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HOW TO MANAGE HIVES IN CHILDREN

HOW TO MANAGE HIVES IN CHILDREN
Is your child itchy? Do they come out with a slightly risen rash? They may suffer from Hives. A hives rash may range from the size of a pinhead to that of a dinner plate. 

When hives first start to appear, they can be mistaken for mosquito bites as they are itchy. Swellings usually disappear within minutes however some will stay for an hour or so. In most cases, hives are not due to allergy and they can be effectively treated with a non-drowsy, over the counter antihistamine like Zyrtec or by cooling down in air-conditioning. The use of an ice pack can also be beneficial. If hives occur most days for more than six weeks, this is defined as chronic (ongoing) condition, which may require additional medication.

Top tips

  • Hives are common – up to 20 per cent of kids develop hives at some time during their life.
  • Hives can also cause deeper swellings in the skin and mucosa called angioedema. These swellings are often bigger, last longer, may itch less, sometimes hurt or burn and do not respond as well to antihistamines. This type of hives most frequently affects the face and lips.
  • Although hives and facial swelling can be super uncomfortable and a little embarrassing, it is important to remember that they are not dangerous.
  • In many cases, hives are not due to allergy. Contact allergy to plants or animals or even stress can also cause hives.
  • Ongoing hives lasting days at a time are almost never allergic in origin, with the exception of some cases of allergy to medicines. Stress is a very rarely the only cause of hives, but can make the symptoms worse. 
  • I do not endorse smacking children as it can cause allot of stress. Did you know that if you have a reactive child and you smack your child, they may create contact hives in the shape of your hand. 

Daniels Story with Chronic urticaria (CU)

Daniel first began to get an occasional small symptom from the age of three. By age 6, he was severe with multiple breakouts a day requiring a referral to a clinical immunologist, allergist. 

Sadly pin prick tests could not be completed on the day as stress also caused Daniels' hives to erupt so he has too many hives at the time of testing for there to be an accurate result. 

It was decided that Daniel be placed on an intensive 6  month intensive Zyrtec trial. The results of this trial was that Daniel may have hives for a minimum of ten years or perhaps forever. I did not worry too much about this as it did not seem to worry my easy going son too much. He has daily antihistamine and the odd trip to the school nurse (especially on hot days for an ice pack).  

We did eventually get that pin prick test though and discovered that Daniel is allergic to dust and most grass and we already knew that he was allergic to  lactose and soy. Although he tested negative to dog allergies, he does tend to break out in hives when he plays with our two dogs but he does not mind. Unlike CU in adults, in children this is rarely associated with autoimmune diseases and blood testing is not indicated in most cases. 

Treatment

  • Second generation antihistamines (desloratidine, cetirizine, loratadine and fexofenadine) can be given regularly if hives occur daily. It may be necessary to increase the daily dose for refractory rash under the supervision of your doctor as Daniel did. 
  • Diets – there is no evidence to suggest special diets have a role in managing children with acute or chronic hives. 
  • Air-conditioning or ice packs will ease the uncomfortable feeling. 

Prognosis

There is rarely any risk of a severe episode involving the breathing or circulation (anaphylaxis).If it’s not an emergency but you have any concerns, and you are in Australia then contact 13 Health (13 43 2584). Qualified staff will give you advice on who to talk to and how quickly you should do it.

In an emergency, always contact 000 for immediate assistance.
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