Hives are an allergic disease that appears as spots or red, intensely itchy plaques on the skin. Prevalence depends on age and environmental conditions, as well as comorbidities. The most common allergic dermatosis is recurrent urticaria.
The swelling and itching caused by hives can be severe. The feature that distinguishes this disease from others is red spots on the surface of the skin. They have irregular edges and small bubbles. Typically, hives are caused by allergies. When an allergen enters the body, histamine is released into the bloodstream and causes: swelling, redness and itching.
What are the causes of hives in a child?
It is impossible to answer this question in a few words. It can be caused by a huge number of irritants, so the source of the problem must be sought in each specific case. Here are just some of the causes of this disease.
Allergic
A wide range of food products, in particular fish, shellfish, eggs, nuts, tomatoes, strawberries. Various food additives - dyes, preservatives (sulfites, salicylates) and others.
Toxic
Bites from wasps, bees, mosquitoes, fleas, spiders and other insects. Contact with certain plants, in particular nettles. Contact with jellyfish and other marine inhabitants.
Physical
Mechanical influences such as pressure or vibration. Exposure to cold, heat, sunlight. High physical activity, stress.
Pseudo-allergic
Medicines, in particular penicillin drugs, non-steroidal anti-inflammatory drugs (for example, aspirin), some antibiotics, insulin, radiocontrast agents and others.
Autoimmune
Autoimmune reaction.
Idiopathic
For no apparent reason.
In addition to the direct causes listed in the table, urticaria in a child may be associated, i.e. be a symptom of another disease. Sometimes it occurs as one of the manifestations of a bacterial, viral or fungal infection, a deficiency of certain enzymes in the baby’s body, or hereditary diseases.
As you can see, there are a lot of reasons. The only good thing is that it occurs very quickly after exposure to the stimulus, so it is often possible to calculate it “hot on its heels.”
Forms of nettle fever
Depending on the severity of the disease, there are two stages:
- Spicy. The rash appears suddenly and persists for several days. May be accompanied by fever and headache. If the acute period lasts longer, the disease becomes chronic.
- Chronic dermatitis. Typical rashes appear from time to time and do not go away for a long time. May have an allergic, viral, autoimmune nature.
Based on the severity, urticaria is classified into mild, generalized and giant. With generalized, a large area of skin is affected; giant is Quincke's edema, which affects the face: lips, eyelids, oral cavity, skin and genital mucosa, where the tissue is looser. The mechanism that triggered urticaria allows it to be divided into the following types:
- allergic;
- food;
- contact (for example, resulting from wearing latex gloves, cleaning with chemicals, and so on);
- viral;
- nervous;
- aquagenic (occurs upon contact with water).
Polina Vasilyeva
dermatologist
| Separately, I would like to talk about the manifestations of urticaria in pregnant and nursing mothers and figure out whether it is dangerous. The first appearance of urticaria during pregnancy is a fairly common occurrence, and the reason for this is excessive sensitivity to placental proteins, as well as concomitant pathologies during pregnancy (gestational diabetes, for example). If a woman was already “familiar” with urticaria before pregnancy, then in some cases her condition may worsen during pregnancy due to hormonal changes. It is important to remember that most often urticaria does not have any negative effect on the fetus (during pregnancy) and the newborn (during breastfeeding), but you need to be careful with taking medications (antihistamines and hormonals) during these periods. Be sure to consult with your healthcare provider. |
Children under two years of age usually suffer only from the acute form. Between the ages of 2 and 12 years, urticaria sometimes becomes chronic, but more often it still occurs in an acute form. In adolescence, the chronic form takes precedence over the acute form.
Symptoms
The rash is very similar in appearance to a nettle burn, which is why it got its name. It develops quickly, blisters of various shapes can grow, merge, appear and disappear on different parts of the body. The rash is not painful, but is usually accompanied by severe itching. After treatment or after eliminating the allergen, the urticaria disappears without a trace, and if the skin has not been scratched, it will look healthy as before. Sometimes the rash can affect the mucous membranes and subcutaneous tissue, which is dangerous due to the possibility of aponeurotic edema, commonly known as Quincke's edema.
What does urticaria look like in children?
The name of this disease is no coincidence: it really looks like a nettle burn. Characteristic symptoms are pink, sometimes red blisters. Their size can vary widely - from a few millimeters to 10 centimeters, adjacent blisters can merge with each other. The blisters have a clear border and rise above the surface of the skin. When pressed, they disappear, then appear again. Another common symptom of the disease is itchy skin.
The photo below shows examples of what urticaria can look like. You can find other photos on the Internet.
Diagnostic methods
When this disease develops, the patient or his parents are interviewed and the symptoms are analyzed.
The doctor can make a preliminary diagnosis after examining the child’s skin. A rash with urticaria is difficult to confuse with another. However, to exclude errors and establish the cause, tests are prescribed:
- stool analysis, which will help identify parasites - they can be pathogens;
- general blood test - identifies or excludes inflammatory and immune processes;
- allergy tests - skin tests to identify the pathogen;
- liver tests - to determine liver function and exclude its pathologies.
Thyroid function may be tested because the disease can be caused by hypo- or hyperthyroidism.
Why is urticaria dangerous?
In most cases it causes discomfort, but nothing more. By itself, it is not capable of causing damage to the child’s organs and systems. However, there are a number of situations in which it can be deadly:
- Acute urticaria may be accompanied by an anaphylactic reaction. The child quickly develops swelling of the larynx and begins to choke. At the first suspicion of swelling, call an ambulance immediately!
- If the cause of hives is cold, this can lead to suffocation and a drop in blood pressure, which is also deadly. Dial 112 without hesitation if you see that after hypothermia the child breaks out in hives and feels unwell!
Such cases occur infrequently, but it is better to be aware of dangerous symptoms so that they do not take you by surprise.
| Our expert |
Possible complications and their consequences
Urticaria, despite its apparent harmlessness, can lead to serious consequences, primarily to Quincke's edema. Its characteristic initial symptoms, in addition to the swelling itself, are difficulty breathing and paroxysmal cough with whistling (bronchospasms). Swelling of the internal mucous membranes is dangerous due to disruption of the housing and communal services, the first signs of which are a gag reflex and stool disturbance. From the nervous system, severe cases of urticaria are dangerous due to damage to the meninges, which can be fatal in the absence of medical assistance.
Polina Vasilyeva
dermatologist
| If you or your baby are experiencing urticaria in one form or another, it is important to know a few first aid rules. They consist of applying a cold compress in combination with taking 2nd generation antihistamines. If urticaria is accompanied by suffocation, hoarseness, difficulty swallowing and breathing, blueness of the face, as well as symptoms of anaphylaxis (drop in blood pressure, dizziness, loss of consciousness), you must immediately call an ambulance! The doctor will give an injection of adrenaline, which acts on anaphylaxis with lightning speed (unlike antihistamines and hormonal drugs). Also, if possible, it is necessary to eliminate the allergen as quickly as possible and provide the patient with plenty of fluids. |
Treatment of the disease
If the allergen is known, then the main recommendation is to avoid, if possible, contact with the substance that provokes hives. That is why accurate diagnosis is important - it is necessary to understand which group of chemical compounds can lead to the development of urticaria. It often happens that the same substance is found in different foods or in different pharmaceuticals. And an allergy to pets can affect only one breed or spread to almost all pets, from cats to hamsters.
Therapy is needed if the disease has become a recurrent form - this happens if it is impossible to stop contact with the provocateur. In a situation where test results show the presence of an infectious focus, it is necessary to determine the infectious disease. It is likely that the urticaria will go away after healing.
If a patient is diagnosed with an allergy to dust, food or plants, then lifestyle changes are required: frequent wet cleaning, following a proper diet and avoiding walking during the flowering period of plants. Concomitant treatment is designed to alleviate symptoms when they reappear.
Is hives in children contagious?
Urticaria is an allergic disease. Like any other allergy, it is a feature of the body and cannot be transmitted to another person in any way. The resulting rashes do not contain any “allergy triggers”. You can't infect her!
Theoretically, the following situation is possible: urticaria in a child is not an independent disease, but a sign of infection. If he passes the infection to another baby, who reacts to it with hives, he will also develop rashes. However, even in this case, you can only blame the child’s parents for bringing the infection to the kindergarten or playground.
How to treat urticaria in a child?
Treatment always begins with eliminating the causes. If the situation is simple, and it is clear what exactly became the “trigger” of the disease, it is necessary to protect the child from repeated exposure to this factor. For example, if hives developed after a wasp sting, you just need to try to ensure that the baby no longer encounters these insects. If your toddler is blistered after prescribing a certain drug, treatment by elimination will also not take much time.
| Our expert |
Prices
| Name of service (price list incomplete) | Price |
| Appointment (examination, consultation) with an allergist-immunologist, primary, therapeutic and diagnostic, outpatient | 1750 rub. |
| Prescription of treatment regimen (for up to 1 month) | 1800 rub. |
| Consultation (interpretation) with analyzes from third parties | 2250 rub. |
| Consultation with a candidate of medical sciences | 2500 rub. |
| Allergen-specific immunotherapy (ASIT) - maintenance course (excluding the cost of the drug) | 8100 rub. |
Polina Vasilyeva
dermatologist
| There are several important prevention rules to prevent the recurrence of urticaria. These include eliminating or limiting hives triggers and seeing a doctor (pediatrician or allergist) to identify the allergen to limit your exposure to it as much as possible. A patient prone to anaphylactic reactions is also recommended to wear a bracelet or note with information about the allergens that cause them. |
There are situations, and they are not isolated, when it is not possible to understand what irritant caused the symptoms of urticaria. This happens especially often if the parents did not consult a doctor in time, thinking that the annoying rash would go away on its own, but this did not happen.
If the irritant is unknown, the child is prescribed treatment in the form of a hypoallergenic diet. All foods containing histamine liberators should be excluded from his diet. The list of risks includes:
- Bright red and orange fruits: orange, pineapple, tomato, strawberry, etc.
- Chocolate, coffee, cocoa.
- Legumes, including soy products.
- Wheat and other grains containing gluten.
- Fermented cheeses and blue cheeses.
- Marinated, salted, fermented foods.
- Fish and seafood.
- Ham and smoked meats.
- Nuts, seeds.
- Spices, herbs and spicy vegetables such as radishes, horseradish, etc.
- Eggs.
- Honey.
- Spinach.
- Food additives - dyes, preservatives, flavors.
The diet is prescribed for a while until the symptoms disappear. After this, you can begin to return foods to your baby’s diet one at a time, monitoring the body’s reaction.
If within 1–2 months the diet does not bring results, it is necessary to move on to drug treatment. It is prescribed by the doctor who is observing the child.
How can you tell if your child has severe urticaria or not?
To assess the signs of the disease, a special method has been developed, which is called the “7-day urticaria activity index”. It is very simple and you can easily master it.
Two signs of hives—blisters and itching—should be assessed for seven days. Give each symptom a daily score from 0 to 3 depending on how severe it is.
The total score for 1 day for both traits will be from 0 to 6. To get the total score for 7 days, add all the daily numbers together. The result will show how severe the child's urticaria is:
The results obtained will allow you to evaluate how effective the treatment is.
Authors: Huggies experts, dermatologist Polina Vasilyeva
