Urticaria in children

Urticaria, or urticaria, is a problem in which red, itchy, and swollen patches appear on the skin. It can develop as an allergic reaction to certain foods or medications. Although sometimes the cause may not be known. Blisters and rashes can vary in size from 2-3 mm to several centimeters in diameter. Urticaria may appear all over the body or only one part of the body.

Urticaria are red raised bumps or blisters on the skin. This is a common skin reaction to different types of allergens (substances that cause allergies). Spots can appear anywhere on the body and look like tiny spots, diffuse redness, or large bumps connected together. Individual blisters can last from a few hours to a week (sometimes longer), and new ones can replace those that disappear. Urticaria that persists for 6 weeks or less is called acute urticaria. Those forms that last more than 6 weeks are chronic urticaria.

What is urticaria

Urticaria (anaphylactic reaction) is the sudden appearance of red, itchy, and swollen patches on the skin. This condition often occurs as an allergic reaction to certain foods or medications. In some cases, the cause is unknown. Rashes can be of different sizes from microscopic dots to confluent spots. Urticaria may appear all over the body or only one part of the body.

Causes of hives in children

Although it is believed that hives are most often provoked by an allergic reaction, other factors are also relevant in addition to it:

• extreme temperatures;
• stress;
• infection;
• some diseases.

Occasionally, a child may have hives and angioedema, a condition that causes swelling around the eyes, lips, hands, feet, or throat. Very rarely, urticaria and angioedema are associated with an allergic reaction affecting the whole body or anaphylactic shock. Red hives blisters occur when mast cells in the bloodstream release the chemical histamine, which causes tiny blood vessels under the skin to leak. Fluid builds up inside the skin, forming patches and large blisters. This can happen for a number of reasons. But in many cases, the cause is never found.

Most often, hives are associated with an allergic reaction, which can cause a skin rash within minutes. Common causes of allergies include:

• foods, especially shellfish, peanuts and nuts, milk and fruits;
• medications (antibiotics) and allergy shots;
• pets and wild animals;
• pollen;
• bites and poisons, insect saliva.

Sometimes the appearance of hives has nothing to do with allergies. Other reasons include:

• infections, including viruses;
• exercises;
• anxiety or stress;
• sun exposure;
• exposure to cold, such as cold water or snow;
• contact with chemicals;
• combing (dermatography);
• strong pressure on the skin, for example, due to sitting too long or carrying a heavy backpack on the shoulder.

Urticaria caused by physical causes (such as pressure, cold, or sun exposure) is called physical urticaria. It is difficult to understand what causes chronic hives, although it is sometimes associated with an immune system disorder such as lupus. In other cases, drugs, food, insects, or infection can cause another outbreak. However, doctors often don’t know what causes chronic hives.

Symptoms of hives in children

Bright red raised blisters or plaques are the main sign of hives. The rashes can have a pale center, appear in groups, change shape and location in a matter of hours, and are tiny or as large as a plate in size. The rash provokes itching, tingling or burning.

Children may develop Quincke’s edema at the same time. It may cause swelling, patchy redness, swelling, or large bumps around the eyes, lips, arms, legs, genitals, or throat. Other symptoms may include nausea, vomiting, or abdominal pain.

Rarely, a person with hives and angioedema may experience anaphylactic shock. Signs of anaphylactic shock include trouble breathing, a drop in blood pressure, dizziness, or loss of consciousness (fainting).

Treatment of urticaria in children

Urticaria can be diagnosed by the child’s doctor. Your doctor will first take a complete medical history and perform a physical examination.

Diagnostics

In most cases, a doctor can diagnose hives simply by looking at the skin. To find the cause, parents may be asked questions about the child’s medical history, recent illnesses, medications, exposure to allergens, and everyday stressors.

If a child has chronic hives, the doctor may ask parents to keep a daily record of activity, such as what the child eats and drinks and where the rashes tend to appear on the body. Diagnostic tests—such as blood tests, allergy tests, and tests to rule out conditions that can cause hives, such as thyroid disease or hepatitis—help determine the exact cause of hives.

To test for physical hives, the doctor may apply ice to the child’s skin to see how they react to cold, or place a sandbag or other heavy object on their thighs to see if pressure will cause hives.

Modern methods

Your child’s doctor will determine the best treatment for your child based on:

• How old is the child;
• what is your general health and medical history;
• how pronounced is the urticaria;
• how well the child tolerates certain medications, procedures, or treatments;
• how long the condition will last;
• your opinion or preferences.

The best treatment for a child is to avoid known triggers. If the urticaria was caused by a drug, that drug should be avoided. Your child’s doctor may also prescribe:

• antihistamines such as diphenhydramine or hydroxyzine;
• other antihistamines that do not make the child drowsy, such as cetirizine or loratadine.
• if the baby has trouble breathing, the allergist may use an adrenaline shot to reduce swelling and itching, and your child’s doctor can show you how to use an adrenaline first aid kit to keep near your child in case of future attacks.

Prevention of urticaria in children at home

In many cases, mild hives do not require treatment and will go away on their own. If a specific trigger is found, eliminating it is part of the treatment. If your hives are itchy, your doctor may recommend an antihistamine medication to block the release of histamine into your bloodstream and prevent a rash.

Popular questions and answers

Answered popular questions about childhood urticaria allergist-immunologist Olesya Ivanova.