What to do if your kid gets hives

One itchy spot on your child's skin isn’t likely to make you speed-dial the doctor. However, if your child wakes up with red marks covering his body, or you notice blotches on his face after lunch, you’re right to worry—and want answers.

What are hives? Hives, or urticaria, are red raised welts on the skin. Individual hives may look like mosquito bites, but in large numbers, can resemble a rash. Fotini Kavadas, paediatric clinical immunologist and allergist at Alberta Children’s Hospital in Calgary, explains that hives occur when allergy cells in our body are attacked and release allergic chemicals called histamines. Hives can last for minutes, several hours or, in the case of chronic urticaria, can come and go for six weeks or more. They are typically itchy, but can also burn or sting.

Top triggers Hives have myriad causes, including allergies to food, medicine, animals, dyes or perfumes; physical forces, such as the skin being pressed or scratched; and viral infections (even the common cold). Heat, cold and emotional distress can also trigger hives, as Cari Mistry of Orangeville, Ont., knows all too well. “I have a five-year-old son who, since the age of two, has gotten hives from being upset,” she says. “If he’s crying wildly, he’ll break out on his face and torso.”

Sometimes there is a clear cause, but in other cases, figuring out why a child is getting hives can be extremely frustrating for parents. It took several years of hospital visits, medical specialists and allergy testing before Jenn Hatton, of Regina, Sask., was told that dyes in medications and fish were among the triggers of hives outbreaks in both her son and daughter.

What can you do? Before you see a doctor, Kavadas recommends documenting what your child was doing before the hives appeared. What did she eat? Have you changed shampoo or laundry detergent? Do you have a new pet?

“Hives typically go away once the allergen is removed,” explains Kavadas, “but antihistamines can be used to alleviate symptoms.” She cautions against over-the-counter antihistamines that cause kids to become drowsy: “Sleepiness is an indicator of a severe allergy, so these antihistamines can mask a more serious issue.” Try a non-sedating product instead.

Want to avoid medication entirely? Oatmeal baths and aloe vera or calamine lotion help with itching, though they don’t get rid of the hives. Prevention—identifying and removing the irritant—is ultimately the best medicine. As Mistry says, “Now that we know crying causes my son’s hives, we ‘treat’ them by helping him calm down.”

When to call for help If your child is wheezing, vomiting, sleepy, or his lips or eyes are swelling, call 9-1-1, as this may indicate an allergic reaction. “Let a medical professional make the decision about how severe things are,” says allergist Fotini Kavadas. A physician can prescribe an epinephrine auto-injector (EpiPen), which is an effective way of reversing a reaction.

Read more: 5 signs your child may have an allergy An age-by-age guide to skin rashes and conditions 6 tips for dealing with your kid’s eczema