Hives in children, also known as urticaria, are raised, itchy rashes on the skin that can occur anywhere on the body. It is a common disease that can be seen once in a lifetime in one in five people. Redness and swelling may subside in one area of the body, but may occur in another. Angioedema is swelling that occurs in the lower layers of the skin and can most often be seen in the eyes, lips and tongue.

What are the causes of urticaria (hives)?

Urticaria (hives) occurs with the release of a substance called histamine from the cells of the skin (mast cells). The most common cause of urticaria in childhood is infections caused by viruses. Less frequently, bacterial infections can also cause urticaria.

Medications are another common cause of urticaria. Penicillin and penicillin-like drugs, drugs used as pain killers and antipyretics can often cause urticaria.

Another cause of urticaria is food allergens. It should be kept in mind that urticaria, which occurs within 1-2 hours following the intake of foods such as milk, eggs, nuts, seafood and fish, which are known to cause food allergy, may also be a food allergy.

Insect stings can also cause urticaria.

What are the types of urticaria disease?

Recurrence of urticaria (hives) eruptions for 6 weeks is called acute urticaria, while this condition lasting longer than 6 weeks is defined as chronic urticaria. Chronic urticaria is divided into 2 types in itself. The first group is chronic spontaneous (spontaneous) urticaria and the second group is chronic stimulus (induced) urticaria. The types of urticaria that occur with chronic stimuli (induced) are as follows:

1) Dermographism:

It is the excessive response of the skin to simple stimuli such as pressure (such as trouser belt), scratching, and rubbing. It disappears within minutes with the removal of the causative agent. It is the most common type.

2) Acquired cold urticaria:

It is a type of urticaria that occurs after cold exposure such as cold air and cold drinks and is more common in women than in men. Widespread exposure to cold (such as immersion in cold water) can cause low blood pressure, shortness of breath, unconsciousness, allergic shock, and even death.

3) Heat-induced urticaria:

A rash lesion develops that is limited to areas of the skin that are exposed to heat. It is a rare type. Hives usually last 1-3 hours.

4) Delayed pressure urticaria:

They are swellings that occur in areas of the skin that are exposed to pressure. Unlike the rash seen in others of this type, it is a painful, itchy and burning rash that can occur hours after pressure exposure. It can go on for hours or even longer than 24 hours. Carrying a bag on the shoulder or on the back, sitting on a hard chair, tight shoes, carrying a heavy bag in hand can cause rashes.

5) Solar urticaria:

Solar urticaria usually occurs with UV-A. It is rare and more common in women.

6) Cholinergic urticaria:

Cholinergic urticaria occurs in situations that cause a sudden increase in body temperature (exercise/exertion, fever, hot bath, emotional stress, hot or spicy food and drink). It is common in young adults and during the winter period. It is more common in people with allergies and sensitive bronchi. Typically, they are short-lived, widespread, itchy, 5-6 mm needle point-like rashes.

7) Vibratory angioedema:

Angioedema occurs with local pulsation in this very rare type. It can occur during snoring or dental procedures.

8) Contact urticaria:

It is a rash of hives that appears suddenly after contact with the stimulant substance and regresses within a few hours. Common causes are plant components (stem, leaves), latex, cosmetics, industrial chemicals and textiles.

9) Urticaria caused by water (aquagenic):

After the skin comes into contact with water, sweat, and tears, 1-3 mm of swelling and 20-30 mm of redness occur around it. While these short-term rashes are usually on the trunk and arms, they are not seen on the soles of the feet and hands.

What are the symptoms of hives?

Hives are white-pink, raised skin rashes that occur very quickly, sometimes within seconds. It usually occurs in other body parts while the rash disappears without a trace in less than 24 hours. These raised rashes are intensely itchy and may sometimes be accompanied by a stinging and burning sensation. They are variable in size and sometimes large rashes involving the entire body may appear. Sometimes angioedema may accompany the hives or only angioedema may be seen. Angioedema is swelling of the tissues under the skin. It can disappear without a trace in 24-48 hours. It is most commonly seen on the face, tongue and lips.

What are Hives triggers in children?

The most common causes of acute urticaria (hives) in children are infections. It can be seen during infections with some bacteria or parasites, most commonly viruses. Among the drugs, antibiotics (especially those containing beta-lactam) and pain killers.

Hives appearing within 2 hours after ingestion of food (such as milk, eggs, nuts, fish, wheat) that are known to cause food allergy often suggest food allergy. Especially if it is accompanied by shortness of breath, vomiting, intense weakness, sudden sneezing, runny nose, it should be evaluated in terms of allergic shock.

Apart from these reasons, food additives (such as benzoate) or colorants (tartrazine) may cause it. Insect bites may also cause urticaria (hives) rash.

Hives lasting longer than 6 weeks can be spontaneous or may occur due to the hypersensitive structure of the skin (dermographism), cold, heat, pressure, sun exposure, cholinergic (due to increased body temperature), contact or water. Since urticaria lasting longer than six weeks may be present in the presence of autoimmune thyroid disease, rheumatological disease, the patient may need to be evaluated in these respects.

How is Hives treated in children?

The first thing to do in the treatment of urticaria (hives) is to eliminate the cause. In acute urticaria, treatment can be started without the need for examination. However, if it happened after food exposure, a test may be required in terms of food allergy. In chronic urticaria, your doctor asks questions about known triggers and performs a test (such as an ice cube test in cold urticaria). In the treatment of hives, allergy medications called anti-histamines are used. Depending on the severity of the complaints, high doses and more than one anti-histamine can be used.

If your child has persistent symptoms of urticaria or signs of allergic shock accompanying urticaria rash (such as shortness of breath, cough, vomiting, fainting), make an appointment with a pediatric allergist.