What is urticaria?
Urticaria (hives) are itchy, raised, red or skin-coloured wheals caused by histamine release in the skin. Individual wheals typically fade within 24 hours but new ones can keep appearing, giving the impression the rash is 'moving.' Deeper swelling of the lips, eyelids or face is called angioedema and can accompany hives.
Acute vs chronic
Acute urticaria (lasting under 6 weeks) is often triggered by a viral infection, a food, a medicine, or occasionally an insect sting. Chronic urticaria (lasting 6 weeks or more, most days) is less often linked to a single food allergen and more often needs a broader medical work-up.
Common triggers in children
- Viral infections — the most common cause of acute hives in children
- Specific foods in a minority of cases
- Insect stings
- Certain medicines (notably some antibiotics)
- Physical triggers — heat, cold, pressure, sweating, in some children
Diagnosis
A careful timeline of the episode, associated illness, recent food or medicine intake and physical triggers guides diagnosis. Skin prick testing is used selectively — it is far more useful in acute, food-related hives than in chronic urticaria, where blind food testing is usually not helpful.
Treatment approach
- Regular, adequately-dosed second-generation antihistamines are the mainstay of treatment
- Identifying and avoiding a confirmed trigger where one is found
- Short courses of oral steroids only for severe flares, not routine use
- Referral for further work-up if hives persist beyond 6 weeks or are accompanied by other symptoms
Talk to Dr. Narwani: If your child's symptoms are affecting sleep, school, play or growth, or you suspect a specific trigger, book a consultation for proper allergy work-up rather than guessing at home remedies.