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

  • Hives with no complications and you don’t think your child needs to be seen

Home Care Advice for Hives

  1. 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
  2. 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
  3. 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
  4. Remove Allergens: Give a bath or shower if triggered by pollens or animal contact. Change clothes
  5. Avoid Allergens: If you identify a substance that causes hives, help your child avoid that substance in the future
  6. Contagiousness: Hives are not contagious. Your child can return to day care or school if the hives do not interfere with normal activities
  7. Expected Course: Hives normally come and go for 3 or 4 days, then disappear. Most children get hives once
  8. 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