Urticaria (Hives) Pediatric Care Plan

By David Shafran, MD
Medically reviewed
December 9, 2020

What are Urticaria?

Urticaria, or hives, are raised, itchy plaques on the skin that can occur out of nowhere or from an easily identifiable cause. When there is associated swelling in the area around the hives this is called ‘angioedema.’

Examples of urticaria triggers include:

  • Allergies, to things like medicine, foods or plants
  • Infections of any kind
  • Changes in body temperature 
  • Exposure to temperature extremes such as a hot shower

Hives are classified as acute or short-term when they last less than 6 weeks and chronic or long-term when they last for more than 6 weeks. When hives last for more than 6 weeks, they can be a sign of a more chronic illness. 

Read More About Urticaria Here 

Urticaria Diagnosis and Treatment

Diagnosis is made by reviewing medical history and a physical exam with special focus on figuring out the trigger, especially if the trigger is an allergy.

Since they are caused by a release of histamine, hives can be treated with antihistamines such as benadryl (diphenhydramine), claritin (loratadine), or zyrtec (cetirizine).

Do Hives Mean My Child Has an Allergy?

Not necessarily and, actually, not usually. Most hives in children occur because of infections which children are fighting all of the time.

However, if hives occur near the time of exposure to a certain food or medicine, then an allergy should be suspected. In this case, watch closely for the following symptoms:

  • Throat tightening
  • Difficulty breathing
  • Stomach cramping
  • Vomiting and/or diarrhea
  • Passing out

These can be symptoms of a serious allergic reaction, or anaphylaxis, and you should take your child to the emergency room immediately. After treatment, they will need to see an allergist.

Check in With K If…

  • You have general questions about your child’s condition
  • You want general followup for your child
  • You have questions about supportive care
  • Your child’s symptoms don’t go away after treatment but are not alarming

See a Doctor in Person If…

  • If your child develops facial swelling of the lips or tongue
  • If your child develops throat tightness or difficulty breathing
  • If the urticaria last more than 6 weeks
  • If your child experiences weight loss or night sweats
  • If your child loses consciousness
K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

David Shafran, MD

Dr. Shafran is a board-certified pediatrics physician. He joins K Health from the Cleveland Clinic, where he led a pediatrics practice and completed a fellowship in transplant ethics. He has completed multiple fellowships, including one in pediatric nephrology at Rainbow, Babies & Children's University Hospitals. He received his medical degree from the Sackler School of Medicine in Tel Aviv and completed his medical residency at the Jacobi Medical Center.