Definition

• Hives is a rash made up of raised pink bumps with pale centers
• Most often, rash is very itchy

Health Information

Symptoms

• Raised pink bumps with pale centers (welts)
• Hives look like mosquito bites
• Sizes of hives vary from ½ inch (12 mm) to several inches (cm) across
• Shapes of hives are not all the same. They can also change shape and location frequently.
• Itchy rash

Causes

• Hives all over the body are most often caused by a viral infection. Can also be an allergic reaction to a food, drug, or insect bite. Often, the cause is not found. Hives from foods usually resolve in 6 hours.
• Hives just in one spot are usually due to skin contact with an irritant. Examples are plants, pollen, food or pet saliva. Localized hives are not caused by drugs, infections or swallowed foods.

Prevention of Recurrent Hives

• If you know what is causing the hives, avoid this substance. An example is certain foods.
• Help your child stay away from this allergen in the future.

Care Advice

1. Hives Only on One Part of the Body - Overview:
   • Most often caused by skin contact with an irritant. Examples are plants, pollen, food or pet saliva.
2. Hives Only on One Part of the Body - Treatment:
   • Wash the allergic substance off the skin with soap and water.
   • If itchy, use a cold pack for 20 minutes. You can also rub the hives with an ice cube for 10 minutes.
   • Hives just on one part of the body should go away on their own. They don’t need Benadryl.
   • They should go away in a few hours.
3. Hives All Over the Body - Overview:
   • Over 10% of children get widespread hives 1 or more times.
   • Often, they are part of a viral infection. Sometimes the cause is not found.
   • Most hives don’t turn into a severe allergic reaction.
   • Here is some care advice that should help.
4. Benadryl for Hives All Over the Body:
   • Give Benadryl 4 times per day for hives all over that itch. No prescription is needed.
   • If you only have another allergy medicine at home (but not Benadryl), use that.
   • Continue the Benadryl 4 times per day until the hives are gone for 12 hours.
   • Caution: Do not use if age is under 1 year. Reason: Benadryl is a sedative. Give your doctor a call for advice.
5. Hives Caused by Foods:
   • Foods can cause widespread hives.
   • Sometimes, the hives are just around the mouth.
   • Hives from foods usually last just a short time. They often are gone in less than 6 hours.
6. Cool Bath for Itching:
   • To help with the itching, give a cool bath. Do this for 10 minutes. (Caution: Avoid causing a chill).
   • Can also rub very itchy spots with an ice cube for 10 minutes.
7. Get Rid of Allergens:
   • Give a bath or shower if caused by pollens or animal contact.
   • Change clothes.
8. What to Expect:
   • Hives all over from a viral illness normally come and go.
   • They may last for 3 or 4 days. Then, they go away.
   • Most children get hives once.
9. Return to School:
   • Hives cannot be spread to others.
   • Your child can go back to school once feeling better. The hives shouldn’t keep him from normal activities.
   • For hives from an infection, can go back after the fever is gone. Your child should feel well enough to join in normal activities.

Call Your Doctor If

• Severe hives not better after 2 doses of Benadryl
• Itch not better after 24 hours on Benadryl
• Hives last more than 1 week
• You think your child needs to be seen
• Your child becomes worse

Author: Barton Schmitt MD, FAAP

Copyright 2000-2020 Schmitt Pediatric Guidelines LLC

Disclaimer: This health information is for educational purposes only. You the reader assume full responsibility for how you choose to use it. The information contained in this handout should not be used as a substitute for the medical care and advice of your pediatrician. Listing of any resources does not imply an endorsement.

#AAP