Children's Hospital Colorado

Hives

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

Symptoms of Hives

  • 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 and location of hives can be different. They can also change frequently.
  • Itchy rash

Causes of Widespread Hives

  • Viral Infection. The most common cause of hives all over the body is viral infections. Research has confirmed this. Other symptoms such as a fever, cough or diarrhea are also present. The hives may last 3 days. This is not an allergy.
  • Bacterial Infection. Some bacterial infections can also cause hives. A common example is Strep. Hives are also seen with bladder infections. (UTIs)
  • Drug Reaction. An example is a penicillin rash. Most rashes that start while taking an antibiotic are viral rashes. Allergy tests are normal 90% of the time. Only 10% turn out to be a drug allergy.
  • Food Reaction. May be an allergy or a coincidence. If the food is a high risk one (such as peanuts), consult an allergist. Hives from foods usually resolve in 6 hours. Hives from infections last for days. Only 3% of hives are due to a food.
  • Bee Sting. Widespread hives after a sting may be part of a serious allergic reaction. Need to consult an allergist.
  • Anaphylactic Reaction (Very Serious). The sudden onset of hives with trouble breathing or swallowing. This is a severe allergic reaction to an allergic food or drug. Most often begins within 30 minutes of swallowing the substance. Always within 2 hours of exposure.
  • Unknown. Over 30% of the time, the cause of hives is not found.

Causes of Localized Hives

  • Irritants. Hives just in one spot are usually due to skin contact with an irritant. They are not an allergy.
  • Plants. Many plants cause skin reactions. Sap from evergreens can cause local hives.
  • Pollen. Playing in the grass can cause hives on exposed skin.
  • Pet Saliva. Some people get hives where a dog or cat has licked them.
  • Food. Some children get hives if a food is rubbed on the skin. An example could be a fresh fruit. Some babies get hives around their mouth from drooling a new food.
  • Insect Bite. Local hives are a reaction to the insect's saliva. Can be very large without being an allergy.
  • Bee Sting. This is a reaction to the bee's venom. Can be very large without being an allergy.
  • Localized hives are not caused by drugs, infections or swallowed foods. These get into the bloodstream and cause widespread hives.

Call 911 Now

  • Hives and life-threatening allergic reaction to similar substance in the past and exposure less than 2 hours ago
  • Trouble breathing or wheezing
  • Hoarse voice or cough start suddenly
  • Trouble swallowing, drooling or slurred speech start suddenly
  • You think your child has a life-threatening emergency

Go to ER Now

  • Hives start within 2 hours after a bee sting

Call Doctor Now or Go to ER

  • Hives start after eating a high-risk food. High-risk foods include nuts, fish, shellfish, or eggs.
  • Hives started after taking a prescription medicine
  • Age under 1 year with hives all over
  • Your child looks or acts very sick
  • You think your child needs to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • Hives started after taking an over-the-counter medicine
  • Severe hives (such as eyes swollen shut or very itchy)
  • Fever or joint swelling is present
  • Stomach pain or vomiting is present
  • You think your child needs to be seen, but the problem is not urgent

Call Doctor During Office Hours

  • Hives make it hard to go to school or do other normal activities. (Note: Taking Benadryl for 24 hours has not helped)
  • Food could be the cause
  • Had hives 3 or more times and the cause is not clear
  • Hives last more than 1 week
  • You have other questions or concerns

Self Care at Home

  • Hives with no complications

Care Advice for Hives

  1. Hives Only on One Part of the Body - What You Should Know:
    • Most are caused by skin contact with an irritant. Examples are plants, pollen, food or pet
      saliva.
    • Localized hives are not caused by drugs, infections or swallowed foods. They are also not an allergy.
    • 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.
  2. Hives All Over the Body - What You Should Know:
    • Over 10% of children get hives 1 or more times.
    • Most widespread hives are caused by a viral infection. This is not due to an allergy. Less than 10% are an allergic reaction to a food, drug, or insect bite. Often, the cause is not found.
    • Here is some care advice that should help.
  3. 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.
  4. 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.
  5. 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.
  6. Wash Allergens Off Body:
    • Give a bath or shower if caused by pollens or animal contact.
    • Change clothes.
  7. Stay Away from Allergens:
    • 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.
  8. 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.
  9. 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.
  10. 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

Care Advice for Hives

Hives on the Back
  • Hives is an itchy rash.
  • The shapes of hives are variable. Sizes of hives vary from ½ inch to several inches across.
  • Hives may disappear in one area and then reappear somewhere else, over the course of several hours.
Hives on the Abdomen
  • Hives is an itchy rash.
  • The shapes of hives are variable. Sizes of hives vary from ½ inch to several inches across.
  • Hives may disappear in one area and then reappear somewhere else, over the course of several hours.

Disclaimer

The information contained in these topics is not intended nor implied to be a substitute for professional medical advice, it is provided for educational purposes only. You assume full responsibility for how you choose to use this information.

Always seek the advice of your physician or other qualified healthcare provider before starting any new treatment or discontinuing an existing treatment. Talk with your healthcare provider about any questions you may have regarding a medical condition. Nothing contained in these topics is intended to be used for medical diagnosis or treatment.

  • Not a Substitute - The information and materials in Pediatric HouseCalls Symptom Checker should not be used as a substitute for the care and knowledge that your physician can provide to you.
  • Supplement - The information and materials presented here in Pediatric HouseCalls Symptom Checker are meant to supplement the information that you obtain from your physician. If there is a disagreement between the information presented herein and what your physician has told you -- it is more likely that your physician is correct. He or she has the benefit of knowing your child's medical problems.
  • Limitations - You should recognize that the information and materials presented here in Pediatric HouseCalls Symptom Checker have the following limitations, in comparison to being examined by your own physician:
    • You can have a conversation with your child's doctor.
    • Your child's doctor can perform a physical examination and any necessary tests.
    • Your child could have an underlying medical problem that requires a physician to detect.
    • If your child is taking medications, they could influence how he experiences various symptoms.

If you think that your child is having a medical emergency, call 911 or the number for the local emergency ambulance service NOW!

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