Treat Hives in Children

Hives are a very common condition in children. They present as itchy, red and white raised welts or bumps on the skin.[1] Hives are not contagious and they can last for a few hours to a few days, though in some acute and chronic cases, they may stay for a few weeks.[2] Hives appear when the body releases histamines in reaction to an allergy or even from heat, anxiety, infection or changes in temperature.[2] If your child has hives, there are simple ways to treat the welts either using home remedies or by getting a prescription from your child’s pediatrician.

Steps

Visiting a Doctor to Diagnose Your Child’s Hives

  1. Learn about the presentation of hives. If your child develops hives, they may present on either a localized part of her body or over her entire body. Learning about the presentation of hives on your child’s body may help you identify their cause.[1]
    • Localized hives appear on one part of the body and are usually caused by direct skin contact with plants, pollen, food, or pet saliva and fur.[3]
    • Widespread hives appear all over the body. They may be a reaction to a viral infection or an allergic reaction to a food, drug, or insect bite.[1]
  2. Be aware of the causes of hives. There are many different reasons a child may develop hives. Whether the hives are localized or widespread on your child’s, knowing what can cause hives may help you effectively treat the hives at home or decide to visit the pediatrician.[3]
    • Foods such as shellfish, nuts, milk, and fruit may cause hives.[4] Hives from food usually go away within six hours of ingestion.[1]
    • Medications such as penicillin or allergy shots may cause hives.[5]
    • Contact with pets or animals may cause hives.[5]
    • Exposure to pollen from flowering plants may cause hives.[4]
    • Stings/bites from insects such as bees and mosquitoes may cause hives.[4]
    • Anxiety or stress may cause a child to develop hives.[4]
    • Exposure to extreme temperatures or the sun may spur a case of hives.[5]
    • Contact with chemicals, including laundry detergent or perfumed soaps, may cause hives.[5]
    • Viral infections like the common cold, infectious mononucleosis and hepatitis[6]
    • Bacterial infections such as urinary tract infections and strep throat[6]
  3. See your pediatrician if your child has hives. See your pediatrician if your child has hives and you are unsure of the cause, the hives don’t disappear within a week, has recently started a new medication or food, has been stung by an insect, or your child becomes very uncomfortable. The doctor may prescribe oral medications, steroid creams, or other treatments to ease the hives.[1]
    • It’s important to see your doctor if you are unsure of the cause of the hives. This can minimize the risk of treating the hives with something that may harm your child or is unnecessary.[1]
    • See the doctor if your child’s hives are still severe after a second dose of antihistamines.[1]
    • If your child experiences any of the symptoms of anaphylactic shock, including facial or throat swelling, coughing, wheezing, trouble breathing, or feeling dizzy or fainting, take them to the emergency room or call 911 immediately.[3]
  4. Get medical tests. If your doctor can’t determine the underlying cause of your child’s hives, she may use different tests to diagnose your child’s condition. This will not only give you a cause, but can also help form the best treatment plan for your child’s hives.[7]
    • Your child’s doctor may prescribe blood tests to identify underlying causes.[7]
    • Your child’s doctor may prescribe allergy tests to identify specific allergens your child has.[7]
  5. Treat underlying conditions. If your doctor determines that your child’s hives are caused by an underlying condition, she may treat this to help alleviate the welts and itching. Some studies have shown that treating underlying conditions can be more effective at healing hives than addressing the hives.[8]
    • For example, if your child has a thyroid issue, your doctor may treat that first and see how it helps the hives.[8]
    • If your doctor determines your child has a specific allergy, she will likely ask you to keep the allergen from contacting your child.
  6. Avoid what triggers your child’s hives. This skin condition can occur because of an allergen or a specific irritant. Knowing what triggers your child’s hives can help you avoid the irritant and help relieve and prevent her hives.[1]
    • The trigger could be an allergen, medication, food allergy, cosmetic, environmental factor, insect bite, infection, or harsh soap or detergent.[1]
    • If you suspect a specific trigger, try to limit exposure to it and see if it relieves your child’s symptoms.[1]
    • Certain external factors can worsen hives including sun exposure, stress, sweat, temperature changes.[4]
    • Use mild or “hypoallergenic” soaps and laundry detergents. These contain fewer harmful chemicals that can irritate your child’s skin. Any product marked “hypoallergenic” has been tested for sensitive skin and will not irritate your child’s skin.[4]

Treating Hives at Home

  1. Wash off the allergen for localized hives. If your child’s hives are localized on one area of their body, wash the allergen off with soap and water. This should help relieve the hives and may keep them from getting worse because the allergen is lingering on the skin.[1]
    • You don’t need to purchase any special soap, using any soap will work to remove the allergen.[9]
  2. Draw a cool bath to reduce the itching and redness. A cool bath can soothe irritated skin and help decrease inflammation. It is most helpful when the hives are all over your child's body. You may want to consider adding a colloidal oatmeal preparation to help further soothe your child’s skin.[10]
    • Sprinkle water with baking soda, uncooked oatmeal or colloidal oatmeal, all of which can help calm your child’s skin.[1]
    • Let your child stay in the bathtub for only 10-15 minutes so they don’t get a chill.[1]
  3. Apply calamine lotion or anti-itch cream. Applying a calamine lotion or non-prescription anti-itch cream can relieve hives, itching, and inflammation. You can purchase anti-itch cream at grocery and drug stores both in-store and online.[10]
    • A nonprescription anti-itch, or hydrocortisone, cream, can help relieve itching. Make sure to purchase a cream with at least 1% hydrocortisone.
    • Apply the cream once a day after your child’s bath to the affected area.[10]
  4. Apply a cold compress to relieve itching and inflammation. The itching and inflammation from hives come from histamine in your blood. Cold packs or compresses can help relieve itching and inflammation associated with hives by constricting blood flow and cooling the skin.[1]
    • Histamine is produced when an allergen enters in the body. It causes all allergic reactions, including itching and inflammation.
    • You can place a cold compress on your rashes intermittently for 10 to 15 minutes, once every 2 hours or as needed.[1]
  5. Keep your child from scratching. Help your child avoid scratching as much as possible. Scratching the can spread allergen, exacerbate symptoms, or cause other problems, including a skin infection.[1]
  6. Protect your child’s skin. You can help prevent and relieve hives by protecting your child’s skin. Clothing, bandages, and even bug spray may offer some protection and help relieve symptoms.
    • Wear cool, loose, smooth textured clothing such as cotton or merino wool to keep your child from scratching and prevent excess sweating, which can exacerbate hives.[10]
    • Have your child wear long-sleeved shirts and long pants to keep her from scratching and protect it from external irritants.[10]
    • If your child will be exposed to insects, you can also apply bug repellant to areas that do not have hives. This may prevent insects from getting too close to your child’s skin and causing further allergic reactions.

Treating Hives with Medication

  1. Give your child an antihistamine. If your child has hives all over her body, give her an antihistamine. These drugs can block the histamine that causes allergic reactions and help relieve itching and skin inflammation.[3]
    • Follow the recommended dose for your child’s age and weight. If you’re unsure of dosing, check with your child’s doctor.[1]
    • Common antihistamines include cetirizine,[11] chlorpheniramine,[3] and diphenhydramine.[3]
    • These drugs often have sedative effects so make sure to watch your child for safety.[1]
  2. Take histamine (H-2) blockers. Your child’s doctor may suggest taking histamine, or H-2, blockers to help relieve the hives. Your child may receive an injection or oral dosage of these medications.[8]
    • Examples of histamine blockers are cimetidine (Tagamet), ranitidine (Zantac), nizatidine (Axid), and famotidine (Pepcid).[8]
    • Side effects from these drugs may include digestive problems or headaches.[8]
  3. Use prescription corticosteroids. Your doctor may prescribe either a stronger topical or oral corticosteroid such as prednisone if other treatments don’t ease your child’s hives. Make sure to follow your doctor’s directions on taking these medications as they can weaken your child’s immune system.[12]
    • Oral steroids are only used for a short time because they can have serious side effects when used long term.[8]
  4. Have an asthma drug injected. Several studies have demonstrated that injections of the asthma drug omalizumab may help relieve hives. This drug comes with the benefit that it has no side effects.[8]
    • This treatment costs more than other options and is generally not covered by insurance.[8]
  5. Combine asthma drugs and antihistamines. Your doctor may prescribe your child a course of asthma medication with antihistamines. This treatment may help relieve your child’s hives.[8]
    • Your doctor may prescribe the asthma drugs montelukast (Singulair) or zafirlukast (Accolate) with an prescription or over the counter antihistamine.[8]
    • This treatment can cause behavior and mood changes.[8]
  6. Consider immune system suppressants. If your child’s hives are chronic and don’t respond to other treatments, your doctor may suggest drugs that affect the immune system. These drugs can help relieve acute and chronic hives.[8]
    • Cyclosporine limits the immune system’s response to hives and can help provide relief of your child’s hives. However, it comes with side effects that range from headaches to nausea and, in some cases, reduced kidney function.[8]
    • Tacrolimus also reduces the immune system’s reaction that causes hives. It comes with similar side effects to cyclosporine.[8]
    • Mycophenolate suppresses the immune system while improving the signs and symptoms of hives.[8]

Warnings

  • Hives are generally harmless. In rare instances, hives can be harmful, especially when caused by an allergic reaction which can cause your child to have difficulty breathing. If you have any doubts about your child’s hives or if home remedies have not worked and the hives have gotten worse, it is always recommended to consult a doctor.

Related Articles

  • Get Rid of Allergies in Infants

Sources and Citations

  1. ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 http://www.seattlechildrens.org/medical-conditions/symptom-index/hives/
  2. ↑ 2.0 2.1 http://kidshealth.org/parent/infections/skin/hives.html
  3. ↑ 3.0 3.1 3.2 3.3 3.4 3.5 http://www.seattlechildrens.org/medical-conditions/symptom-index/hives/
  4. ↑ 4.0 4.1 4.2 4.3 4.4 4.5 http://kidshealth.org/parent/infections/skin/hives.html#
  5. ↑ 5.0 5.1 5.2 5.3 http://kidshealth.org/parent/infections/skin/hives.html#
  6. ↑ 6.0 6.1 http://acaai.org/allergies/types/skin-allergies/hives-urticaria
  7. ↑ 7.0 7.1 7.2 http://www.mayoclinic.org/diseases-conditions/chronic-hives/basics/tests-diagnosis/con-20031634
  8. ↑ 8.00 8.01 8.02 8.03 8.04 8.05 8.06 8.07 8.08 8.09 8.10 8.11 8.12 8.13 8.14 http://www.mayoclinic.org/diseases-conditions/chronic-hives/basics/treatment/con-20031634
  9. ↑ http://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/hand-washing/art-20046253
  10. ↑ 10.0 10.1 10.2 10.3 10.4 http://www.rch.org.au/kidsinfo/fact_sheets/Hives/
  11. ↑ http://www.nlm.nih.gov/medlineplus/druginfo/meds/a698026.html
  12. ↑ http://www.mayoclinic.org/diseases-conditions/chronic-hives/basics/treatment/con-20031634
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