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Urticaria in children

Urticaria symptoms

Urticaria is a raised rash, or patches, often white, surrounded by red, inflamed skin.

  • There may be tiny bumps, known as hives or nettle rash or large raised patches.
  • It can affect any part of the body.
  • It is usually very itchy but can also be painful or feel like burning.
  • Each skin mark or ‘wheal’ usually lasts for a few hours and new ones can appear as older ones fade.
  • Sometimes it is accompanied by deep tissue swelling, typically of the face, neck, hands or feet. This is called angioedema.

Urticaria can be called

  1. Acute: come and go daily but lasts less than 6 weeks
  2. Acute intermittent urticaria: will appear unpredictably for hours and days and then resolve with repeated episodes
  3. Chronic urticaria: occurs every day for more than 6 weeks

Causes of urticaria


Some people will have these symptoms after eating certain foods, medicines or being in contact with something in the environment such as animals, plants, or plasters. Most cases of urticaria are not related to an allergy.

Non allergic

Many children will get hives when they have an infection. Viral infections are often the cause but on occasion it can be a bacteria. The hives can be severe but will disappear within 2 to 6 weeks (you should see them slowly improve).

  1. Physical causes
    • Being in sunlight (solar urticaria)
    • Being exposed to hot things such as after exercise, hot showers or baths or eating spicy food that makes you sweat
    • Cold urticaria – after eating very cold food or cold wind on a child’s skin
    • Dermographism – writing on the skin with your finger will produce wheals which soon go
    • Delayed pressure on the body or limbs
    • Aquagenic urticaria is very rare and caused by contact with water
  2. Other illnesses, such as thyroid gland diseases or coeliac disease can occasionally cause urticaria and angioedema. Your doctor will decide whether other tests are needed.
  3. Idiopathic urticaria – approximately 80% of urticaria is idiopathic, meaning that there is no cause.


  • If possible, avoid the triggers. For example, wear gloves in cold weather, keep the shower at a lower temperature.
  • Antihistamines may be helpful but higher than normal doses may be needed. Your doctor will advise.
  • There are many different antihistamines and some work better than others in each person. If one is not working then either the dose or the medication may need to be changed.
  • Other types of medications can be considered in extremely severe cases.

If you are at all concerned that your child’s symptoms are not settling, or if they are becoming more severe then you must discuss this with your doctor.

Questions to think about

  • When does the rash happen? (For example, is it in the morning, evening, spring, winter.)
  • Where are you when it happens?
  • Have you done anything differently?
  • How long does an episode last?
  • Does it move around the body?
  • How big are they? You can take a photo.
  • Is it itchy?
  • Does the rash leave a brown mark when it goes?
  • Do you get other swellings?
  • Is it better on holiday?

Further information

Please call the allergy nurses on 0114 226 7872 or the allergy secretaries on 0114 271 7585. An answer machine is available out of hours.

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Please note: this is a generic information sheet relating to care at Sheffield Children’s NHS FT. These details may not reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If this information has been translated into another language from English, efforts have been made to maintain accuracy, but there may still be some translation errors. If you are unsure about any of the guidance in this resource or have specific questions about how it relates to your child, always ask your healthcare professional for further advice.

Resource number: ALG5

Resource Type: Article

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