Urticaria and Angioedema

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What is urticaria?

Urticaria is a red itchy rash that can occur anywhere on your child’s skin. It often improves in one area of the skin and then affects another area. It is also known as hives, nettle rash, welts or wheals.

Although the rash and swelling may look quite dramatic, it is not usually dangerous.

Urticaria is very common, affecting 1 in 5 people, and in most children will only last a few days.

Angioedema can happen at the same time as urticaria. It is swelling deep in the skin, often affecting the eyelids and lips and sometimes the limbs.

Why does urticaria happen?

Urticaria and angioedema are caused by the release of histamine from cells in the skin.

Histamine is a chemical your body makes that causes allergy symptoms, although urticaria in children is more commonly caused by viral infections. These normally don’t need any treatment and will get better by themselves.

Uncommonly other infections can cause urticaria, for example the mycoplasma or streptococcus bacteria. Other less common causes of urticaria and angioedema including allergies to foods, chemicals such as washing powders, or certain medicines. Exercise, heat or cold, or even stress can also trigger the rash. A lot of the time no specific cause will be found.

When should I be worried?

Urticaria is usually harmless. But in some children the same rash can happen with a severe allergic reaction called anaphylaxis. This can be to certain foods, insect bites or medication. Anaphylaxis can be very serious and needs immediate medical attention.

What is the treatment of urticaria?

Antihistamine medication is usually recommended for most cases of urticaria. It can help with the symptoms of itching and swelling and can bring down the rash.

Antihistamines like cetirizine are usually advised because they are non-sedating. This means they do not cause sleepiness. Some antihistamines like Chlorphenamine (also called Piriton) can cause sleepiness.

You can usually buy antihistamines from your Pharmacy. Talk with your Pharmacist if you are not sure which one to give your child.

Sometimes your doctor or nurse will also give your child a short course of oral steroid medication. This can sometimes help if the symptoms of urticaria are severe. Simple moisturizers can help soothe the skin and keeping cool may help to reduce itching.

Your child’s doctor or nurse practitioner will tell you if they think your child needs
antibiotics for one of the rarer infections that can cause urticaria, but they are not
usually needed.

Does my child need any tests?

No. There are no specific tests needed for a diagnosis of urticaria. Most cases of acute urticaria do not need routine allergy testing.

How long will my child’s urticaria last?

Most children have a single episode of urticaria that lasts for less than 24 hours. However, your child’s rash may come and go over several weeks and may even last more than six weeks. If this happens, it is called chronic urticaria.

We recommend getting your child seen by their GP if you are worried that the rash is not going away or keeps coming back. This may mean that the rash needs to be investigated further.

Further resources

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This leaflet is intended for patients receiving care in Brighton

The information in this leaflet is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.