When to See a Doctor for Hives
Hives: When Ontario Parents Need to Know It's Time to See a Doctor
Seeing red, itchy bumps pop up on your child's skin can be alarming, but most hives are harmless and go away on their own. The key is knowing when to watch and wait versus when to seek medical care.
What's going on?
Hives, also called urticaria, are raised, red or pink welts that appear on the skin. They're your child's immune system reacting to something it sees as a threat, whether that's food, medication, an infection, or even stress. The reaction causes cells to release histamine, which makes blood vessels leak fluid into the skin, creating those characteristic bumps.
Most hives in children are acute, meaning they last less than six weeks. They often show up suddenly and can be quite dramatic looking, but they're usually more bothersome than dangerous. Common triggers include foods like nuts, eggs, or shellfish, medications like antibiotics, viral infections, or even things like heat, cold, or pressure on the skin.
The good news is that hives are incredibly common. Up to 20% of people will experience them at some point, and children get them frequently as their immune systems encounter new things in their environment.
What you might notice
- Raised, red or pink bumps that can be small or large
- Intense itching that may worsen at night
- Welts that change shape, move around, or disappear and reappear
- Blanching when you press on them (they turn white temporarily)
- Swelling, especially around the eyes, lips, hands, or feet
- Bumps that come and go over hours or days
What helps at home
Cool compresses can provide immediate relief for itchy areas. Have your child take cool baths or showers, and pat their skin dry gently rather than rubbing. Loose, soft clothing prevents further irritation.
Antihistamines like children's Benadryl or Reactine can help reduce both the welts and the itching. Follow the dosing instructions on the package for your child's age and weight. Keep their fingernails short to prevent scratching, which can make hives worse or lead to infection.
Try to identify and avoid any obvious triggers, but don't stress if you can't figure out the cause. Most of the time, the trigger remains a mystery, and that's completely normal.
When to worry
Head to the emergency room immediately if your child has trouble breathing, wheezing, swelling of the face or throat, vomiting, or seems dizzy or confused. These could be signs of a severe allergic reaction called anaphylaxis.
You should also see a doctor or text Arlo if hives last longer than a few days, keep coming back, or if your child seems unwell with fever or other symptoms. If the hives are interfering with sleep or daily activities despite home treatment, it's time to get professional help. A healthcare provider can prescribe stronger antihistamines or other treatments to get your child comfortable.
The takeaway
Most hives look scarier than they actually are and will resolve on their own with some patience and simple home care. Trust your instincts, and don't hesitate to reach out for guidance when you need it.
You can always text Arlo and talk to a provider in 5 minutes!
References - [Hives (Urticaria)](https://caringforkids.cps.ca/handouts/health-conditions-and-treatments/hivesurticaria)
- [Hives](https://www.aboutkidshealth.ca/article?contentid=789&language=english)
- [Allergic Reactions and Anaphylaxis](https://caringforkids.cps.ca/handouts/health-conditions-and-treatments/allergicreactionsandanaphylaxis)