Main Symptoms

  1. Raised pink bumps with pale centers (welts)
  2. Hives look like mosquito bites
  3. Sizes of hives vary from 1 inch to several inches across
  4. Shapes of hives are also quite variable
  5. Location, size, and shape change rapidly and repeatedly
  6. Itchy rash
  7. Main Cause: reaction to a viral infection
  8. Other Common Causes: widespread hives can be an allergic reaction to a food, drug, infection, insect bite, or other substances
  9. Localized hives are usually due to skin contact with plants, pollen, food or pet saliva. Localized hives are not caused by drugs, infection or swallowed foods
  10. A severe allergic reaction is called anaphylaxis

See More Appropriate Topic

  1. If doesn't look like hives, see RASHES WIDESPREAD AND CAUSE UNKNOWN
  2. If it's probably mosquito bites, see INSECT BITES

Call 911 Now (your child may need an ambulance) (for symptoms of anaphylaxis) If

  1. Difficulty breathing or wheezing
  2. Hoarseness or cough with rapid onset
  3. Difficulty swallowing or slurred speech with rapid onset
  4. Severe allergic reaction in the past to similar substance and hives present < 2 hours

Call Your Doctor Now (night or day) If

  1. Your child looks or acts very sick
  2. Hives began after a bee sting, unusual food or medicine and no previous reactions

Call Your Doctor within 24 Hours (between 9 and 4) If

  1. You think your child needs to be seen
  2. Severe hives (eyes swollen shut, very itchy, etc.) not improved after 2nd dose of Benadryl
  3. Fever, abdominal pain or joint swelling is present

Call Your Doctor during Weekday Office Hours If

  1. You have other questions or concerns
  2. Hives interfere with school or normal activities after taking Benadryl every 6 hours for more than 24 hours
  3. Unexplained hives have occurred 3 or more times

Parent Care at Home If

  1. Hives with no complications and you don't think your child needs to be seen

Home Care Advice for Hives

  1. Localized Hives: For localized hives, wash the allergic substance off the skin with soap and water. If itchy, massage the area with a cold washcloth or ice. Localized hives usually disappear in a few hours and don't need Benadryl
  2. Benadryl: Give Benadryl 4 times per day for widespread hives that itch. (See Dosage chart) (Note: if you only have another antihistamine at home, use that)
    1. Contraindication: Do not give Benadryl if your child weighs less than 20 pounds, instead give your doctor a call for advice
    2. Continue the Benadryl 4 times per day until the hives are gone for 12 hours
  1. Cool Bath: Give a cool bath for 10 minutes to relieve itching. (Caution: avoid any chill) Rub very itchy areas with an ice cube for 10 minutes
  2. Remove Allergens: Give a bath or shower if triggered by pollens or animal contact. Change clothes
  3. Avoid Allergens: If you identify a substance that causes hives, help your child avoid that substance in the future
  4. Contagiousness: Hives are not contagious. Your child can return to day care or school if the hives do not interfere with normal activities
  5. Expected Course: Hives normally come and go for 3 or 4 days, then disappear. Most children get hives once
  6. Call Your Doctor If
    1. Severe hives persist after 2nd dose of Benadryl
    2. Most of the itch is not relieved within 24 hours on continuous Benadryl
    3. Hives last > 1 week
    4. Your child becomes worse or develops any of the "Call Your Doctor" symptoms