Seeing red raised spots on your child's skin can be scary, especially if you don't know what caused them. Often, though, these spots are a case of the hives — a common skin reaction to something like an allergen (a substance that causes allergies). Most will clear up and go away
If your child has hives, keep him or her as comfortable as possible, then try to figure out what caused them to help prevent them from coming back.
Hives (or urticaria) are red raised bumps or welts on the skin. They can appear anywhere on the body and can look like tiny little spots or large interconnected bumps.
Individual hives can last anywhere from a few hours to a week (sometimes longer), and new ones might replace those that fade. Hives that stay for 6 weeks or less are called acute hives; those that go on longer than 6 weeks are chronic hives.
An allergic reaction can cause hives, as can temperature extremes, stress, infections, or illnesses. In some cases, hives are accompanied by angioedema, a condition that can cause swelling around the eyes, lips, hands, feet, or throat. Very rarely, hives and angioedema are associated with an allergic reaction that involves the whole body or anaphylactic shock.
The red welts of hives happen when mast cells in the bloodstream release the chemical histamine, which causes tiny blood vessels under the skin to leak. The fluid pools within the skin to form spots and large welts. This can happen for a number of reasons, but in many cases a cause is never identified.
Most often, hives are associated with an allergic reaction, which can cause the skin to break out within minutes. Common allergies include:
Sometimes a breakout of hives has nothing to do with allergies. Other causes include:
Hives due to physical causes, such as pressure, cold, or sun exposure, are called physical hives.
It can be hard to figure out what causes chronic urticaria, though it's sometimes linked to an immune system illness, like lupus. Other times, medications, food, insects, or an infection can trigger an outbreak. Often, though, doctors don't know what causes chronic hives.
The hallmark red raised welts of hives sometimes have a pale center, can appear in clusters, and can change shape and location in a matter of hours. They can be from a few millimeters wide to as big as a dinner plate, and can itch, sting, or cause a burning sensation.
If a person also has angioedema, there might be puffiness, swelling, or large bumps around the eyes, lips, hands, feet, genitals, or throat. In severe cases, swelling in the throat can cause breathing trouble and lead to a loss of consciousness.
Rarely, a person with hives and angioedema can also get anaphylactic shock. Signs of anaphylactic shock include difficulty breathing, a drop in blood pressure, dizziness, or a loss of consciousness.
Most of the time, a doctor can diagnose hives just by looking at the skin. To find the cause, you may be asked questions about your child's medical history, recent exposure to allergic triggers, and daily stressors.
If your child has chronic hives, the doctor may ask you to keep a daily record of activities, such as what your child eats, drinks, and where the hives tend to show up on the body. Diagnostic tests — such as blood tests, allergy tests, and tests to rule out underlying conditions such as thyroid disease or hepatitis — might be done to find the exact cause of the hives.
To check for physical hives, a doctor may put ice on your child's skin to see how it reacts to cold or place a sandbag or other heavy object on the thighs to see if the pressure will cause hives to appear.
In many cases, mild hives won't need treatment and will go away on their own. If a definite trigger is found, avoiding it is part of the treatment. If the hives feel itchy, the doctor may recommend an antihistamine medicine to block the release of histamine in the bloodstream and prevent breakouts.
For chronic hives, the doctor may suggest a non-sedating (non-drowsy) prescription or over-the-counter antihistamine to be taken every day. Not everyone responds to the same medications, though, so it's important to work with a doctor to find the right one for your child.
If a non-drowsy antihistamine doesn't work, the doctor may suggest a stronger antihistamine or another medicine or a combination of medicines. In rare cases, a doctor may prescribe a steroid pill or liquid to treat chronic hives. Usually this is done for just a short period (5 days to 2 weeks) to prevent harmful steroid side effects.
Anaphylactic shock and bad attacks of hives or angioedema are rare. But when they happen, they need immediate medical care.
Kids with bad allergies should carry an injectable shot of epinephrine to prevent life-threatening allergy attacks. If your child is at risk, the doctor will teach you and your child how to safely give an injection in the event of a severe allergic reaction.
Reviewed by: Rupal Christine Gupta, MD
Date reviewed: August 2014
|American Academy of Allergy, Asthma, and Immunology The American Academy of Allergy, Asthma, and Immunology offers up-to-date information and a find-an-allergist search tool.|
|American College of Allergy, Asthma, and Immunology The ACAAI is an organization of allergists-immunologists and health professionals dedicated to quality patient care. Contact them at: American College of Allergy, Asthma, and Immunology|
85 W. Algonquin Road
Suite 550 Arlington Heights, IL 60005
|Food Allergy Research and Education (FARE) Food Allergy Research & Education (FARE) works on behalf of the 15 million Americans with food allergies, including all those at risk for life-threatening anaphylaxis.|
|Babysitting: Dealing With Allergic Reactions What should you do if a child you're babysitting has an allergic reaction? Our tip sheet can help you be prepared.|
|Rashes: The Itchy Truth Learn about rashes in a flash. Check out our article just for kids!|
|Food Allergies Doctors are diagnosing more and more people with food allergies. Knowing what to expect and how to deal with food allergies can make a big difference in preventing serious illness.|
|Food Allergies Struggling with strawberries? Petrified of peanuts? Sorry you ate shellfish? Maybe you have a food allergy. Find out more in this article for kids.|
|Going to School With Food Allergies With preparation and education, a child with a food allergy can stay safe at school.|
|Food Allergies Food allergies can cause serious and even deadly reactions in kids, so it's important to know how to feed a child with food allergies and to prevent reactions.|
|Allergies Your eyes itch, your nose is running, you're sneezing, and you're covered in hives. The enemy known as allergies has struck again.|
|Serious Allergic Reactions (Anaphylaxis) A person with severe allergies can be at risk for a sudden, serious allergic reaction called anaphylaxis. This reaction can seem scary, but the good news is it can be treated.|
|Learning About Allergies During an allergic reaction, your body's immune system goes into overdrive. Find out more in this article for kids.|
|Shellfish Allergy Shellfish allergies can be serious - and shellfish can appear in some surprising foods and products. Read about shellfish allergy and what to do when a reaction is severe.|
|Help With Hives Hives are red, itchy blotches that can appear because of an allergic reaction. Find out more in this article for kids.|
|What Is Skin Testing for Allergies? A scratch or skin prick test is a common way doctors find out more about a person's allergies.|
|Can Cake Cause Hives? Find out what the experts have to say.|
|First Aid: Allergic Reactions Although most allergic reactions aren't serious, severe reactions can be life-threatening and can require immediate medical attention.|
|Hives (Urticaria) Hives cause raised red bumps or welts on the skin. They're pretty common and usually not serious. Find out what to do about hives in this article for teens.|
|Blood Test: Immunoglobulin E (IgE) The immunoglobulin E (IgE) test is often performed as part of an initial screen for allergies. High IgE levels also may indicate a parasitic infection.|
|Egg Allergy Helping your child manage an egg allergy means reading food labels carefully, being aware of what he or she eats, and carrying the right medicines in case of an allergic reaction.|
What to expect when coming to Akron Children's
For healthcare providers and nurses
Residency & Fellowships, Medical Students, Nursing and Allied Health
For prospective employees and career-seekers
Our online community that provides inspirational stories and helpful information.