Urticaria - Hives (Children)

Urticaria, commonly known as hives, are itchy rashes characterised by redness and swelling of the skin. These rashes may resemble mosquito bites of varying size.

When rashes develop around loose tissue such as the eyes or lips, the affected area may swell too. This reaction is called angioedema as shown in the images below.

Urticaria can be categorised into acute and chronic. Acute urticaria is the most frequent type of urticaria seen in children and each episode lasts for less than six weeks. During this period, the urticaria may increase and decrease in size and travel to different areas of the body. Chronic urticaria lasts for more than six weeks.

Urticaria is common and up to 20% of people will develop an episode during their lifetime.

The most common cause of acute urticaria is viral infection. Urticaria may also appear due to food or drug allergy. It is rarely related to physical agents (cold, pressure, sweat or sunlight).

Chronic urticaria can occur in both children and adults. The cause cannot be identified in the majority of the cases. Rarely, it may occur when the body’s immune system is reacting against itself. Chronic urticaria usually resolves over time - in six months for most cases.

If your child present with urticaria, bring your child to see a doctor immediately if:

• The urticaria is painful or does not fade.
• The urticaria is associated with swelling of the throat or difficulty in breathing.
• There is a loss of consciousness.
• You suspect a specific trigger and want to perform tests to confirm it.

Tests are usually not required for Urticaria. However, some children may require skin or blood tests if there is a suspicion of a trigger or an underlying illness.

Antihistamines are the treatment of choice for urticaria and are used to relieve the itch.

Non-sedating antihistamines are first-line medicine and can decrease the number of urticarial lesions, the frequency of flare ups and diminish itchiness. Sedating antihistamines can also be used. However, they can cause sleepiness and loss of alertness. They are useful at bedtime especially when combined with a non-sedating antihistamine during the day.

Prednisolone (steroids) are usually not indicated.

Please consult a doctor for a proper diagnosis before administering medication.