My child has hives

Rash is relatively common in kids as they grow. While there are many types of rashes, one rash that can be seen as kids grow is hives. Hives (or urticaria), will often go with swelling of skin/membranes such as fingers, lips, around eyes.

When hives results in our kids or in adults, the assumption might be made that it represents an allergic reaction of some type. This is definitely not the case. Below are some believed causes of hives (however not an exhaustive list).

Infection - The most common reason of kids to get acute hives, meaning the hives last less than 6 weeks, is related to infection. In most cases no testing is needed if hives last less than 6 weeks. 2nd generation antihistamines such as cetirizine are a good option for run of the mill hives.

Food – Food should usually not be suspected as a cause of hives, unless hives result within 1 hour after eating the food. There are exceptions to this, and an allergist can be consulted if there is concern.

Environmental allergens – Animal saliva can cause hives in patients. If other environmental allergens are indeed involved in hives, such as pollen, dust mite, animal or mold allergy, I would expect some rhinitis symptoms to be present around the time of hives to make the involvement of these allergens seem more reasonable. These symptoms could include sneezing, runny nose, nasal congestion, itchy nose, post nasal drainage.

Drugs – If you/your kid started a new medication around the time of hives, this would be an important piece of information and should be discussed with a health care professional.

Contact allergy – Allergy to chemicals coming in contact with skin is thought to be a potential cause of hives. I generally expect this rash to look more like an eczema-like rash than hives, however consideration to look for this type of allergy with patch testing could be discussed with an allergist.

Anaphylaxis (severe allergic reaction) – can cause hives, however other sign(s) or symptom(s) would be required for anaphylaxis to be diagnosed.

Autoimmune related hives - hives could be related to autoimmune conditions such as lupus or rheumatoid arthritis, however I would have more concern for this being the case if atypical symptoms were present, such as joint pain, muscle aches, or painful hives.