Hives

Main Symptoms

Raised pink bumps with pale centers (welts)
Hives look like mosquito bites
Sizes of hives vary from 1 inch to several inches across
Shapes of hives are also quite variable
Location, size, and shape change rapidly and repeatedly
Itchy rash
Main Cause: reaction to a viral infection
Other Common Causes: widespread hives can 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
A severe allergic reaction is called anaphylaxis

See More Appropriate Topic

Call 911 Now (your child may need an ambulance) (for symptoms of anaphylaxis) 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 and hives present < 2 hours

Call Your Doctor Now (night or day) 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 (between 9 and 4) 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 Office 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
Unexplained hives have occurred 3 or more times

Parent Care at Home If

Home Care Advice for Hives

Localized Hives: For localized hives, wash the allergic substance off the skin with soap and water. If itchy, massage the area with a cold washcloth or ice. 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. (See Dosage chart) (Note: if you only have another antihistamine at home, use that)
- Contraindication: Do not give benadryl if your child weighs less then 20 pounds, instead give your doctor 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, 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