Allergy & Skin · Belfast
Urticaria (Hives) in Children — Belfast
Private assessment and management of urticaria and angioedema in children in Belfast and Northern Ireland. Dr Mugilan Anandarajan, Consultant Paediatrician, offers allergy testing and personalised management plans with no GP referral required.
What is Urticaria?
Urticaria (hives) is a common skin condition in children characterised by raised, itchy wheals (welts) that can appear anywhere on the body. Each wheal typically fades within 24 hours, but new ones may continue to appear.
Urticaria affects up to 20% of people at some point in their lives. In children, it is most commonly acute and triggered by viral infections or allergic reactions. Chronic urticaria — lasting more than 6 weeks — is less common but can significantly affect quality of life.
Emergency Warning Signs
If your child develops swelling of the lips, tongue, or throat, difficulty breathing, or collapse alongside hives — call 999 immediately. This may be anaphylaxis.
Symptoms
- Raised, itchy red or skin-coloured wheals (welts)
- Wheals that change shape, move, or fade within 24 hours
- Rash that can appear anywhere on the body
- Burning or stinging sensation on the skin
- Swelling of lips, eyelids, or face (angioedema)
- Symptoms that may be worse at night
- Rash triggered by heat, pressure, or exercise in some cases
Types of Urticaria
Acute Urticaria
Lasts less than 6 weeks. Most common in children. Often triggered by viral infection, food allergy, or medication. Usually resolves completely.
Chronic Spontaneous Urticaria
Lasts more than 6 weeks with no identifiable external trigger. Often idiopathic or autoimmune. Can persist for months to years.
Allergic Urticaria
Triggered by an allergic reaction to food (nuts, eggs, milk, shellfish), insect stings, latex, or medications. May be accompanied by other allergic symptoms.
Inducible Urticaria
Triggered by physical stimuli such as cold (cold urticaria), pressure (delayed pressure urticaria), heat, exercise, or sunlight.
Angioedema
Deeper swelling beneath the skin affecting lips, eyelids, face, hands, or genitals. Often occurs alongside urticaria. Throat swelling requires emergency treatment.
Contact Urticaria
Localised hives at the site of skin contact with a trigger substance such as latex, certain plants, or foods.
What Happens at the Consultation?
Detailed History
Thorough history of the rash — onset, duration, distribution, potential triggers, associated symptoms, medications, and family history of allergy.
Clinical Examination
Examination of the skin and assessment for signs of angioedema or other allergic conditions.
Allergy Testing
Skin prick testing and/or specific IgE blood tests where a food or environmental allergen trigger is suspected.
Management Plan
Personalised treatment plan including antihistamine therapy, trigger avoidance advice, and emergency action plan if anaphylaxis risk is identified.
Treatment Options
Non-sedating antihistamines
First-line treatment. Cetirizine or loratadine taken regularly to control symptoms. May need to be taken daily for weeks or months in chronic urticaria.
Trigger avoidance
Where a specific trigger has been identified (food, medication, physical stimulus), avoidance is a key part of management.
Adrenaline auto-injector
Prescribed for children at risk of anaphylaxis. Training provided on recognition of anaphylaxis and correct use of the device.
Allergy testing
Skin prick testing and specific IgE blood tests to identify allergic triggers where relevant.
Specialist referral
For refractory chronic urticaria, referral for consideration of omalizumab (Xolair) or other specialist treatments may be arranged.
Paediatric Allergy Assessment — Belfast
Dr Mugilan Anandarajan is a Consultant Paediatrician with a special clinical interest in allergy and skin conditions in children. He holds a Postgraduate Certificate in Clinical Health Science Allergy and has extensive experience assessing and managing children with urticaria and angioedema across Belfast and Northern Ireland.
Appointments are available at Kingsbridge Private Hospital (Lisburn Road) and Ulster Independent Clinic (Stranmillis Road). No GP referral is required. All major private health insurers are accepted.
Frequently Asked Questions
What is urticaria (hives) in children?
Urticaria, commonly known as hives, is a skin condition characterised by raised, itchy, red or skin-coloured welts (wheals) that appear suddenly on the skin. Each individual wheal typically lasts less than 24 hours before fading, but new ones may continue to appear. Urticaria is very common in children and can occur at any age.
What causes urticaria in children?
Acute urticaria (lasting less than 6 weeks) is most commonly triggered by viral infections, allergic reactions to foods (nuts, eggs, milk, shellfish), medications (antibiotics, NSAIDs), insect stings, or contact allergens. Chronic urticaria (lasting more than 6 weeks) is often idiopathic (no identifiable cause) and may involve an autoimmune mechanism. In many cases, no specific trigger is found.
What is the difference between acute and chronic urticaria?
Acute urticaria lasts less than 6 weeks and is often triggered by an identifiable cause such as infection, food, or medication. It usually resolves completely. Chronic urticaria persists for more than 6 weeks, often with daily or near-daily symptoms. Chronic spontaneous urticaria (CSU) is the most common form and is frequently idiopathic. It can last months to years but usually resolves eventually.
What is angioedema and is it related to urticaria?
Angioedema is deeper swelling beneath the skin, typically affecting the lips, eyelids, face, hands, feet, or genitals. It often occurs alongside urticaria. Angioedema involving the throat or tongue is a medical emergency requiring immediate treatment. If your child develops swelling of the lips, tongue, or throat alongside hives, call 999 immediately.
Do I need a GP referral to see Dr Anandarajan about my child's urticaria?
No. You can book directly without a GP referral. Dr Anandarajan sees children aged 0–16 with acute and chronic urticaria at Kingsbridge Private Hospital and Ulster Independent Clinic in Belfast.
How is urticaria diagnosed?
Diagnosis is primarily clinical, based on the history and appearance of the rash. For acute urticaria with a suspected allergic trigger, allergy testing (skin prick testing or specific IgE blood tests) may be performed. For chronic urticaria, blood tests including full blood count, inflammatory markers, thyroid function, and autoimmune markers may be requested. A detailed history of potential triggers, medications, and associated symptoms is essential.
How is urticaria treated in children?
First-line treatment for urticaria is a non-sedating antihistamine (such as cetirizine or loratadine) taken regularly. For chronic urticaria, antihistamines may need to be taken daily for weeks or months. Trigger avoidance is important where a trigger has been identified. For severe or refractory chronic urticaria, additional treatments such as higher-dose antihistamines or specialist referral for omalizumab (Xolair) may be considered.
When should I seek emergency help for urticaria?
Seek emergency help immediately (call 999) if your child develops swelling of the lips, tongue, or throat; difficulty breathing or swallowing; a hoarse voice; dizziness or collapse; or if they have been prescribed an adrenaline auto-injector (EpiPen) and you need to use it. These are signs of anaphylaxis, which is a life-threatening emergency.
Common Questions
Frequently Asked Questions
About urticaria in children in children
Is your child affected by hives or urticaria?
Dr Anandarajan offers same-week appointments with no GP referral required at Kingsbridge Private Hospital and Ulster Independent Clinic, Belfast.