Red flags & when to go in person for Hives (Urticaria) in Children

Audience: pediatric

Hives, also called urticaria, are raised, itchy red or skin-colored bumps or welts that can appear on a child's skin. They often come and go quickly and may be caused by allergies, infections, or other triggers. While many cases of hives are mild and can be managed at home or through telemedicine, some signs mean your child needs to see a healthcare provider in person right away. These include difficulty breathing, swelling of the face or throat, or if the hives last more than a few days or keep coming back. Telemedicine can help assess mild symptoms, provide advice on managing itching, and guide when to seek further care. Always watch for warning signs and trust your instincts to get prompt care if your child seems very unwell.

Red flags — go in person / ER

• Difficulty breathing, wheezing, or noisy breathing — seek emergency care immediately.
• Swelling of the face, lips, tongue, or throat — go to emergency services right away.
• Dizziness, fainting, or feeling very weak — urgent in-person evaluation needed.

What telemedicine can do

• Assessment of mild hives and itching
• Advice on over-the-counter antihistamines
• Guidance on avoiding triggers
• Monitoring symptom progression
• Determining when in-person care is needed

What telemedicine cannot do

• Emergency treatment for breathing difficulties or swelling
• Physical examination for severe symptoms
• Administering injections or intravenous medications
• Diagnosing underlying causes requiring tests
• Managing severe or persistent hives needing specialist care

What Are Hives (Urticaria)?

Hives are raised, red or skin-colored bumps that often itch. They can appear suddenly and may change shape or move around the body. In children, hives are usually caused by an allergic reaction to foods, medicines, insect bites, or infections. Sometimes the cause is unknown.

Common Symptoms of Hives in Children

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When to Seek In-Person Care

Some signs mean your child should be seen by a healthcare provider in person immediately:

If your child has mild hives but symptoms worsen or do not improve, an in-person visit is important.

How Telemedicine Can Help

Telemedicine providers can:

However, they cannot perform physical exams or emergency treatments.

Managing Hives at Home

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If symptoms worsen or new symptoms develop, seek medical care promptly.

How to prepare for your tele-visit

• Have a clear view of your child's skin rash for video examination.
• Note when the hives started and how they have changed.
• List any new foods, medicines, or exposures your child had recently.
• Prepare to describe any other symptoms like breathing difficulty or swelling.
• Have a list of current medications and allergies ready.

After your tele-visit

• Follow the treatment advice given during the tele-visit.
• Monitor your child's symptoms closely for any worsening.
• Use recommended over-the-counter medications as directed.
• Seek in-person care if red flags or new symptoms appear.
• Schedule follow-up if hives persist or recur frequently.

FAQs

What causes hives in children?

Hives can be caused by allergic reactions to foods, medicines, insect bites, infections, or sometimes the cause is unknown. They happen when the body releases chemicals that cause skin swelling and itching.

Can hives be dangerous?

Most hives are not dangerous and go away on their own. However, if your child has trouble breathing, swelling of the face or throat, or feels faint, these are emergency signs and need immediate medical care.

How can I help relieve my child's itching?

You can apply cool compresses and give age-appropriate antihistamines as advised by a healthcare provider. Avoid scratching to prevent skin damage or infection.

When should I take my child to see a doctor in person?

If your child's hives last more than a day without improvement, if they have difficulty breathing, swelling of the face or throat, dizziness, or signs of infection, see a healthcare provider promptly.

Are hives contagious?

No, hives are not contagious and cannot be spread from one person to another.

Sources

1. Urticaria — MedlinePlus, U.S. National Library of Medicine.
2. Hives (Urticaria) — Mayo Clinic.
3. Hives (Urticaria) — Centers for Disease Control and Prevention (CDC).
4. Urticaria and Angioedema — National Institute of Allergy and Infectious Diseases (NIAID).

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If your child has severe symptoms or you are concerned about their health, seek immediate medical attention.