Internist Questions Hives

How can my daughter treat hives?

My daughter has hives and I'm not really sure how to treat them. What is the best way to treat them?

4 Answers

Hives (Urticaria) is caused by release of histamine which causes local edema under the skin. The acute hives can be treated with anti-histamines such as over the counter Benadryl, claritin, zyrtec, xyzal, and with prescription steroids such as prednisone.
Knowing what caused it, how ever, is just as important as the acute treatment.
The most common foods that can cause hives are nuts, chocolate, fish, tomatoes, eggs, fresh berries, and milk. Fresh foods can cause hives more often than cooked foods as cooking can alter some antigenic factors in food. Certain food additives and preservatives could also cause this reaction.

If this problem is recurrent you can see an allergist and do a blood or skin test for allergies.

Stress, substances, and mechanical pressure over skin can lower the threshold of histamine release. So given exposure to the cause the person would more likely experience hives. You can commonly see it under belt line, bra line, or areas of scratched skin due to the mechanical pressure over those areas.

In rare cases it could be a manifestation of systemic diseases but you must refer to your physician to investigate those.
HIVES can be quite complicated. They are an immune mediated skin reaction that can come from a variety of causes. They are best managed seeing a doctor to evaluate the cause and then finding a treatment. I suggest an ER if she does not have a physician.
Hives is caused by allergy to some substances or some immunological perturbance in the body. The immunological part could be genetic and is congenital which happens from birth or young childhood. It could also be acquired, and in that case, autoimmune diseases such as Lupus or malignant disease such as lymphoma comes to mind. She needs to be checked out by allergist specialist. It can usually be treated by anti histamines. You can try a combination of Allegra 60 mg twice a day and Zantac 150 mg twice a day. Both medications are available in over the counter. This is the the dose for adults and children above age of 12. For below age of 12, Allegra is 15-30 mg twice a day. For Zantac, the dose is 4-8 mg/kg/day divided in twice a day manner.
I hope this is helpful to you.
Antihistamines will take the edge off. Benadryl (diphenhydramine) is the strongest as long as she doesn't mind sleeping all day; the nonsedating antihistamines (Claritin, Zyrtec etc--the pharmacist can help) are less effective.
If she is pregnant or nursing she needs to avoid all of these and just rub some nonprescription on the hives as they appear. This usually lasts only 3 days or so; she has my literal sympathy since I had this when I was nursing.