Hives (also known as weals or wealing of the skin) are an allergic reaction to a food, drug, viral infection, insect bite or a host of other substances. When weals are accompanied by deeper swelling of eyelids, lips, hands and elsewhere this is called angioedema. Angioedema may occur with or without urticarial weals. Usually the cause is not found. Hives are not contagious.

Chronic WealingGiant Urticaria

AngioedemaAcute Urticaria

Hives are a very itchy rash. Raised pink spots with pale centers. The size range from 1/2 inch to several inches across and the shapes vary. Hives can also change location, size and shape rapidly.

More than 10% of children get hives. Most children who develop hives have it only once. The hives come and go for 3-4 days and then mysteriously disappear.

Hives are rarely caused by an allergic reation. Most allergies are mild, but very allergic individuals may develop serious anaphylactic shock within a few minutes of exposure. The most frequent causes are antibiotic injections, bee stings or ingestion of peanuts.

Anaphylaxis results in urticaria, a tight chest, wheezing (bronchospasm), faintness and collapse. Medical attention must be sought urgently. A subcutaneous adrenaline injection will usually be given - those prone to anaphylaxis should carry an emergency supply (an EpiPen®).

Most cases of urticaria are not due to allergy - histamine and other vasoactive chemicals can be released into the skin for many reasons. Urticaria can occur the first time that a person is exposed to the material.

A recent outbreak of hives accompanied by headache appears to be viral in nature and relieved by traditional methods of antihistamines and acetaminophen or ibuprophen for pain.

Treatment:

	The best drug is an antihistamine medicine. It won't cure the hives but will reduce their numbers and relieve the itching. Benadryl is a commonly used antihistamine and is over the counter. Give medicine regularly every 6-8 hours to keep your child comfortable until the hives go away.
	The Doctor may prescribe a steriod medication for hives that are recurring or not responding to antihistamines. Prednisone is a preferred steriod for hives. However, steriods should only be given for short periods of time - i.e. 4-6 days and tapering off for several more days.
	If your child has generalized urticaria, ask his/her doctor if a medicine could be the cause. Reduce intake of acidic fruits. Don't allow your child to eat foods or confectionery containing tartrazine (a yellow dye, numbered 102 in the list of ingredients on the container), or meats preserved with benzoates (210-220). Try not to let your child get overheated or too uptight. Cool the affected area with a cold cloth or ice pack.

Call your doctor if:

	Breathing becomes difficult
	Tongue becomes swollen
	Any abdominal pain occurs
	Your child starts acting very sick
	Hives that don't improve with antihistamine medicine
	A fever occurs
	The hives last more than 1 week
	Joint swelling occurs

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Hives (Urticaria)