Hives, or urticaria, refer to a certain type of itchy skin rash. Hives in babies can be acute or chronic. Hives may improve on their own in some cases. A doctor may also recommend medical treatments for hives in a baby.

Hives result from an immune reaction to a particular substance or trigger. In children, hives can appear similar to other rashes.

Read on to learn more about hives in babies. This article looks at symptoms, causes, treatments, and more.

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Hives are itchy raised bumps, often called wheels or welts. They can vary in size and may be:

  • round
  • donut shaped
  • target shaped

The skin in the middle of the rings might appear similar to the rest of the baby’s skin. Sometimes it appears purple or like a bruise. This can last longer than the rest of the rash.

Younger children with hives might also develop swelling of the hands and feet. They may fuss and show discomfort and unhappiness.

Most symptoms of hives resolve within 2 weeks.

Two different types of hives can develop in children: acute and chronic.

Acute hives in babies

Acute, or short-term, hives are the most common type.

Hives are a response to an infection in more than 40% of children who develop them, according to a 2017 research review. Infection as a cause of hives is more common in children than in adults.

Hives in babies and children can also occur as a result of the following:

  • some medications
  • foods they are allergic to
  • additives and dyes, including certain food colorings
  • stress
  • insect bites
  • infection by parasites
  • sunlight
  • extremely cold objects and environments, including exposure to ice

It is worth noting that, in up to one-third of cases, there is no known cause.

Chronic hives in babies

Doctors define chronic hives as hives that last longer than 6 weeks.

Children typically receive a diagnosis in only 20–50% of cases, according to the 2017 review mentioned earlier. This means that, in most cases, the cause of chronic hives is unclear. Hives without a clear cause are called chronic idiopathic urticaria.

The same review notes that using nonsteroidal anti-inflammatory drugs (NSAIDs) may be a major contributing factor to chronic hives in children.

Doctors can usually identify hives just from how they look.

In cases of chronic hives or if the diagnosis is unclear, a doctor may request testing, especially if a child has other symptoms along with the rash.

The doctor can advise on which tests they recommend to help rule out other possible causes.

Learn about what can cause a rash on a baby.

While it may be possible to treat hives with medication, not all medications are safe for infants of all ages.

For example, a person should not give antihistamines to babies and toddlers without a doctor’s prescription or recommendation. It is important to receive an accurate diagnosis before beginning medical treatment for a rash, especially because it may be due to a condition other than hives.

Doctors may prescribe antihistamines for an off-label use. If the doctor assesses that antihistamines will be safe for a particular child’s symptoms, they may recommend several over-the-counter options, including:

  • cetirizine
  • loratadine
  • fexofenadine
  • diphenhydramine, for nighttime use

Children with hives that do not respond to antihistamines may need a prescription for more intensive medications. These might include corticosteroids to manage acute flare-ups or immunosuppressants, such as cyclosporine, to reduce severe immune responses.

Learn more about treatments for hives.

In many babies, hives go away without treatment. Often, just keeping a baby away from suspected triggers can help keep the hives from getting worse while they recover.

Other steps that can help ease discomfort and itchiness in a baby with hives include:

  • applying a cool compress
  • dressing the baby in loose clothing
  • using moisturizers and lotions that are fragrance-free

If a baby has a rash, it is best to contact a doctor for an accurate diagnosis.

If hives occur along with other symptoms that suggest that the child is having a severe allergic reaction, known as anaphylaxis, they may need emergency hospital treatment.

Anaphylaxis can cause symptoms such as breathing difficulties, swelling, and clammy skin.

Another sign may be that a child goes limp, floppy, and unresponsive. They may be unable to lift their head or seem like they are unable to focus on human faces. Call 911 or a local emergency number if these symptoms develop.

Anaphylaxis: Symptoms and what to do

Anaphylaxis is a severe allergic reaction that can be life threatening. The symptoms develop suddenly and include:

  • hives
  • swelling of the face or mouth
  • wheezing
  • fast, shallow breathing
  • a fast heart rate
  • clammy skin
  • anxiety or confusion
  • dizziness
  • vomiting
  • blue or white lips
  • fainting or loss of consciousness

If someone has these symptoms:

  1. Check whether they are carrying an epinephrine pen. If they are, follow the instructions on the side of the pen to use it.
  2. Dial 911 or the number of the nearest emergency department.
  3. Lay the person down from a standing position. If they have vomited, turn them onto their side.
  4. Stay with them until the emergency services arrive.

Some people may need more than one epinephrine injection. If the symptoms do not improve in 5–15 minutes, or they come back, use a second pen if the person has one.

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Here are some frequently asked questions about hives in babies.

What do I do if my baby has hives?

If a baby develops a rash, it is important to contact a doctor to rule out possible causes and get an accurate diagnosis. If the rash is hives, try to identify and remove possible triggers. This may not always be possible. Applying a cold compress can help relieve itchiness and discomfort. A doctor can advise on whether they recommend any medical treatments.

What do mild hives look like on a baby?

Hives on a child may appear as raised bumps or patches. On children with white skin, the rash might look pink or red. The rash can be harder to identify for those with dark skin because it might match the surrounding skin in color.

The rash might appear in one area or spread across the body, and it can develop anywhere. The rash may also come and go.

Are hives in babies serious?

Most hives in babies resolve without treatment. However, hives that do not resolve within 6 weeks could be chronic and may require further investigation.

However, doctors often cannot identify the cause of chronic hives. For this reason, they can be persistent and difficult to treat. This can reduce an infant’s quality of life and cause ongoing itching, burning, and pain.

A doctor can recommend the best treatments or home remedies to soothe a baby with hives.

What viruses cause hives in infants?

In a 2016 analysis, experts determined that Herpesviridae viruses had the most frequent links to hives in children.

However, many types of infections can cause hives in babies, including viral infections.

Hives in babies can cause raised, itchy bumps on the skin. The rash may occur in response to an infection or an environmental trigger. In some cases, the cause is unclear.

Doctors may recommend treatment at home with cold compresses and the avoidance of triggers, as hives often resolve without treatment. However, a doctor may recommend medical treatments in more severe or chronic cases.

If hives accompany symptoms of a more severe allergic response, it is important to seek immediate medical attention.