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Hives

Description / Symptoms

  • Raised pink bumps with pale centers (welts)
  • Hives look like mosquito bites
  • Sizes of hives vary from ½ inch to several inches across
  • Shapes of hives are variable and change repeatedly
  • Itchy rash

Cause

Widespread hives usually are caused by a viral infection. Can also be an allergic reaction to a food, drug, infection, insect bite, or other substances.

Localized hives are usually due to skin contact with plants, pollen, food or pet saliva. Localized hives are not caused by drugs, infection or swallowed foods.

See More Appropriate Topic (instead of this one)

When to Call Your Doctor for Hives

Call 911 Now If:

  • Difficulty breathing or wheezing
  • Hoarseness or cough with rapid onset
  • Difficulty swallowing or slurred speech with rapid onset
  • Severe allergic reaction in the past to similar substance

Call Your Doctor Now If:

  • Your child looks or acts very sick
  • Hives began after a bee sting, unusual food or medicine and no previous reactions

Call Your Doctor Within 24 Hours If:

  • You think your child needs to be seen
  • Severe hives (eyes swollen shut, very itchy, etc.) not improved after 2nd dose of Benadryl
  • Fever, abdominal pain or joint swelling is present

Call Your Doctor During Weekday Hours If:

  • You have other questions or concerns
  • Hives interfere with school or normal activities after taking Benadryl every 6 hours for more than 24 hours
  • Food suspected as cause
  • Unexplained hives have occurred 3 or more times

Home Care (Read "Call Your Doctor…" first):

Localized Hives

For localized hives, wash the allergic substance off the skin with soap and water. If itchy, massage the area with a cold pack or ice for 20 minutes.

Localized hives usually disappear in a few hours and don't need Benadryl.

Benadryl

Give Benadryl 4 times per day for widespread hives that itch. (Note: if you only have another antihistamine at home, use that):

  • Contraindication: Weight < 20 pounds (Reason: Benadryl is a sedative). Give us a call for advice
  • Continue the Benadryl 4 times per day until the hives are gone for 12 hours

Cool Bath

Give a cool bath for 10 minutes to relieve itching. (Caution: avoid any chill). Rub very itchy areas with an ice cube for 10 minutes.

Remove Allergens

Give a bath or shower if triggered by pollens or animal contact. Change clothes.

Avoid Allergens

If you identify a substance that causes hives (e.g. a food), help your child avoid that substance in the future.

Contagiousness

Hives are not contagious. Your child can return to day care or school if the hives do not interfere with normal activities.

Expected Course

Hives normally come and go for 3 or 4 days, then disappear. Most children get hives once.

Call Your Doctor If:

  • Severe hives persist after 2nd dose of Benadryl
  • Most of the itch is not relieved within 24 hours on continuous Benadryl
  • Hives last > 1 week
  • Your child becomes worse or develops any of the "Call Your Doctor…" symptoms

Parent Care for Pediatric Symptoms. Copyright 2000-2006.