Anyone at any age can get hives. Hives (fancy name is urticaria) are pink or red bumps in the skin. They’re also called welts.

These bumps usually occur out of the blue without warning. Each hive tends to flatten out over a few hours, but new bumps can continue to appear for several days or longer. These swellings can be all different shapes. Sometimes they’re even ring or donut-shaped or shaped like a target. The rings may have normal skin in the middle or look purplish or bruise-like.

Sometimes there’s just swelling of the face, especially the eyes and the mouth or sometimes the legs, arms or feet. This is called angioedema. Sometimes there’s swelling in the mouth, throat or airway that might make it hard to breathe. This is what happens when someone has anaphylaxis, which can be a life-threatening emergency.

The different types of hives are as follows:

• Acute: Hives that last for less than six weeks are considered acute, meaning they come on suddenly. Allergic reactions to certain foods or medications often cause acute hives.

• Chronic: Hives that linger longer than six weeks are chronic. Ninety-five percent of chronic hives are thought to be autoimmune in nature, but nobody knows what causes them.

• Physical: Some people develop hives and swelling in specific situations. Hives might pop up when you’re in the cold, heat or sun. Some people react to vibrations or pressure, or exercise and sweating. Physical hives usually appear within an hour after exposure.

Allergens can cause these reactions. An allergen, such as cat dander, is a substance that the body doesn’t like and causes the immune system to release chemicals called histamines. The body may respond to the flood of histamines by having hives or swelling.

All causes of hives aren’t allergens. Hives are a reaction to many different causes. Minor infections from viruses are a common cause in young children. Often the child seems well before the hives begin with few sick symptoms.

Other things that can cause hives include: foods, medicines, additives to foods and vitamins such as color dyes, and in some cases, even exercise, stress, sunlight, ice or other cold things touching the skin. In up to a third of cases, no cause can be found.

Treatment of hives starts with avoiding a known cause. Most cases in children have no clear trigger. Antihistamines are the main treatment for hives. Your health care provider may recommend over-the-counter cetirizine, loratadine or fexofenadine during the day.

You should let your doctor know immediately while on the way to the emergency room if your child has swelling or tingling of the mouth, tongue or throat, trouble breathing or swallowing and/or vomiting with the hives. These symptoms need emergency care. For more information, visit HealthyChildren.org.

Sally Robinson is a clinical professor of pediatrics at UTMB Children’s Hospital. This column isn’t intended to replace the advice of your child’s physician.

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