$Unique_ID{PAR00103}
$Pretitle{}
$Title{Medical Advice:  Hives}
$Subtitle{}
$Author{
Editors of Consumer Guide
Chasnoff, Ira J}
$Subject{Hives Raised red welts Itching calamine lotion cornstarch allergy
tongue coughing breathing difficulty swallowing fever strep throat culture
urticaria skin allergic reaction foods citrus fruits chocolate nuts peanut
butter tomatoes berries spices candies tropical fruits fruit juices artificial
food flavorings touch touched touching plant plants ointment ointments
cosmetic cosmetic dog cat pet saliva insect bite sting bites stings
overexposure sunlight cold temperatures inhale inhaled inhaling pollen mold
insecticide animal dander feathers erythema multiforme respiratory virus
viruses streptococcus bacterium bacteria rapid appearance change rapidly
arthritis antihistamines epinephrine venom}
$Log{}

Your Child:  A Medical Guide


Hives


     Quick Reference

     SYMPTOMS
     - Raised, red welts
     - Itching
     - Welts that change appearance rapidly

     HOME CARE
     - Use cold-water compresses, calamine lotion, and cornstarch baths to
       help relieve itching.
     - If hives are caused by an allergy, medication prescribed by the doctor
       can be given to the child when the hives appear.

     PRECAUTIONS
     - See the doctor if hives appear on the child's tongue.
     - See the doctor immediately if the child is coughing or has difficulty
       in breathing or swallowing.
     - If the child has hives accompanied by fever, the doctor will order a
       culture to check for strep throat.
     - If an allergic child's medication does not relieve the hives, call the
       doctor.


     Hives (also called urticaria) are an allergic reaction of the skin.
About 20 percent of children have hives at least once.  In about 95 percent of
cases, hives are caused by foods, beverages, or medications to which the child
is allergic.  Among the substances most likely to trigger a reaction are
citrus fruits, chocolate, nuts (including peanut butter), tomatoes, berries,
spices, candies, tropical fruits and fruit juices, and artificial food
flavorings.
     In the small proportion of cases of hives not caused by a food or
medication allergy, hives are caused by one of the following:  a substance
that the child has touched, such as a plant, ointment, or cosmetic, or the
saliva of a dog or cat; an insect bite or sting; overexposure to sunlight or
cold temperatures; or something the child has inhaled, such as pollen, mold,
insecticide, animal dander, or feathers.  One rarely seen form of hives,
erythema multiforme, is caused by respiratory or other viruses, by the
streptococcus bacterium, or by certain medications.

SIGNS AND SYMPTOMS

     Hives appear as itchy, red, raised welts that can range in size from a
quarter-inch to several inches across.  Hives can involve any area of the
skin.  The most noticeable characteristic of hives is that they change
appearance rapidly--they come and go and change in size from one hour to the
next.  Because no other type of rash has this characteristic, you can be
fairly certain that any welts that itch and change appearance rapidly are
hives.
     Sometimes an insect bite looks like a hive at the point of a bite;
however, it does not come and go as rapidly.  Hives that are triggered by
an allergic reaction to an insect bite appear at sites distant from the
bite itself.  Hives can also accompany allergic arthritis, which is signaled
by stiff, swollen, red joints.
     The form of hives known as erythema multiforme appears as welts that look
like red targets of different sizes painted on the skin.
     You can sometimes pinpoint the cause of your child's hives by considering
his or her activities in the minutes or hours before the hives appeared.

HOME CARE

     Unless the child has been given medication with instructions to take it
when the hives recur, home treatment of hives should be confined to measures
to relieve the itching.  Cold-water compresses, calamine lotion, and
cornstarch baths may help make the child more comfortable.  Frequent or
repeated cases of hives require medical attention.  Also, if the child has
been given medication but the medication fails to relieve the symptoms, you
should call the doctor.

PRECAUTIONS

  -  If hives appear on the tongue, make the child cough, or cause difficulty
     in breathing or swallowing, see your doctor immediately.
  -  If hives are accompanied by fever, see your doctor to rule out a strep
     infection.
  -  If antihistamines do not help relieve a case of hives, telephone your
     doctor for advice.

MEDICAL TREATMENT

     Your doctor may administer epinephrine to reduce the intensity of the
outbreak and then prescribe antihistamines to be taken by mouth.  If the hives
recur and it is not possible to pinpoint the cause, the doctor may order skin
tests or refer the child to an allergy specialist.  The doctor may also order
a throat culture to check for strep infection.  If the child shows symptoms of
arthritis, tests are necessary to confirm or rule out that possibility.  If
the hives are caused by an allergy to the venom released in an insect bite,
the doctor may suggest a long-term course of injections to decrease the
child's sensitivity to the venom; these shots may be given over a period of
years.  In the case of an allergy of this type, the doctor may prescribe a
medication to be taken in the event of a bite.

RELATED TOPICS:  Arthritis; Food allergies; Insect bites and stings; Rashes;
Strep infections