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
- If doesn’t look like hives, see Widespread Rashes with Unknown Cause
- If it’s probably mosquito bites, see Insect Bites
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
- Hives with no complications and you don’t think your child needs to be seen
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