Hereâ€™s what parents and others should know about managing hives in children.
Hives Tend to Look the Same on Kids as They Do on Adults
Hives in children look no different from those in adults. Theyâ€™re simply red, raised blotches or welts that appear on the skin singly, connected over an area of the skin, or in a group.
Fortunately, theyâ€™re not contagious, and they can disappear as quickly as they appear, usually within 24 hours for a single hive, says Adam Friedman, MD, a professor of dermatology at the George Washington University School of Medicine and Health Sciences in Washington, DC.
Kidsâ€™ Food Allergies Are on the Rise
As with adults, hives in kids occur in response to some trigger or allergen, often appearing within two hours of exposure. (1) Common allergens include foods, spices, fragrances, topical products like soaps and lotions, pet dander, medications, and insect bites, Dr. Woods says. Other causes include infections (even the common cold), illnesses, stress, physical pressure, extreme temperature changes, exercise, and scratching.
Note, though, that while these are similar to the causes for adults, food stands out for kids. â€œItâ€™s more common that kidsâ€™ hives are related to food than adult hives, making it more likely that kids will require allergy testing,â€ says Sarina Elmariah, MD, PhD, a board-certified dermatologist at Massachusetts General Hospital in Boston.
Sometimes Hives in Kids Do Require Immediate Care
Itâ€™s natural to worry if you see hives on your child. â€œThey can be really big welts, which can scare parents,â€ says Anthony M. Rossi, MD, an assistant attending dermatologist at Memorial Sloan Kettering Cancer Center in New York City.
Sometimes Hives in Kids Can Be Treated at Home
If that first hive isnâ€™t accompanied by the above symptoms, itâ€™s okay to treat the child at home. The main goal will be to help your child feel less miserable, because hives can be extremely itchy and uncomfortable. The hives themselves will usually go away on their own and wonâ€™t pose further risk to the child in the absence of those other symptoms.
To help quell the itch and provide some relief, the best defense is an over-the- counter antihistamine like Benadryl or Claritin. That should block or prevent the release of a chemical called histamine thatâ€™s largely responsible for the hive itself and the itching that accompanies it. Dosage is based on weight and age, so follow label instructions, Dr. Rossi says.
What to Know About Scratching
You should also prevent your child from scratching the hive. Itâ€™s a natural response, Dr. Elmariah says, but scratching can cause hives to break, putting your child at risk of infection. You can dress your child in clothes that cover the hives to prevent scratching. And one of the best itch busters is cold therapy: Place a cool washcloth or cold pack on the hives.
The American Academy of Dermatology recommends bathing your child in lukewarm water, limiting the bath to about 10 minutes and adding colloidal oatmeal to the water, which will further relieve itching. (2)
Do, however, avoid bubble baths and scented lotion. After bathing, moisturize your childâ€™s skin with a gentle cream or lotion. You might also want to dress your child in loose-fitting clothes and adjust the temperature in your house, as heat and cold in some cases can aggravate hives.
As youâ€™re doing this, take notes, which will come in handy if your child develops hives again. Write down what time you noticed the hive, what activities your child was doing, and what your child was eating over the previous day, which may help you identify a trigger, Rossi says. You should also note how you treated the hive, how your child responded to that treatment, and how long the hive lasted. If you think youâ€™ve pinpointed a potential trigger, make sure your child isnâ€™t exposed to that trigger again.
Pediatricians Can Help Identify Hives Triggers if They Keep Coming Back
If your child continues to get hives, make an appointment with your pediatrician. He or she will want to know the specifics about whatâ€™s been happening with your child, including what medications youâ€™ve tried and how theyâ€™ve worked; whether youâ€™ve been able to identify a trigger for the hives; and how often your child is getting hives. (3) You should also call your doctor if any single hive or welt lasts longer than 24 hours without changing.
Depending on what that information reveals, your pediatrician may send you to an allergist to test for a food allergy. Treatment may then include antihistamines, a doctorâ€™s first line of defense. For more involved cases of hives, the doctor may prescribe oral steroids like prednisone or simply treat an underlying illness, Woods says.
Hives can be an alarming condition to see on your child. But rest assured: â€œMost hives arenâ€™t dangerous and will resolve on their own,â€ Woods says.
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