Is your baby getting red bumps on his body? Let's be aware of these so-called hives!

As a mother, it's normal to feel a little panicked and scared when you see a red, itchy rash suddenly appear on your little one's body, whether it's a toddler or a little older. "Oh, what happened to my child?" You might think, right? Rashes like this can sometimes be a condition called hives , or what we call hives in Sinhala. So, let's talk about this in a little more detail today, shall we?

What exactly are these hives?

Simply put, hives are small, raised, pink or red welts or patches that appear suddenly on the skin. They can affect anyone of any age, not just children. However, they are more common in young children.

There can be various reasons for these hives to appear. Most of the time, these are not that dangerous, and they will get better on their own in a short time or a day or two. However, sometimes this can be a symptom of a more serious condition. Therefore, if your child has these rashes, the most important thing is to take care of them and seek medical advice if necessary. What I am saying is don't panic, but don't take it lightly either.

What do these hives look like? How do they feel?

Hives don't look or feel the same for everyone. It can vary from person to person. Check to see if your child has these symptoms:

• Some spots may have a pale center with red around them, like a small target.
• They also vary in size. They can range from a small dot, like a blister from a small ant bite, to a blister as big as your palm .
• Sometimes these spots can appear in a circle like rings . Or, you can see many such rings together in clusters .
• This is the most amazing thing: Hives are not fixed in one place. They can change places within a few hours. Imagine, a rash that was on a child's face in the morning may appear on an arm or leg by evening.
• These sores are often very itchy . Some children scratch so much that they can't stop scratching. Not only that, but sometimes they can also feel a burning or stinging sensation .

If your child says, "Mommy, it itches, it hurts," and has these kinds of bumps on their body, it's very likely that they're hives.

How long will these hives last?

This also varies from person to person. For some people, these spots may appear within a few minutes and then disappear quickly. For others, they may last for a few hours . Sometimes, these spots may appear and disappear in places for two or three days .

We call this acute urticaria. This usually lasts less than 6 weeks. However, some people have hives that last longer than 6 weeks. We call this chronic urticaria. It is a more complicated condition and may require separate treatment. However, the most common type of hives seen in children is the one that gets better quickly. So there is nothing to worry about.

Why do these hives occur? What are the causes?

"Why on earth does my child get these?" you may be wondering. There is not just one reason why hives occur, there can be many. Let's look at the main causes:

• Allergic Reaction: This is the most common cause.
• Foods: Some foods can cause allergies in children. For example, milk, eggs, peanuts, soy, wheat, and seafood such as fish, shrimp, and squid. If something like this happens after introducing a new food to your child, be careful about it.
• Medications: Some children can be allergic to medications such as painkillers and antibiotics. This can happen even if it is a medication prescribed by a doctor.
• Insect bites: When animals such as mosquitoes, ants, wasps, and wasps bite you, and the venom enters your body, hives can appear as an allergic reaction.
• Some plant parts or pollen: This condition can occur in sensitive children even after touching the pollen of flowers or the leaves of some trees.

• Viral Infections: Don't be surprised, hives can also appear as a response to a viral infection, such as a common cold or the flu. They can also appear a few days after the fever subsides.

• Cold Weather: Some children's skin is very sensitive to cold. Some children get hives after taking a cold shower, being exposed to cold air, or eating something like ice cream.

• Sun Exposure: Similarly, some children can be harmed in this way even when exposed to strong sunlight.

• Stress: Don't think, "What kind of stress is it for little ones?" Things like schoolwork, exams, and moving to a new environment can cause stress for little ones too. This stress can sometimes cause hives.

• Scratching or Pressure on Skin: Some people have very sensitive skin. If the skin is scratched too hard, or if something like a belt is stuck in it, it can cause a rash. This is also called `(Dermatographism)`.

• Exercise: Some children get hives even after a lot of running and playing, sweating and getting hot.

• Sometimes you can't find a reason: Yes, sometimes no matter how much you search, you can't find a specific reason for these hives. There are times when even doctors can't identify a cause even after conducting tests. That's called `(Idiopathic Urticaria)`. It's a bit of a worry, but it does happen.

How do hives form? What happens inside the body?

This is a very interesting thing. Hives are actually caused by some activity in our body's immune system.

Simply put, this is what happens:

When something harmful (e.g. an allergen, a virus) enters our body, or as mentioned earlier, due to something like stress or cold, a special type of cell in our body called Mast Cells becomes activated. These Mast Cells suddenly release other chemicals like Histamine .

This chemical called histamine plays the main role here. Histamine causes the very fine blood vessels (capillaries) under the skin to widen slightly, and their pores also become larger. Then, blood plasma, the liquid part of the blood, slowly starts to leak out from those blood vessels under the skin.

When this excess fluid accumulates under the skin, it causes the red, itchy bumps (hives) that we see. Histamine is what causes the itching and inflammation. Do you understand?

That means this is the result of a more complex process inside the body than what is visible from the outside.

What is the doctor doing?

Most of the time, hives will go away on their own in a day or two, so you don't always need to see a doctor. However,

• If the child is too much to bear,
• If the disease has spread throughout the body,
• If this condition persists for more than two or three days,
• Or if you have any doubts or fears about this,

The best thing to do is definitely take the child to a doctor.

The doctor will first examine your child's skin carefully. Then they will ask you questions about the condition. They will ask questions like, "How long have you had these rashes? Are they itchy? Are there any other illnesses? Have you been given any new foods? Have you taken any medicine?" and will try to find the cause.

• Most of the time, the doctor can identify these lesions as hives immediately upon seeing them and hearing the details you describe.
• To control itching and hives, you can take a medication called an antihistamine . These come in the form of tablets or syrups. These medications reduce the action of histamine and provide relief.
• Sometimes, if it's a little severe, a medication like a corticosteroid can be given for a short period of time. But that's rare.
• If your child has hives frequently, or if the cause is difficult to find, your doctor may refer you to an allergy specialist . They may also perform allergy tests.

Can hives be an emergency?

This is a very important thing to remember. Although hives are usually not very dangerous, sometimes they can be part of a severe, life-threatening allergic reaction called anaphylaxis .

Anaphylaxis may be accompanied by one or more of the following symptoms along with hives:

• Difficulty breathing, shortness of breath, chest tightness.
• Feeling like your throat is blocked, unable to speak, a hoarse voice.
• Swelling of the lips, tongue, or face (especially around the eyes).
• Feeling dizzy, lightheaded, or losing consciousness.
• Severe stomach cramps, nausea, vomiting, diarrhea.
• Rapid heartbeat, slow pulse rate.
• Suddenly feeling cold and sweating.

If you notice any of these symptoms in your child along with hives, don't delay! It could be anaphylaxis. It is a life-threatening condition that requires emergency medical attention. Take your child to the nearest hospital emergency room as soon as possible, without delaying for a second!

Some children may have been diagnosed with severe allergies by their doctors and may have been given an ``Epinephrine auto-injector'' (e.g., ``EpiPen'') to use in such cases. If you have one, your doctor will have taught you how to use it. Even if you use it, you should definitely go to the hospital.

Can hives be prevented?

It's difficult to completely prevent hives, as we don't always know the cause. However, there are some things you can do:

• If you know the cause, avoid it: If you know for sure that your child's hives are caused by a certain food, medication, or other substance, avoid giving that substance to your child or exposing your child to it. For example, if you know that it was caused by eating peanuts, don't give them peanuts again.
• Skin-friendly clothing: Dress your baby in soft, breathable, loose-fitting clothing like cotton. Tight, rough clothing can irritate and chafe the skin.
• Prevent dry skin: Dry skin can also increase itching. Apply a good moisturizer after bathing your baby.
• Reduce stress: Create an environment for your child to play and relax.

If the cause cannot be found, hives may return. But don't panic. Talk to your doctor and be aware of things like what to do if they do, what medications to keep on hand, etc.

Let's remember this.

Okay, so let's recap the most important points from what we've talked about:

• Hives are a type of red, itchy rash that appears on the surface of the skin, which can be seen in both children and adults.
• Most of the time, these are not dangerous and will get better on their own in a few days.
• Hives can occur for a variety of reasons, including food, medication, viruses, cold, sun, and stress. Sometimes, no cause can be found.
• The doctor will prescribe medication such as antihistamines for itching and discomfort.
• Most importantly: If hives are accompanied by severe symptoms such as difficulty breathing, swelling of the face/lips/tongue, and dizziness, it could be a dangerous condition called anaphylaxis. If that happens, go to the hospital without delay!
• If your child is experiencing hives frequently, it is very important to see an allergist for advice.

I hope this information is helpful to you. I wish your child a speedy recovery!

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