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Hives in Kids: What You Should Know About Common Causes and Treatments

Louisa Salisbury, MDKarla Robinson, MD
Written by Louisa Salisbury, MD | Reviewed by Karla Robinson, MD
Published on August 25, 2022

Key takeaways:

  • Hives (urticaria) is a common rash in kids. It involves itchy, raised bumps that usually resolve within 24 hours.

  • Usually people don’t know the specific cause of hives. But viral infection is a leading cause in kids. 

  • If the rash has signs of a serious allergic reaction — like difficulty breathing — you should seek emergency medical attention.

A close-up on a young girl's arm with hives.
Eik Scott/iStock via Getty Images

Hives (urticaria) is a common rash that can pop up in kids. And the cause is often quite puzzling. Most of the time these itchy bumps go away quickly with no known cause. But in some cases it may indicate an allergic reaction or a more long-term issue. So it’s important to know when to seek medical attention. 

What causes hives in kids?

Hives are itchy bumps that occur when your body releases histamine. Histamine is part of your immune response to a perceived threat. But, in many cases, the body reacts when there’s no real threat. 

Idiopathic hives in kids means there’s no clear cause or trigger. This is most often the case for hives in children, especially when chronic. Even when you can’t confirm a cause, certain environmental factors can cause the body to release histamine and cause hives. These triggers include:

  • Heat 

  • Cold

  • Stress

  • Pressure on the skin   

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In some cases there’s a known cause for hives. The most common identified causes of hives in kids are:

  • Infection (usually a virus)

  • Medication reaction

  • Allergic reaction (foods, insects, environment, or medications)

  • Anaphylaxis

Infection

Infection is the most commonly identified cause for hives in kids. Viral or bacterial infections can both trigger hives. 

Infections that can often lead to hives include:

Hives related to infection can occur at any time. They can appear at the start of an infection or after the infection has resolved.

Medication

All medications have the potential to cause hives, but some are more likely to cause hives. These include:

In some cases the cause of hives is an allergic reaction to a medication. In other cases, medications might cause hives due to hypersensitivity reactions. These types of reactions can cause the same symptoms but are not due to an allergy. Your provider can help you figure out if your child is allergic to a medication.

Allergic reaction

Some kids develop hives as part of an allergic reaction to a certain substance. Hives in kids from an allergic reaction develop almost immediately after an exposure. 

Common allergens that trigger hives include:

  • Foods (like dairy and nuts)

  • Insect bites (like from a bee, spider, or ant)

  • Environmental allergies (like pollen, dust, and mold)

  • Pets

  • Chemicals (like soaps and detergents)

  • Medications 

Anaphylaxis

Anaphylaxis is a less common but more severe type of allergic reaction. It’s important to recognize its signs and symptoms because it can be life-threatening. In addition to hives, symptoms of anaphylaxis may include:

  • Swelling (angioedema)

  • Vomiting

  • Difficulty breathing

  • Dizziness

Can COVID-19 cause hives in kids?

Yes. The cause of COVID-19 is a respiratory virus. Although it’s mainly a respiratory illness, it can cause many different symptoms — including hives. In children, the rash may appear before fever or other symptoms. COVID-19 can cause several different types of rashes in kids. Notify your healthcare provider if you notice new skin changes in your child. 

What are the symptoms of hives in kids?

Hives in kids can be of different shapes and sizes, just like in adults. The bumps usually appear as a cluster. And they can involve just one area or cover much of the skin. Symptoms of hives include:

  • Itch

  • Sting

  • Warmth of the skin

  • Swelling in deeper layers of skin (angioedema)

How long do hives last?

Hives usually go away within 24 hours. But new ones may appear over several days to weeks. If new bumps continue to appear after several weeks, it may be long-term (chronic) hives. In this case, the causes and treatment may be different. 

What is chronic urticaria?

Chronic urticaria is the presence of hives for at least 6 weeks. With this condition, individual bumps may come and go. But there must be some welts present most days of the week. 

There are two types of chronic urticaria:

  1. Chronic inducible urticaria: External factors — like heat, cold, vibration, or pressure — trigger these hives.

  2. Chronic spontaneous urticaria: There’s no known trigger for these hives. They come and go spontaneously.

How do you treat hives?

In most cases, hives will resolve on their own within a few days. But they can be very itchy and uncomfortable, so treatments to decrease the symptoms can provide some relief. 

You can help reduce your child’s symptoms with the following at-home remedies:

  • Over-the-counter (OTC) antihistamines (like cetirizine, loratadine, or fexofenadine

  • Cool compresses to reduce itch

  • Loose cotton clothing to avoid overheating

  • Hypoallergenic lotion to keep skin moisturized

  • Anti-itch lotions (like calamine)

Treatments are sometimes necessary if your child has chronic hives that keep returning.

Beyond avoiding known triggers, common treatments include:

When should you take your child to a provider for hives?

You can manage most cases of hives at home. But if your child's symptoms are severe or don’t go away, it’s a good idea to visit a provider. If the hives last more than 6 weeks, they may recommend a referral to an allergy specialist or dermatologist. 

If your child develops any of the following symptoms, you should seek emergent medical care:

  • Swelling of the lips or tongue

  • Swelling or tingling of the mouth or throat

  • Difficulty swallowing

  • Difficulty breathing

  • Vomiting

The bottom line

Urticaria (hives) is a common itchy rash in children that usually resolves within 24 hours. In many cases there’s no identified cause. But viral infection is the most commonly identified cause in children. In some cases, hives may indicate an allergic reaction. Seek urgent help if there are symptoms like swelling or difficulty swallowing and breathing.

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Why trust our experts?

Louisa Salisbury, MD
Louisa Salisbury, MD, is a licensed, board-certified general pediatrician. She received a bachelor’s degree in human development from the University of California, San Diego, and obtained her medical degree from the University of Vermont Robert Larner College of Medicine.
Karla Robinson, MD
Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

References

American Academy of Dermatology Association. (2021). Hives: Causes.

American Academy of Dermatology Association. (2021). Hives: Overview.

View All References (7)

American College of Allergy, Asthma and Immunology. (2018). Hives.

Bezirganoglu, H., et al. (2022). The common triggers of urticaria in children admitted to the pediatric emergency room. European Academy of Allergology and Clinical Immunology (EAACI) Congress.

Lavery, M. J., et al. (2021). Cutaneous manifestations of COVID-19 in children (and adults): A virus that does not discriminate. Clinics in Dermatology.

Macy, E. (2021). Practical management of new-onset urticaria and angioedema presenting in primary care, urgent care, and the emergency department. The Permanente Journal.

Saini, S. S., et al. (2018). Chronic spontaneous urticaria: The devil’s itch. The Journal of Allergy and Clinical Immunology: In Practice.

Saini, S. S., et al. (2020). Current and emerging treatments for chronic spontaneous urticaria. Annals of Allergy, Asthma and Immunology.

Shin, M., et al. (2017). Prevalence and causes of childhood urticaria. Allergy, Asthma and Immunology Research.

GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.

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