Hives in toddlers

What are the itchy, raised red patches on my toddler's skin?

Your child may have hives, also known as urticaria. It is sometimes referred to as welts, or wheals. Hives are raised, swollen areas on the skin that are very itchy. They may appear on any part of your child's body, and typically come and go for anything from a few hours, to a few days. Hives are common, particularly in young children (NHS 2010).

If your child has hives, her rash may begin as small raised patches, or wheals, which are about 1cm to 2cm wide. These wheals may be red or white, and will be surrounded by an area of redness. Later on, these wheals may join together with others, making the rash more extensive (CKS 2008).

See what hives look like in our rashes and skin conditions gallery.

Why does my toddler have hives?

Many cases of hives do not have an identifiable cause. When a cause is found viral infections are the most common, such as a cold or flu.

Or your child may have developed hives as a result of an allergic reaction to:

• Food, such as nuts, eggs, chocolate, citrus fruits, strawberries, shellfish, and food additives.
• Environmental allergens caused by irritants such as stinging nettles, plants, latex, and chemicals. If your toddler is allergic to cats, she may break out in hives when she strokes one.
• Medicines, in particular antibiotics and non-steroidal anti-inflammatory drugs, such as ibuprofen. This may happen about a week after your child has started a medicine for the first time, or during a subsequent course of the drug.
• Insect bites and stings. If your child is allergic to bees or some ants, for example, she may develop hives in reaction to being stung or bitten.
• Heat. Your child may break out in hives if she becomes overheated, such as after a particularly active play session or on a very hot day.
  (CKS 2008, NHS 2010)

Make a note of the time when the hives first appeared, how long they lasted, and any possible triggers you can think of. This will help your doctor to work out what has caused the hives. Though bear in mind that it's usually not possible to identify the cause (CKS 2008).

How should I treat my toddler's hives?

Hives often settle without the need for treatment. However, if your child's hives are particularly itchy or swollen, take her to your doctor. He may prescribe an antihistamine medicine to reduce the swelling and itching. If your child's hives are severe, she may need to take a course of corticosteroid tablets.

You can also try these treatments at home:

• Rub calamine lotion on her rash to soothe the itching.
• Keep her nails short and clean to minimise damage to her skin if she tries to scratch.
• Dress her in clothes made from natural fibres, such as cotton, to reduce any irritation to her skin.
• If you think certain detergents or skincare products may be making her condition worse, try alternatives. Non-biological washing liquid and mild cleansers and soaps are gentler on your child's skin.
  (CKS 2008)

Could having hives cause a problem for my toddler?

Hives that are caused by an allergic reaction can sometimes be an early sign that your child is having an anaphylactic reaction. Symptoms come on very quickly, and can be life-threatening.

Call 000 and ask for an ambulance immediately if your child has hives and develops other symptoms, such as:

• wheezing
• difficulty with breathing
• swelling of her lips, tongue and the lining of her mouth and throat
• a rapid heart rate
• skin that feels cold and clammy
• nausea and vomiting (NHS 2009)
• loss of consciousness