Hives in children: not always cause for concern

Hives on Enzo’s hands and feet appear primarily as red, blotchy, inflamed areas rather than raised spots. These hives weren’t agitated at the point of the photo.

After waiting for months to get in with an allergist here in Washington, we finally went to our appointment and… it was anticlimactic in the best way possible.

Back in October 2022 Baby E had his first hives outbreak less than a month after turning 2. It was a cause for concern but because it occurred instantaneously when playing under an old, real-fur rug, we knew something in the rug — most likely the chemicals used to tan the hide — caused the hives. They lasted for a week and were huge, full body welts that covered him from head to toe, but after taking an antihistamine once per day and a cortisone cream a few times per day, he was fine.

His next two reactions were far more confusing in origination but looked and symptomatically behaved similarly to the first hives. In both cases he had had highly processed foods the night before, and then woke up with hives that worsened throughout the day (turning into big blotches rather than jut spots)… but they resolved entirely after about 7 days. We were definitely concerned — and in touch with our pediatrician throughout each occurrence — but because Enzo eats such a clean diet, it wasn’t surprising to us that when he had a fast food meal and on the other occasion a similarly processed meal, this happened.

When hives appear on his face they tend to concentrate on his cheeks but this last time he did get some right by his eyes and only one or two on his cheeks.

Fast forward to last week when E awoke with hives after having no “odd” foods for his normal diet… we were perplexed. Although I normally would have given him an antihistamine at the first sight of hives, because we had the appointment with the allergist we could not give him any and it thankfully worked out just fine. His hives were fairly mild in nature this time around, mostly concentrated on his legs (but a few were sprinkled all over his body), and resolved within 48 hours.

I tell you all that background information so you’ll know what was shared with the allergist. First of all, I completely appreciate a doctor who isn’t wanting to put children through a myriad of unnecessary testing that they don’t actually think will be useful; our doctor — located in Tacoma — reviewed his medical history and spoke to me at length, and concluded that she doesn’t believe this is a food allergy nor does he need allergy testing of any type at this time (although if we felt strongly that he did need it, she was willing to provide.) Apparently hives from a food allergy happen almost instantaneously but at least within two hours and also resolve fairly quickly unless a huge amount of the food was consumed. For Enzo, she did say the hives could have come from eating processed items when his body just simply isn’t used to that. In addition, she let us know that hives are actually quite common in children from heat, allergens like grass and pollen, stress, virus, and anything else that causes inflammation in the body. Being a first-time-mom who doesn’t recall ever really having hives except when touching cats — a known allergy for me — or once from a heat rash, I was completely unaware that many otherwise healthy children get hives (sometimes for MONTHS at a time) and it is often not a cause for huge alarm.

This was on probably day four of a hives breakout back in the end of May… they get pretty blotchy and in some cases look like cloud or flower patterns. My pediatrician told me that that’s perfectly normal and even to see some bruising as they itch the hives.

Let me be clear, this is not medical advice. I am not a doctor (clearly.) But I wanted to share what was shared with me because I think a lot of what you find on the internet sounds way more extreme (scary)… and perhaps it is good to know that it could be what our doctor called Chronic Urticaria (basically a benign condition where hives form and then resolve.) Although, even when doing a Google search on Chronic Urticaria, the definitions I found are far more extreme than what Enzo experiences… but I digress. We left the office with information on what to do next time to wipe out the hives sooner if we think they’re bothering him, peace of mind from the doctor, and that’s about it… we will check-in with our doctor in 6 months to see where things are at. In case it wasn’t obvious, E never had any difficulty breathing, dizziness, vomiting, etc. (although, he did have a fever during one of the times, which the doctor said most likely indicates that his body was indeed fighting a virus) but if your child ever has hives please do reach out to your pediatrician and of course, in serious cases where breathing is impacted calling 911 would be necessary.

Although we haven’t found a holistic pediatrician for E in Washington, I am very grateful for the doctors I have found who have been extremely receptive to providing care while working with parents and who really do seem to take the child’s whole life and body into consideration. Doctors like these are gold — and not found everywhere — so if you live in Washington and are in need of a pediatrician or allergist whom I certainly have been impressed by, contact me for names. 🙂

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