BABY AND CHILDHOOD SKIN DISORDERS: HIVES
Doctors called this urticaria, and it usually represents a patient's adverse skin reaction to something either eaten or contacted, although the offending item may be very dif f icul t to locate. Food is a very common cause. Shellfish, nuts, berries, eggs, milk, chocolates and various medicines (the antibiotic penicillin is notorious) are all starters. Also, stings from various insects, touching certain plants and trees, heat or cold, and certain injections are all on the known list. Sometimes emotional anxieties and stresses may play a part.
All kinds of symptoms may occur. Often a red, raised skin area which is intensely irritating may develop, the common-or-garden variety of hive. This may be more diffuse, a larger area (or wheal) occurring, which is also raised and red and often very itchy. Several of these may join together to form a large sheet of skin irritation. The itch is often extremely marked, and frequently it is the first indication, preceding the red marks.
Sometimes a special kind of hive occurs: this is referred to as angioneurotic oedema, and it occurs on the tongue or larynx or some part of the face. It tends to be pale, does not itch so much, and is not nearly so common. The main danger is when this occurs in the throat which may swell up and cause choking through a constricted airway. Immediate treatment is essential, from the doctors or at a hospital emergency ward.
Treatment
Remove or stop taking any food or medicine that obviously relates to the appearance of hives. Children who are known to be sensitive to certain items should avoid these, and the doctor acquainted with the problem before any medication is prescribed for any illness. Avoiding extremes of heat and cold is advisable, for this often precipitates an attack (for example, hives often appear after a hot shower, or a cold swim, in certain individuals). Diagnosing hives is fairly easy, and most parents soon recognize what they look like.
Local applications usually bring relief from the heat and itch. Cool-water or ice-water packs are often effective. Apply often and change as soon as they start to warm up. Then apply a simple lotion or cream. Ones containing anti-itch products often help. A simple effective remedy is calamine liniment containing benzo-caine 3 per cent, or menthol 1 per cent, or camphor 1 per cent. Many commercial creams already made up are readily available from the pharmacist. Antihistamine creams, contrary to expectations, are of little benefit.
Antihistamine mixtures are frequently effective when taken orally. They may quickly reduce the redness, heat, itch and swelling. They tend to make the child tired. Often he will fall asleep soon after, so be prepared for this; in any case, a good sleep will do him no harm. Giving the appropriate dose early in the evening, so permitting a long undisturbed night (for junior and for everyone else in the family), is a good idea.
If food is responsible and the connection seems apparent, a mild laxative may assist in eliminating what is left in the system. Plenty of fluids taken orally will also help to eliminate these unwanted troublemakers from the system. However, regular use of laxatives by any infant or child is not recommended.
If simple measures fail to improve the condition, it may be necessary to call the doctor. There are various other forms of medication available, stronger and more effective. Corticosteroid creams may be ordered for a short bout, and these are often dramatic in reducing irritating symptoms locally.
Occasionally (but fortunately rarely) a horrid condition called anaphylactic shock may occur. This means the system has a sudden severe reaction to the foreign material. The child may suddenly feel uneasy, feel faint, develop a headache and throbbing in the ears. Sudden onset of hoarseness from the throat or breathing difficulty may also take place. This means that urgent medical attention is essential, for fluids are collecting in vital internal areas, and these on rare occasions are life-endangering. Special emergency treatment may be essential. Get to the doctors' or the emergency department of the nearest hospital, as a matter of urgency if this ever happens.
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General Health
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