Hives Giving Bumps the Bump Off
HIVES Giving Bumps the Bump-Off
If your child feels itchy, really itchy, have a good look at the area he's scratching. The good news about hives--those itchy, red raised bumps with pale centers--is that they usually go away on their own within 24 hours. The bad news is that it is very difficult to figure out why your child got them in the first place.
hives may be a reaction to foods. The most common offenders are berries, chocolate, nuts, eggs, peanuts, fish and shellfish. But some children get hives when they're exposed to other allergens, such as penicillin, aspirin, pollen, some kinds of plants, a viral or bacterial infection, cold water or insect bites and stings. (Occasionally, these reactions can be severe and require emergency treatment. See ''Medical Alert'' on page 220.) In some cases, hives might be caused by an internal disease such as arthritis.
Hives may appear all over the body or just in one area. They may bloom and fade within a matter of hours, only to pop out somewhere new. Or they may persist for six weeks or longer--sometimes almost disappearing, only to recur. Although hives usually itch like crazy, occasionally they are not itchy at all.
Itching to do something about them? Read on.
Leave them alone. If your child has hives that don't itch, leave them alone, says Peter LoGalbo, M.D., assistant professor of pediatrics at the Albert Einstein College of Medicine of Yeshiva University in New York City and director of the Asthma and Allergy Center of Schneider Children's Hospital of the Long Island Jewish Medical Center in New Hyde Park, New York. ''They may not be attractive, but if they don't itch, why worry?'' Dr. LoGalbo says.
Give a soak. If the hives are the itching kind, have your child soak in a tub filled halfway with warm water and add ½ cup of cornstarch, baking soda or an oatmeal product known as Aveeno (available in drugstores), suggests Stanley I. Wolf, M.D., clinical professor of pediatrics at George Washington University School of Medicine in Washington, D.C., and an allergist in Silver Spring and Rockville, Maryland. Once a day may be enough, but do the soak more often if the hives persist or your child feels very uncomfortable.
Chill out. Applying an ice-pack or a cold compress on the itchy area frequently brings relief, says Dr. LoGalbo. You can apply this cool relief as often as necessary, for about ten minutes each time. But be sure to wrap the ice-pack in a towel so it isn't directly against the skin.
Use an antihistamine. ''An oral antihistamine such as Benadryl or Chlor-Trimeton given every four to six hours as needed will usually ease the itching, but it may also cause your child to be tired and cranky,'' notes Beth W. Hapke, M.D., a pediatrician in private practice in Fairfield, Connecticut. These medicines are available without prescription at most pharmacies. Be sure to read package directions to make certain the product is recommended for your child's age. For the correct dosage, follow package directions or consult your physician. Some doctors don't advise Benadryl cream or spray because it could cause a reaction. Also, consult your doctor about alternative antihistamines if your child strongly dislikes taking a particular kind.
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| When to See the Doctor There are two situations in which an allergic reaction involving hives can be serious, even life-threatening. If you notice any of the following symptoms, call for emergency medical help immediately, recommends Stanley I. Wolf, M.D., clinical professor of pediatrics at George Washington University School of Medicine in Washington, D.C., and an allergist in Silver Spring and Rockville, Maryland. Angioedema is a hivelike reaction that causes swelling of the feet, hands, face and lips. Usually, it is no more serious than regular hives, but it can become acute in rare instances. '' When your child has a severe reaction, her eyes and face become extremely swollen and grotesque looking. If the angioedema involves the tongue or the larynx, it can close off the airway unless your child gets a shot of adrenaline,'' says Dr. Wolf. Anaphylaxis is a severe allergic reaction that causes difficulty in breathing or swallowing, according to Beth W. Hapke, M.D., a pediatrician in private practice in Fairfield, Connecticut. Dr. Hapke notes that anaphylaxis is not common in children. If your child gets hives and suddenly has difficulty swallowing, however, you should seek medical help at once, according to Dr. Hapke. ( In infants, the warning signs include vomiting, excessive drooling or refusal to drink). The reason for urgency, according to Dr. Hapke, is that your child may stop breathing unless she gets a shot of adrenaline. ''If a severe reaction occurs, it will be within 30 minutes to an hour after your child has been in contact with an allergen,'' says Dr. Hapke. It will not occur hours or days after the onset of hives, she notes. |
| Tracking Down the Cause ''Finding the cause for chronic hives is really detective work. In some research studies, doctors were able to find an answer about 50 percent of the time. But in practice, any doctor who can pinpoint the problem in even 25 percent of the cases is doing a good job,'' says Stanley I. Wolf, M.D., clinical professor of pediatrics at George Washington University School of Medicine in Washington, D.C., and an allergist in Silver Spring and Rockville, Maryland. Although there is no guarantee of success when you take your child to an allergist, it's worth trying to track down what is causing hives. Expect to give your doctor a detailed history about your child's diet, medication and lifestyle. If you are lucky, your doctor will be able to identify the source of the hives and be able to advise you about ways to prevent their recurrence. |
Consult an allergist. ''Hives are usually nothing to worry about, but if your child has chronic hives that recur or persist for a period of six weeks or more, see an allergist,'' advises Dr. Hapke. The allergist can usually help you identify the specific allergens that are causing the hives and may prescribe medication that is more effective than over-the-counter medicines.
