If your child has an itchy rash that consists of raised red bumpy areas, perhaps with pale centers and no flaking skin over the lesions, he probably has hives. This rash may look like mosquito bites, and can occur all over the body or just in one region, such as the face. The location may change, with the hives disappearing in one area of the body and appearing in another, often in a matter of hours.
Among the most common causes of hives are:
- Response to an infection, most commonly a virus
- Foods (most commonly peanuts, tree nuts, egg whites, milk, shellfish, and sesame)
- Medications, either over-the-counter or prescription
- Bites or stings from bees or other insects
In at least half of the cases, it is not possible to identify the cause.
An oral antihistamine should relieve or at least help reduce the itching of hives. It can be obtained without a prescription. You may need to use this type of medication for several days. Some of this medicine may need to be given to your child as often as every four to six hours while others can be given once or twice a day. Applying cool compresses to the area of itching and swelling also may help.
Other treatments may be necessary if internal parts of the body are involved in the allergic reaction. If your child is wheezing or having trouble swallowing, seek emergency treatment. The doctor usually will prescribe a more effective antihistamine and may even give an injection of epinephrine to stop the allergic response. If the allergy causing the hives also results in severe breathing difficulties, your pediatrician will help you obtain a special emergency injection kit containing epinephrine for possible use at home, in child care, or at school, in case of such reactions in the future.
In order to prevent subsequent outbreaks of hives, your doctor will try to determine what is causing the allergic reaction. If the rash is confined to a small area of skin, it probably was caused by something your child touched. (Plants and soaps are frequent culprits.) But if it spreads all over her body, something she ingested (a food or medication) or possibly an infection is most likely to blame.
Often the pattern to the appearance of the hives provides a clue to the allergy. For example, does it usually happen after meals? Does it seem to occur more during certain seasons, or when traveling to particular places? If you discover a specific pattern, alter your routine to see if your child improves. Sometimes hives will occur if your child eats an unusually large amount of a food to which she is only mildly allergic. If you discover the cause of the problem, try keeping your child away from it as much as possible.