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Hives (urticaria) are an inflammation of the skin that causes red, raised welts or bumps. Hives itch, and they tend to come and go in groups. They range in size from a fraction of an inch to many inches in diameter.
The itchiness, grouping and size range of hives make them different from other allergic skin reactions like atopic dermatitis. Hives may occur suddenly as a reaction to a specific trigger (acute hives), or they may occur repeatedly or for long periods of time (chronic hives).
Hives may appear with angioedema (swelling of the deeper tissue of the skin). Angioedema usually does not itch and commonly occurs around the eyes, lips, tongue, hands and feet. Children who have hives with angioedema are more likely to have recurring or chronic hives.
The symptoms of hives may last anywhere from a few minutes to a few months or longer. Signs and symptoms of hives often include:
Angioedema (swelling) can occur at the same time as hives or as a separate reaction. Symptoms of angioedema include:
Hives can appear in one area or all over the body. If your child suddenly develops severe hives or angioedema and is having trouble breathing, is vomiting or loses consciousness, he or she may be experiencing anaphylaxis, a severe allergic reaction. Anaphylaxis is an emergency. If you think your child is experiencing a severe allergic reaction, take him or her to the hospital for immediate treatment.
Many different factors can cause your child to develop hives or swelling. These causes may be physical reactions, allergic reactions or nonallergic reactions.
Physical causes include:
Allergic reactions can cause hives or swelling in response to:
Nonallergic causes of hives include:
As a first step to diagnosing the cause of hives and swelling, the allergy doctors at Riley at IU Health will ask about your child's medical history and do a physical exam. The focus will be on exposures that may be contributing to the problem.
Allery specialists will often perform an evaluation if the problem is chronic (for example, a child is has hives daily for two to three months). It can be extremely difficult to identify and confirm causes of chronic hives, but the allergy specialists at Riley at IU Health are trained to review your child's medical history to help determine a possible cause and direct any further testing.
In the case of acute hives, there may be an obvious food or substance such as peanuts or a medicine that acts as a trigger. Acute hives may not require further evaluation or allergy testing unless a food is part of the history or there is anaphylaxis.
An allergy specialist can treat both hives and angioedema. As with all allergic disorders, avoidance (keeping your child away from allergens) is the only sure therapy. If your child’s doctor is able to determine the cause of the hives, he or she can help you create a plan to avoid your child’s triggers.
Antihistamines are the most common medicines used for treating hives and swelling. These medicines work by blocking the chemicals in the skin that cause hives and swelling. Non-drowsy antihistamines are available. Your child’s allergist may also suggest other treatments.
Learn more about hives and swelling by visiting the trusted websites below.
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