, also known as urticaria, can be caused by a variety of factors. Here are some of the possible causes:

1. Allergic reactions: Food allergies, insect bites, medications, or environmental allergens can trigger hives in children.
2. Infections: Viral infections, such as the common cold or viral gastroenteritis, can cause hives.
3. Viral hepatitis: Certain types of viral hepatitis, such as hepatitis B and C, can cause hives.
4. Bacterial infections: Some bacterial infections, such as strep throat or meningococcal disease, can cause hives.
5. Fungal infections: Fungal infections, such as ringworm or athlete’s foot, can cause hives.
6. Parasitic infections: Parasites like lice, ticks, or scabies can cause hives.
7. Stress: Emotional stress or anxiety can trigger hives in some children.
8. Medications: Certain medications, such as antibiotics, anticonvulsants, and nonsteroidal anti-inflammatory drugs (NSAIDs), can cause hives as a side effect.
9. Food additives: Food additives like tartrazine, azo dyes, or MSG can trigger hives in some children.
10. Other medical conditions: Certain medical conditions, such as thyroid disorders, kidney disease, or liver disease, can cause hives.
11. Vitamin deficiencies: Deficiencies in vitamins like vitamin B12 or iron can cause hives.
12. Autoimmune disorders: Conditions like lupus or rheumatoid arthritis can cause hives in children.

It’s important to note that in most cases, the exact cause of hives in children is unknown. In some cases, hives may be a symptom of an underlying condition that needs to be diagnosed and treated.

If your child is experiencing hives, it’s essential to consult with a pediatrician to determine the underlying cause and develop a treatment plan to help alleviate symptoms and prevent future episodes.

How is the diagnosis of hives in children made?

Diagnosing hives in children typically involves a combination of medical history, physical examination, and laboratory tests. Here are the steps involved in making a diagnosis:

1. Medical history: The pediatrician will ask questions about the child’s symptoms, including:
   • When did the hives start?
   • How long have they lasted?
   • Are they itching or burning?
   • Are they limited to specific areas of the body or widespread?
   • Have there been any triggers or factors that seem to make them worse?
2. Physical examination: The pediatrician will perform a thorough physical examination to look for:
   • The location, size, shape, and distribution of the hives
   • Any signs of other skin conditions or allergies
   • Any evidence of underlying medical conditions
3. Laboratory tests: Depending on the child’s symptoms and medical history, the pediatrician may order one or more laboratory tests to help determine the underlying cause of the hives. These tests may include:
   • Complete blood count (CBC) to check for signs of infection or inflammation
   • Blood tests for allergens like peanuts, tree nuts, milk, eggs, fish, shellfish, wheat, and soy
   • Skin prick testing to identify specific allergens
   • Stool tests for giardiasis or other parasitic infections
   • Urine tests for kidney function or signs of urinary tract infections
4. Elimination diets: If food allergy is suspected, an elimination diet may be recommended to identify the specific food trigger.
5. Patch testing: In some cases, patch testing may be used to identify contact dermatitis or other skin reactions.
6. Imaging studies: In some cases, imaging studies like X-rays or CT scans may be ordered to rule out underlying medical conditions like infections or inflammatory bowel disease.

The diagnosis of hives in children is often based on a combination of these steps. If the pediatrician is unable to identify an underlying cause, they may recommend further testing or consultation with a specialist.

Keep in mind that diagnosis and treatment may vary depending on the severity and duration of the hives, as well as the child’s age and overall health.

What is the treatment for hives in children?

The treatment for hives in children depends on the severity and duration of the outbreak, as well as the underlying cause of the hives. Here are some common treatment options for hives in children:

1. Antihistamines: Over-the-counter (OTC) antihistamines, such as diphenhydramine (Benadryl) or chlorpheniramine (Chlor-Trimeton), can help relieve itching and reduce the size of the hives. However, these medications can cause drowsiness, so they should be used with caution in young children.
2. Corticosteroids: Topical corticosteroids, such as hydrocortisone cream or ointment, can be applied directly to the affected area to reduce inflammation and itching.
3. Cool compresses: Applying a cool compress to the affected area can help reduce itching and inflammation.
4. Bath treatment: Oatmeal baths or colloidal oatmeal baths can help soothe itchy skin and reduce inflammation.
5. Topical anesthetics: Topical anesthetics, such as benzocaine or lidocaine, can be applied to the affected area to numb the skin and reduce itching.
6. Antihistamine creams or gels: Prescription-strength antihistamine creams or gels, such as topical corticosteroids or calamine lotion, can be used to treat hives in children who do not respond to OTC medications.

In severe cases of hives, your pediatrician may prescribe:

1. Systemic corticosteroids: Oral corticosteroids, such as prednisone, can be used to treat severe cases of hives that do not respond to topical treatments.
2. Epinephrine auto-injectors: If your child experiences a severe allergic reaction that causes anaphylaxis, an epinephrine auto-injector, such as EpiPen or Auvi-Q, may be prescribed.

It’s essential to consult with a pediatrician if your child experiences any of the following:

• Difficulty breathing
• Swelling of the face, lips, tongue, or throat
• Abdominal cramps
• Nausea or vomiting
• Fever over 102°F (39°C)
• Hives that do not respond to OTC treatments
• Hives that last for more than 6 weeks

To prevent hives in children, it’s essential to identify and avoid triggers, such as:

• Allergens: Avoid exposure to common allergens like pollen, dust mites, pet dander, or certain foods.
• Stress: Stress can trigger hives in some children.
• Medications: Certain medications, such as antibiotics or pain relievers, can cause hives.
• Food additives: Some food additives, such as tartrazine or sodium benzoate, can trigger hives in some children.

Remember to consult with a pediatrician if you’re unsure about the best course of treatment for your child’s hives.