Home Child HealthCommon Health Problems Understanding Hives (Urticaria)

Understanding Hives (Urticaria)

by Dr. Shubhada Bichu
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Hives are itchy areas of swelling in the skin which typically appear as pink or red puffy spots (“welts”or “wheals”) on the skin. Itching is usually the most bothersome symptom of hives, and it may be severe enough to interfere with work and sleep

“Urticaria” is the medical term for hives.

Hives are a very common condition. About 20 percent of people have hives (Urticaria) at some time during their lives.

They can be different sizes, from very small to quite large and may be associated with swelling of the soft tissues of the eyelids, lips and tongue (angio-oedema)

Individual lesions are typically transient. They come and go within a few minutes to hours

Hives can appear anywhere on the body. It is common for young children with hives to also get swelling of the hands and feet. This can be uncomfortable, and may cause the child to avoid walking.

In over 80% of children, outbreaks of hives will end within 2 weeks. Occasionally hives will continue to break out for longer. The term “chronic urticaria” is used when the breakouts continue for longer than 6 weeks

Hives occur as a skin reaction to many different causes.

Types of Urticaria

Acute urticaria (lasts for less than 6 weeks)

In acute urticaria, a cause is identified in only about half of cases.

Possible triggers include:

  • Allergies: medication, foods. For young babies, in whom urticaria is rare, cow’s milk allergy is the commonest cause. As children grow up, they may react to different foods, including nuts, fruits or shellfish
  • Insect bites, stings
  • Viral infections.
  • Skin contact with chemicals, nettles, latex, etc.

Chronic urticarial (more than 6 weeks)

Subtypes of chronic urticaria are:

  • Chronic spontaneous urticaria. Triggers include medication, stress and infection.
  • Autoimmune urticaria This may account for half of all cases of chronic urticaria in adults and older children. There may be an association with other autoimmune conditions.
  • Inducible urticaria. Triggers include:
  • Contact with hot or cold water (aquagenic).
  • Exercise or emotion (cholinergic).
  • Exposure to cold or heat.
  • Firm rubbing, minor trauma (dermatographism)
  • Pressure
  • Vibration.
  • Sun exposure (solar)


Hives usually respond well to treatment, which includes medicines and avoiding whatever triggered the hives. If the hives last more than a couple of weeks or cause throat swelling, breathing difficulty or other problems contact your healthcare provider immediately

Avoid triggers — The first treatment for hives is to figure out what is triggering the hives and then avoid that trigger. Even if you cannot figure out the trigger, hives usually disappear over days or weeks.

Antihistamines — Antihistamines are medicines that can relieve itching. Most people with hives respond to antihistamines. A relatively high dose may be needed to control symptoms.

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