Irregular Red Swelling in Children: Urticaria or Allergies?

Irregular erythema and swelling of the skin?

Hello, doctor.
My 8-year-old child has been experiencing itching for the past few weeks, with irregular hives that vary in size and are accompanied by redness and swelling.
There are also linear red welts that sometimes appear without scratching, but they typically resolve within about 2 hours.
This occurs daily, regardless of whether it's hot or cool.
We have consulted a doctor who mentioned it could be an allergy or chronic urticaria.
I would like to ask if this is urticaria or an allergy? What can we do to prevent this from happening? Is there a way to identify the cause? What should we avoid? Thank you, doctor.

Juan, 30~39 year old female. Ask Date: 2023/10/16

Dr. Wu Yuxin reply Dermatology

It sounds like chronic urticaria, but the actual situation, underlying causes, and treatment options need to be assessed through a medical consultation.

Reply Date: 2023/10/16

More Info

When it comes to understanding irregular red swelling in children, particularly in the context of your 8-year-old experiencing recurrent itchy hives, it is essential to differentiate between urticaria (hives) and allergies. Urticaria is a skin reaction characterized by raised, itchy welts that can vary in size and shape, often appearing suddenly and disappearing within hours. Allergies, on the other hand, refer to the immune system's overreaction to certain substances (allergens), which can manifest in various ways, including skin reactions like hives, respiratory issues, or gastrointestinal symptoms.

Based on your description, it seems that your child is experiencing symptoms consistent with chronic urticaria. This condition can be triggered by various factors, including allergens, environmental factors, infections, or even stress. The fact that the welts appear and disappear within a couple of hours, regardless of temperature, suggests that it may not be a straightforward allergic reaction but rather a chronic form of urticaria, which can sometimes be idiopathic (without a known cause).

To manage and potentially alleviate your child's symptoms, consider the following steps:
1. Identify Triggers: Keeping a detailed diary of your child's activities, diet, and any potential exposures (such as pets, pollen, or new products) can help identify patterns or specific triggers. This may involve noting when the hives appear, what your child was doing, and what they had eaten.

2. Consult an Allergist: If you haven't already, consulting with an allergist or dermatologist can provide more tailored advice. They may recommend allergy testing to identify specific allergens that could be causing the reactions.

3. Avoid Known Allergens: If any specific allergens are identified, avoiding these substances is crucial. Common allergens include certain foods (like nuts, dairy, or shellfish), pollen, dust mites, and pet dander.

4. Medications: Antihistamines are often the first line of treatment for urticaria. Over-the-counter options like cetirizine or loratadine can help reduce itching and swelling. In some cases, a doctor may prescribe stronger antihistamines or corticosteroids for more severe reactions.

5. Environmental Control: Reducing exposure to potential environmental triggers, such as dust, mold, and pollen, can also be beneficial. Regular cleaning, using air purifiers, and keeping windows closed during high pollen seasons may help.

6. Stress Management: Since stress can exacerbate urticaria, teaching your child relaxation techniques or engaging in calming activities may also be beneficial.

7. Follow-Up: Regular follow-ups with your healthcare provider are essential to monitor the condition and adjust treatment as necessary.

In conclusion, while your child's symptoms may be indicative of chronic urticaria, it is essential to work closely with healthcare professionals to identify potential triggers and develop an effective management plan. Understanding the underlying cause of the hives will not only help in managing the symptoms but also improve your child's quality of life.

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