Bumpy Red Rash – Could it be hives?

WHAT ARE HIVES?

Hives are red or white raised welts on the skin.  They are caused when our body reacts to something and releases an “allergic” chemical called histamine.  They often seem to appear out of nowhere and may initially look like mosquito bites but  then can spread.  Interestingly, each welt usually only lasts up to a few hours, then disappears.  However, new ones may develop in a new location and this can go on for minutes, several hours, or months! They usually last 1-2 days.  They are typically itchy, but can also feel like burning or stinging.

Hives

TOP TRIGGERS

  1. Infection: Most commonly, hives appear as a response to a viral illness.
  2. Foods: Common foods being shellfish, nuts, berries, fish, eggs, milk
  3. Medications: Has your child taken any new medications in the last 24 hours?
  4. Environmental: perfumes, dyes, detergents or grass, trees, etc.
  5. Other triggers can include scratching or pressure on the skin, heat, cold, or even emotional distress.

Unfortunately  most of the time we are unable to know for sure what the trigger was.  Although frustrating,  hives generally resolve by themselves, and so it is not necessary to do testing for allergies unless hives start to become a recurrent or chronic problem.

HOW SHOULD I TREAT IT?

  1. If there is a clear cause, then the trigger should be removed and the hives will typically go away by themselves
  2. Antihistamines can help alleviate the symptoms.  The first dose is important.  You don’t need to continue giving the medication if there are only a few spots and they are not bothering your child.
    1. Parents are often surprised to know that Benedryl is not the only option for children.  There are other options that cause less drowsiness and lasts for about 24 hours.  Aerius Kids and Claritin Kids are two examples which are approved in Canada for children 2 years and older.
  3. Stop the itch! The good thing is that hives usually go away on their own even without treatment. To help with the itching, you can try oatmeal baths, aloe vera, or calamine lotion.

WHEN SHOULD YOU WORRY?

Hives on their own are not serious.  If your child has other signs of a severe allergic reation such as throat tightening, wheezing, difficulty breathing, acting progressively sicker, vomiting, pale and clammy,  or lightheadness then you should go to the emergency department.  The location of the hives or the severity of the hives have no correlation to the severity of an internal allergic reaction.  For example,  hives on the face does not increase the possibility of your child’s throat being affected.



Categories: Ask A Pediatrician, Skin

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