10 year old boy with hives

My 10 year old son ate about a cup of mixed nuts (maybe more).  He developed large itchy hives on his face and neck several hours later.  After several days the hives on his face and neck started becoming dry and rough, but were going away.  He then developed hives on his arms and groin area, which after several days started to heal the same way.  Now he has bright red hives on his lower belly and upper legs.  It seems as if the hives have progressed from the top of the body to the bottom.  Is this common?  I bought aveeno oatmeal bath and I'm giving him an antihistamine at night.  Does he need to be seen by a doctor?  What is going on?

[Bhupinder Kaur, MD]

Hello,

Hives (medically known as urticaria) are red, itchy, raised areas of skin that appear in varying shapes and sizes. They have a tendency to change size rapidly and to move around, disappearing in one place and reappearing in other places, often in a matter of hours.
The mainstay of treatment of hives is antihistamine which may be necessary for prolonged periods (in excess of 6 weeks).Non-sedating antihistamines such as Cetirizine(Zyrtec) or Loratadine(Claritin) may be needed to get symptom relief. Sedating antihistamines such as Chlorphenamine(Benadryl) is used at night to get urticaria control. Short courses of oral cortisone or steroids are taken for short periods (one to three days) to settle more severe symptoms.
You may give Vitamin C along with the prescribed treatment and apply calamine lotion on the rashes. Vitamin C is a general anti-allergy supplement. It helps stabilize mast cells so they are less likely to release histamine.

If the symptoms persist, then you can consult an immunologist. He may start with immunosuppressive drugs.

If the hives don’t go after 6 wks of treatment also, then it can be a case of chronic urticaria which needs further evaluation as it may be due to auto antibodies.

Hope it helps.Take care and pls do keep me posted on how your son is doing or if you have any additional queries.Warm regards.