In this Helping Hand™ we will discuss the causes and treatment of hives, as well as how to prevent them and when to seek help from a doctor.

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Hives, also called urticaria (yer ti CARE ee uh), are red, itchy, raised bumps or welts on the skin. They may be small, like mosquito bites, or many inches wide. Hives can appear alone, in a group or can connect with each other to cover bigger areas. When pressed, the center of the hive turns pale. They can be made worse by scratching.

Hives often appear suddenly on any part of the body. They may appear in one place, go away in a few hours and then come back in another place. In severe cases, hives may come and go for several weeks. For most people, they are not serious.

About 1 out of every 5 people has hives at some time in his or her life.

Causes of Hives

Some of the things that can cause hives

Hives are the body's response to an irritation (Picture 1). The cause (trigger) may be non-allergic or allergic.

Non-allergic hives are the most common type. Usually, their exact cause is unknown. Some causes of non-allergic hives are:

  • Viruses and infections
  • Temperature extremes - hot and cold
  • Sunlight - sunlamps or direct sunlight
  • Pressure - skin that is rubbed very hard or scratched or clothes are too tight-fitting
  • Emotional stress
  • Exercise

Allergic hives have a known cause, but are less common. Some causes of allergic hives are:

When to Get Emergency Help

If your child has trouble breathing, swallowing or talking, nausea or vomiting, or swelling of the mouth or lips, get emergency treatment immediately. These are early symptoms
of anaphylaxis, which can be life-threatening. Call 9-1-1 or take your child to the nearest emergency department.

Treatment of Hives

The goal of treatment is to control the itching and avoid things that may trigger hives to get worse or come back.

For mild hives:Play activities can help keep your child's mind off the itching

  • Give an over-the-counter (OTC) antihistamine. Your child’s health provider can recommend which one to use and how much to give.
  • Take a cool bath, shower or apply a cool compress. Wet a washcloth or towel with
    cold water, wring it out and place it on the child's hives.
  • Distract your child from itching by playing a game, singing a song or reading (Picture 2).

For more severe hives:

  • Your child’s health provider may prescribe an antihistamine or a steroid (such as prednisone), or give your child an injection of epinephrine.
  • If your child’s health provider is concerned about a severe form of allergic reaction (anaphylaxis), a prescription for an EpiPen® (epinephrine auto-injector) is usually given. The EpiPen® should be used right away and as directed if symptoms of anaphylaxis occur. There is no way to know when a trigger will cause a severe reaction, so it is important the EpiPen® is always available. Once an EpiPen® is used, call 9-1-1 or take your child to the nearest emergency department.

To stop hives from getting worse:

  • Avoid scratching or rubbing the skin.
  • Dress your child in loose-fitting clothes to relieve hives caused by pressure.
  • Do not use harsh soaps on the skin and for washing clothes.
  • If your child is sensitive to cold, have him or her wear warm clothes and avoid contact with cold water.  
  • If your child is sensitive to the sun, be sure he or she uses sunblock and wears long sleeves and pants.
  • Everyone should wash hands after touching pets.

Although hives can be frustrating, they are usually not life-threatening. It is important to stay calm so your child does not become more anxious and uncomfortable.

How to use an EpiPen®

Times when you need to use an EpiPen® can be stressful. To calmly react to an allergic reaction, it is important to know when and how to use an EpiPen, understand symptoms of allergic reactions and have an action plan in place.

Watch the Video


If your child develops hives often, keep a record of events that happen just before they break out. This will help your child’s doctor find the cause and make a plan to keep them from coming back.

  • Stay away from things you know can trigger your child to get hives. A more severe reaction may occur the next time.
  • Avoid foods and medicines that have triggered hives in the past. Read labels carefully.

When to Call the Doctor

Call your child's doctor if:

  • The prescribed antihistamine medicine does not relieve the itching.
  • The hives or itching becomes worse or new symptoms develop.
  • Your child develops hives after being stung by an insect or after taking a new medicine or eating a certain food. He may need an EpiPen® to treat a more serious reaction next time.

HH-I-82 11/89, Revised 11/17, Nationwide Children’s Hospital