ADVERTISEMENT
Hives Are Very Common in Kids, Too. Here’s How to Manage Them
Parents should know that given the high incidence of hives in kids, it’s likely they’ll see hives on their child at least once. But don’t panic. “Acute urticaria [the type that lasts less than six weeks and may even just be a one-time deal] is more common in the young [than chronic urticaria],” says Meghan Feely, MD, a board-certified dermatologist in private practice in New York City and New Jersey and a clinical instructor in the Mount Sinai Department of Dermatology in New York City.
Numerous triggers and allergens can cause hives in kids, but food in particular is a common one for kids, especially if they’re allergic to milk, eggs, peanuts, wheat, or soy. You may not even know they’re allergic to something until their first hive appears, especially if it’s accompanied by an allergic reaction called anaphylaxis, which requires emergency care.
Fortunately, most hives in kids can be treated at home with over-the-counter medication, and most hives in kids go away without much need to do anything. But if the hives continue, you’ll want to schedule an appointment with your pediatrician, who may request food allergy testing. Just make sure you’re taking good notes about the hive incidents, which will help the doctor treat and manage the issue.
Prevention of Hives
Hives can be prevented to some degree, but only if you know what’s triggering them for you. “If you can identify your trigger, the best prevention strategy is to avoid that particular trigger (or, in some cases, triggers),” Friedman says
Not sure what your trigger is? After your first hive, write down everything you did, including what you ate and what activities you participated in over the previous 24 hours. If you get another hive, repeat the process and see if you spot any similarities.
Once you’ve identified your trigger, you’ll want to take every precaution to avoid it. But in cases where there is no trigger or a trigger hasn’t been identified, your doctor will work with you to determine how to keep hives from continuing to appear. For some people, taking antihistamines or other medications regularly may be the best course of action. (7)
Hives can be an extremely frustrating condition to deal with, and the longer you have them, the more frustrated you may get. Fortunately, though, with the right treatment, you can get those hives under control.
Complications of Hives: Chronic Hives and Others
Have you struggled with hives that come and go for six weeks or more? You’ve got what experts call chronic hives, and they can be exhausting — especially because they can cause changes in your sleep, performance at work or school, and social life. “The impact chronic hives can have on somebody’s quality of life is well studied,” Friedman says.
While many of the triggers are the same as acute hives (ones that completely clear up in six weeks or fewer), chronic hives have several different causes, including autoimmune issues and long-standing infections. In some cases, you might have to undergo extra testing to determine the cause — and unfortunately in many cases, a definitive cause will not be identified. (4)
The good news is that while treatment generally starts in the same manner as for acute hives, doctors do have additional medications and, in some cases, tests they can use to help diagnose and treat chronic hives. You’ll just have to make sure you put patience on your side, as it can often take several years for improvements to happen.
Other potential (but rare) complications of either acute or chronic hives can include:
- Angioedema
- Anaphylaxis (which technically is a complication that can happen in tandem with rather than because of hives, but can be life-threatening)
- Anxiety
- Depression
Research and Statistics: How Common Are Hives?
About 1 in 5 people will experience hives at some point in their lives. (1) And more than 10 percent of children will experience hives at least once. (6)
About 1 in 20 people will experience chronic hives, which are episodes that last for more than six weeks. (10) About half of people with chronic hives still have them after antihistamine treatment. (7) And for about half of cases, the trigger of chronic hives is unknown. (4) Twenty percent of chronic hives patients suffer for more than five years. (11) Chronic hives are more common among women than men. (12)
Much of the research surrounding hives in the past couple of years has focused on the effectiveness of omalizumab (sold under the brand name Xolair). It’s an anti-immunoglobulin E antibody that was somewhat recently approved as a treatment option and is available by prescription. It’s now recommended to treat chronic hives. (13)
Other studies from the past two years include:
- A 2019 study found that tests intended to diagnose or assess chronic hives rarely shed light on what’s causing the issue, though they significantly increase financial costs. (14)
- A 2018 study explored the diets of people with chronic spontaneous urticaria and how food can exacerbate certain symptoms. The researchers found that food typically is not the trigger for chronic hives, even though many patients think it is. (15)
- Another 2019 study found that autoimmunity and autoallergy antibodies can lead to the development of chronic spontaneous urticaria and predispose people to developing other autoimmune diseases. The researchers also found that patients with the autoallergy antibody seem to respond more quickly to omalizumab than those with autoimmunity issues. (16)
- New treatment options, including infusions, topical treatments, and oral ones, are being explored to treat chronic hives patients who have not responded to current treatments. (11)
Much of the research that’s currently being done regarding hives involves testing whether certain medications are effective treatment options, such as fenebrutinib, AK002, UB-221, ligelizumab, and dupilumab. (17)
Finally, researchers are also exploring how vitamin D levels among hives patients compare with those of others and how vitamin D supplementation affects the severity of hives. (17)
Conditions Related to Hives
Hives can sometimes be a symptom of or be mistaken for other skin problems. Similarly, certain conditions and other things can trigger hives. The following are related to hives for at least one of these reasons:
- Allergies Acute hives (hives that go away quickly) oftentimes occur as part of an allergic reaction. The trigger could be certain foods, medicines, fabrics, pollen, animals, or insect bites. They can appear anywhere on the body. Sometimes they’ll appear within minutes of exposure to the allergen, and other times they may not appear until hours later. (3)
- Exercise Some people experience hives during physical activity. Exercise-induced hives are oftentimes accompanied by flushed skin, itchiness, and difficulty breathing. (18)
- Psoriasis This common skin condition results in red patches in areas where skin cells build up. The irritated area might look like hives, but one way to tell between them is to look for silvery scales on the skin, which is a feature of psoriasis, but not hives. (19)
- Stress Stress can sometimes manifest itself as hives on the body. (3) If you’ve experienced hives as a result of allergies, you’re more likely to see them pop up during stressful times. (20)
- Cellulitis This potentially serious bacterial infection is marked by red, swollen skin that feels warm and painful. Be careful not to brush off symptoms of cellulitis as hives. Cellulitis can become life threatening if left untreated. Be on the lookout for a fever and a rash that’s spreading quickly. (21)
- Irritated Skin A mild case of hives will look very similar to irritated skin. How can you tell the difference? Track how long the irritation sticks around. Hives usually go away within 24 hours, though new hives may take their place. (22)
- Eczema Eczema, a chronic skin condition that generally begins at infancy, also can be mistaken for hives. A key difference is where the rash appears. Eczema tends to occur on the face, elbows, and knees and may look scaly, whereas hives can occur anywhere on the body. (23)
- Rosacea Rosacea typically appears on the face and looks a lot like acne. The red bumps are different from hives in that they may contain pus, and your skin may feel warm and tender. (24)
More than 50 percent of cases of chronic hives are believed to occur alongside an autoimmune disease. (25) The following autoimmune diseases can trigger chronic hives:
- Type 1 Diabetes Long-lasting chronic hives could be an early indicator of type 1 diabetes. (26)
- Lupus It’s not very likely, but lupus can cause hives, possibly because of the existence of certain antibodies, sunlight, or response to some medications. Hives typically will go away within 24 hours, but if they last longer, it could be a condition called urticarial vasculitis. (27)
The Takeaway
Hives are an extremely common immune response that can affect anyone, developing in around 1 in 5 people at some point. Hives appear as red or skin-colored welts that feel itchy, annoying, and occasionally painful.
Keeping track of what might trigger hives for you — including (but not limited to) stress, certain foods, animals, or medications — can be key in preventing them. Hives often last 24 hours, so an OTC antihistamine or cold therapy can help, but see a doctor about long-lasting or multiple hives along with breathing problems, as they may need to prescribe a steroid medication.
