Urticaria (Hives)

Urticaria, also known as hives, is a condition in which red, itchy, and swollen areas appear on your child's skin — usually as an allergic reaction from eating certain foods or taking certain medications.

  • Hives can vary in size from half an inch to several inches in diameter.
  • Hives can appear all over your child's body, or be limited to one area.

What causes urticaria (hives?)

Foods:

Medications:

  • penicillin
  • sulfa
  • anticonvulsant drugs
  • phenobarbital
  • aspirin

Other causes:

  • scratching or stroking the skin, or wearing tight-fitting clothes that rub the skin (dermatographism)
  • exposure to cold air or water
  • exposure to sunlight or even light-bulb light
  • some hives recur with no known cause-this is called chronic urticaria

What is angioedema?

Angioedema is an allergic reaction that causes swelling deeper in the layers of the skin. It most commonly occurs on the hands, feet and face (lips and eyes).

How do we diagnose urticaria?

Your child's physician will diagnose hives based on a physical examination and complete medical history.

How do we treat hives?

The best way to treat hives is to prevent them in the first place; your child should avoid the food or medication that caused them. (This is especially true for medication-induced hives.)

Beyond that, specific treatments will vary based on your child's age, health, and medical history, the extent of your child's disease, his tolerance for specific medications, procedures, and therapies, and, of course, your own opinions and preferences. Your child's physician may prescribe:

  • antihistamines such as Benadryl or Atarax, which help to decrease histamine release and, therefore, symptoms of urticaria (these medications may make your child drowsy)
  • non-sedating antihistamines such as Zyrtec and Claritin, which work similarly to antihistamines but ordinarily without making your child drowsy

If your child is having trouble breathing, your child's physician might use an injection of epinephrine to help decrease the itching and swelling; your child's physician might also prescribe an emergency kit with epinephrine to keep on hand in case of future episodes.

How Boston Children's approaches hives

Boston Children's diagnostic evaluations are supported by state-of-the-art allergy testing facilities, and an individual treatment plan is established for each child. Treatment may include education, medical management, and coordinated care with your child's primary physician.