Hives (urticaria) are an inflammation of the skin that causes a red, raised welt or bump. Hives almost always 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. Hives symptoms often include:
Angioedema can occur at the same time as hives or as a separate reaction. Symptoms of angioedema include:
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:
If your child suddenly develops severe hives or angioedema and is having trouble breathing, vomiting, or loss of 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.
As a first step to diagnosing the cause of hives and swelling, doctors at Riley at IU Health will ask about your child's medical history and do a physical exam. You may also be asked to keep a food diary to see if something in your child’s diet may be causing symptoms. This will help the doctor decide whether more testing is needed.
In the case of acute hives, there may be an obvious food or substance that acts as a trigger, such as peanuts or a medicine. Acute hives may not require further testing or allergy evaluation unless a food is part of the history or there is anaphylaxis.
With chronic hives, the cause may not be so obvious. Often, it can be extremely difficult to identify and confirm a single cause of chronic hives, but an allergy specialist can perform allergy testing to rule out potential triggers.
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 then help you create a plan to avoid your child’s triggers.
Antihistamines are the most common medicine 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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