Hives in Children: When to Worry

There are many types of skin rashes that can appear on all types of skin, at any age. Among the most worrisome for parents, is the skin rash called urticarial, also known as hives. Hives are caused by an allergic reaction within the body. Since this skin rash usually comes on suddenly and includes areas of swelling in the skin, many parents are alarmed. However, it should put your mind at ease that as long as your child is not exhibiting signs of severe allergic reaction, there is no need to rush to the ER.

Hives appear as red or white, raised welts on the skin. They can show up suddenly and spread quickly. You are likely to see hives on your child’s chest, tummy and back, but they can appear on the arms, legs and face occasionally. When your child has an allergic reaction, such as food, an external irritant, medication, extreme temperature, illness or even stress, their body releases histamine under the skin. This histamine release causes the skin to swell in large patches or welts. A very distinct characteristic of hives is that each welt will often come and go over a period of 10 to 15 minutes or as long as a few hours. Hives usually itch, but not always.

Should you worry? If your child has the hives rash but otherwise seems fine, there is typically no need to be concerned. An initial dose of Benadryl (or antihistamine) is recommended to lessen the reaction and buy you some time in case other allergic reaction symptoms start occurring. Signs that your child’s hives warrant an immediate call to the doctor or a trip to the ER include:

  • Throat tightness
  • Wheezing
  • Breathing difficulty
  • Extreme weakness or lightheadedness
  • Significantly pale
  • Persistent vomiting

If you are unsure that your child’s rash is in fact hives, a dermatologist can help you. Olansky Dermatology Associates specializes in the many skin rashes that children experience. They will not only diagnose your child’s rash but they can also offer ways to treat hives and eliminate any allergens that are causing the hives.