Hives?!? - Santa Ana,CA

Neighbor's daughter started having hives. When she took daughter into ped. he said give her some benadryl or zyrtec and see if they come back. There was a virus going around that ped had been seeing with hives. She hasn't had them since. My daughter is 2 and 24 lbs and the dose for benadryl is 3/4 tsp OR zyrtec is half a tsp. Don't give both. I'd try benadryl first. May knock child out or make hyper.

Hi K.,

It is impossible to say what caused the rash without seeing it. It could be a bug bite, an inflamed follicle, an allergic reaction, a virus, a bacterial or fungal infection, a contact dermatitis from a plant secretion (plants secrete a lot of mild and not so mild caustic chemicals as part of their natural protective systems), or even plain old prickly heat. For something like this, and really, anything medical, you shouldn't take advice from anyone who hasn't actually seen and evaluated your child (or you, for that matter), and has the expertise to give you an informed opinion.

That being said, here are some things that need to be considered when evaluating rashes. Is the rash raised or flat (OK, you did say raised!); deeply colored or very light; does it have a more solid or a lacy appearance; is it smooth or bumpy; is it concentrated in one area (such as the trunk or a section of a limb), or is it spread out over the entire body; did it appear immediately (or shortly) after coming into contact with something new to your daughter's experience, within several hours, or 1 or two days later; does it blanch (whiten) when you press on it, and if so, how long does it take to recolor; is it itchy, painful, or does not bother her at all. Another thing to consider is, how long has the rash been present -- did it fade quickly, has there been no change in over 24 hours, or is it fading slowly? At this time of year, in wooded and meadow-type areas, or if you live where there are deer and mice, it is also important to note if the rash is circular, and if it takes on a bull's eye appearance within a few days (rash, cleared area, rash, cleared area, rash, etc).

A doctor will usually evaluate all of these things, plus take a history and come up with a probably diagnosis. Some rashes are so characteristic, that all that's needed is a good look at them.

Now, if the rash is gone today, and you've decided to not take your daughter to see a doctor, keep this in mind. Yes, she could have had an allergic reaction to something. It could have been the almonds (nuts are a common allergen), but it could also have been the grass or a plant she came into contact with. If you don't want to go the route of allergy testing right away, you can see what happens if you expose her to any of these elements again individually -- does she get the same rash? Here's the tricky thing, though -- it may only occur in combination with the "right" stimuli. Allergy is a disease of titer. That means that you can be sensitized to several allergens, but only get a reaction if there's enough stimulus from one or more of them. So, say your daughter is allergic to grass, but only "slightly." She could play in the grass all day and you might never see a reaction. But, say that she's also allergic to almonds, but again only "slightly." She might be able to eat a handful of almonds indoors and have no reaction. But, now put those two together -- a picnic with almonds and a romp in the grass, and you get a full blown allergic response, complete with hives, runny nose, itchy eyes, and maybe a tummyache.

If you do ultimately suspect an allergy, the best course of action is to get your daughter tested to determine exactly what she's allergic to. Personally, I think skin testing is barbaric. Sensitive blood tests, such as the ones made by Siemens and Phadia, are highly specific and have been shown to be as accurate as skin testing. If there's concern for hives or anaphylaxis, skin testing should not be done regardless. Also, component blood tests can now be used to determine exactly what protein in an allergen is causing the response, which can help the doctor determine how serious future reactions are likely to be, whether or not desensitization therapy makes sense, and how to guide any other therapy. The best therapy for most allergens right now, especially oral (food) allergies, is complete avoidance of the allergen. Food allergies in particular may wane over time with complete avoidance, but the without avoidance, allergy tends to progress on "the allergy march" to inhalant allergens, and in the worst-case scenario, to asthma by early childhood or adolescence.

Hives can be caused by a lot of things, but it's an allergic reaction. It can happen due to something environmental or sometimes happens when a child is sick.

If it happens again, take her to the doctor and get a referral for allergy testing, preferably with a pediatric allergist.

If it does happen again, you might want to read up on allergic reactions; there is a whole range of reactions from a little hives/stuffy nose/itchy to facial swelling, and anaphylactic (sp?) shock.

Is she having any other systems? If it's just the rash and no other systems and no breathing problems, I normally just just my kids Benadryl.

Take her into to the dr. When my daughter was a baby and we were starting formula she got hives and it was an allergic reaction. The dr. had her come in right away because her airway could have closed up. We had her allergy tested and now know she is allergic to milk and eggs. Your daughter may be allergic to something.

Yes, give her benadryl for kids. If the hives come back or spread take her to see the doctor.