Urticaria in children

Skin, nail and hair health
1

My almost 5 year old son developed urticaria about 8 weeks ago. I think it was bought on either by smarties or orange squash, he'd had neither before then he started to develop the rash over the next few days.

He has been taking 5Ml of citirizine for 8 weeks and it's done nothing. I've cut so many things out of his diet he is miserable. Today he got a party bag at school and I let him eat a lolly pop......he's in agony.

He has always had eczema so we cover him in epiderm 4 times a day. Could this be making him worse? His eczema has actually been fine recently so that could have been triggered by something I have now cut out of his diet.

I spoke to the gp yesterday and they have increased his dose of citirizine but that's it. I feel so helpless, my boy is crying everyday and is starting to get really self conscious and didn't want to wear shorts this week. I dread another kid at school commenting.

Does anyone have any words of wisdom? Sorry for the rant.

2

Hi lotte

I have had urticaria 3 times and now have it again. I am now 30 but had it when I was 9 also. When I first had it, I changed my washing powder, diet etc and nothing worked. Now after years of research and my experience, it appears that 50% of cases are due to the immune system over working with no real reason why. I have it under control currently by using a mixture of anti histamines on a high dose. I am taking fexofenadine x4 , rantitadine x 2 and one Montelukast in th evening. This keeps it at bay. Not sure if this is possible at your child's age, but worth speaking with your GP about this. If this doesn't work, I can recommend some other alternatives and different avenues to try.

Let me know how you get on

Andrew

3

Ask him if the epadem now makes him feel better or worse, sometimes an ingredient in an emollient becomes an allergen and generates the very problem it isupposed to stop.unusual but not ip unknown with Epaderm .An alternative such as aveeno may be fine . It is sometimes a real help to get a skin swab analysed to see if a bug has colonised the skin more than normal , usually it is a stphylococcus aureus infection when an antibiotic cream such as mupirocin as well lwas a steroid cream will make everything better.With treatment creams you do need to use enough, look at the fingertip unit advice  sheet for the amount to use. ( patients UK)

4

Look on dermnetnz.org website for advice and help. 

 

5

He has a 1% steroid cream to use when his eczema flares up, do you think it would help? I haven't tried it yet. I tried aveeno and it made his skin feel like it was burning. The epiderm is soothing the itch but his skin is like sandpaper now, it's heartbreaking. 

After How long would you expect to see a difference from the increased dose in citirizine?

6

The anti histamines should get to work pretty quick. In my experience if there is not noticeable improvement within 24 to 48 hour, they won't make any further improvement anytime soon. Worth trying a different type or combination .

7

Are you washing him in Epaderm as well as using it to moisturise ? The 1 % steroid cream or ointment if his skin is very dry is an extremely safe option and would take at least  2-3 days to start helping . The cetirizine is not sedative so lovely in the day, a sedative antihistamine  at night might help ? 

8

Thanks for your replies. Yes we wash him with epiderm too and I put a tablet in the bath that neutralises the chlorine in the water (bought from the allergy UK website) We're in London and the water is awfully hard. I'll see how he is in the morning after his higher dose. I'll try the steroid cream too. 

Thanks again. 

9

Hi Lotte, its heartbreaking when our children are ill and we feel so helpless when nothing will help or makes them feel worse.  I get the same reaction as your son when using creams (burning skin and red colour to the skin).  Mine also feels tight immediately after putting any kind of moisturiser or skin cream on my skin and i have a massive flare up anywhere that the cream or lotion touches.  I have tried everything, any aqueus cream, sudacrem, e45, they all did the same thing, even though they are supposed to help.  It took me a while, but i have found something that helps a little and you will laugh when you hear it and think "why didnt i think of that".  Try Aloe vera after sun gel (must be water based gel, not cream) this helps my skin to feel cooler, it doesnt stop all the itching, but it does soothe enough that i dont get as stressed.

This could help your son calm enough so that being upset isnt aggravating things and making it worse.  I know when i am stressed or upset i get more breakouts.

I have suffered since i was 9 years old, my first breakout was caused by a simple horse ride.  That lasted a few days and because the horse ride was a one off treat for me, i didnt get my next breakout until i was 14.  That one was worse, it lasted on and off for 3 years and was triggered by getting a dog, i would get a breakout every month or so.  Back then there wasnt much they could do, told me it was hives and that i just had to put up with it. 

Over the years i have had more breakouts, but was lucky.  By age 26 i was free and clear, and that lasted until july 2012 (about13 years)  when a minor surgical procedure triggered this last episode.  Im coming up on 3 years with this episode and its been the worst i have had so far.  I Suffer multiple breakouts every day, usually between 20 and 30 a day. I have been on multiple therapies, but none have cleared it completely, they do reduce the severity, they just dont clear it completely, which is why I have been classified as treatment unresponsive by my Immunologist.  

I think it would be helpful to you and your son to discuss seeing an immunologist with your doctor.  Your Son is young, so they should be able to help him so that he can enjoy his childhood.  Urticaria has many causes, and the fact that he has excema  already shows that he has issues with his skin.  The steroid treatment for excema might help the urticaria in the area that the cream is used.

An immunologist can identify his triggers (causes of urticaria breakouts) by doing a full allergy screening.  This will then help you to remove triggers from his environment.  Foods can trigger Urticaria, and i empathise with your dilemma about removing things he likes.   My son is autistic (adult now) but when he was a child he was very picky about what he would eat, to the point that his diet was very restricted.    I had to try everything i could to get him to eat healthily.  There is a fruit based product on the market that might be worth you trying.  You might have seen the adverts lately for fruit bowl??  this has been out a long time and my son loved their fruit bars, its pure compressed fruit.  I used these as a treat instead of sweets and chocolate with high levels of e numbers and artificial flavours or preservatives.  They might be worth you trying.

I hope that you can find a way to help your son to be able to enjoy his life and get treatment that means he will be happier in himself.  Good luck lottie

10

The Aloe gel sounds good but beware of 'fruit bars' many dried fruits contain histamine.

Stress does alter the immune system and can be damaging but reducing it is hard work, especially if the family is already stressed. 

Sunshine may help, taking care not to burn. One of our local paediatricians gives children with eczema a trial pack of several different moisturisers a healthy balanced diet is important for the immune system. Read about zinc and selenium, both important for the immune system, many doctors only think of extreme examples but mild deficieny is common in the general population and easily overlooked.

11

I agree with you Norman, yes, some dried fruits do have high levels of histamine in them.  Im not certain that the fruit bowl bars, flakes and snacks contain dried fruit. I think they actually contain fruit pulp.  I would have to check, im sure there is a website to check. Histamine was something i didnt have to worry about with my son, he has luckily not inherited my condition or anything similar. But with autism and several physical complications from birth, it was a blessing that he was safe from my illness. 

Sunshine is a good suggestion, i was unfortunate that full body UV therapy has not helped me.  I had a 12 week session of treatment between September and December 2014.  It made things worse for me, but it could be beneficial for your son.  UV can help other skin complaints including excema and psoriasis.  It is said to work in up to 70% of cases of Urticaria as well. Perhaps this is worth exploring.  I live in the UK, so im not certain of the procedures for other countries, but i accessed this treatment through a Dermatologist that my Immunologist sent a referral to.

I hope that this is helpful in deciding how you approach your sons future care, lottie.