Hives in toddlers

My toddler has itchy raised red patches on her skin. What could it be?

Your toddler could have hives. Hives are raised, swollen areas on her skin that are very itchy. Hives may appear on any part of your toddler's body, and may come and go for anything from a few hours to a few days. They are also known by the medical term, urticaria.

If your toddler has hives, her rash may develop in the following way:

• Small raised patches, known as wheals, about 1cm to 2cm wide, that develop suddenly.
• These wheals can be red or white, and are itchy and surrounded by an area of redness.
• Wheals may join together with others making the rash look extensive (CKS 2008).

Hives are common, particularly in young children. See a photo of hives in our rashes and skin conditions gallery.

Why does my toddler have hives?

The most common cause of hives in young children is a viral infection, such as a cold or flu.

Your toddler can also develop hives as a result of an allergic reaction to something. Your toddler may have had a reaction to:

• Food, such as nuts, eggs, chocolate, citrus fruits, strawberries, shellfish and food additives.
• Environmental allergens caused by irritants such as plants, latex and chemicals. Toddlers who have developed an allergy to cats or dogs may also break out in hives when stroking a pet.
• Medicines, in particular antibiotics and non-steroidal anti-inflammatory drugs such as ibuprofen.
• Insect bites and stings. If your toddler is allergic to bees or red 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 your toddler's hives started, how long they has lasted, and any possible triggers you can think of. This will help your doctor to work out what has caused your toddler's hives. However, it's not possible to identify the cause for most cases of hives (CKS 2008).

How can I treat my toddler's hives?

Your toddler's hives may go on their own in a few hours or days. However, if your toddler's hives are particularly itchy or swollen, take her to your doctor. Your doctor may prescribe an antihistamine medicine to reduce the swelling and itching. If your toddler has very bad hives, she may also need a course of corticosteroids.

You can also try some treatments at home:

• Rub some calamine lotion on her rash to soothe the itching.
• Keeping your toddler's nails short and clean to minimize damage to her skin if she tries to scratch.
• Dress your toddler in clothes made with natural fibres, such as cotton, to reduce any irritation to her skin.
• If you think certain detergents or skincare products may be making your toddler's condition worse, try alternatives. Mild baby cleansers and soaps may be softer on your toddler's skin (CKS 2008).

Can hives cause any complications?

Hives that are caused by an allergic reaction can sometimes be an early sign that your toddler is having an anaphylactic shock. Symptoms come on very quickly and can be fatal.

Call 911 immediately, if your toddler has hives and develops other symptoms such as:

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