Papular urticaria is a common skin condition in children caused by allergic reactions to insect bites. It can be managed with topical creams and antihistamines, and children usually outgrow it. Insect repellent and wearing protective clothing can help prevent outbreaks. Severe cases may require prescription medication.
Papular urticaria is a very common skin condition among young children. It is characterized by multiple small red itchy bumps most often seen on the extremities. The exact causes of the condition are not known, but the bumps are strongly suspected to be the result of allergic reactions to certain types of insects. Most papular urticaria outbreaks can be managed with topical creams and oral antihistamines, and most patients outgrow the condition by the time they reach adolescence or early adulthood.
Fleas, mites, bed bugs, mosquitoes, and many other types of insects can be responsible for hives. Bug bites precede many outbreaks, but it’s possible for reactions to occur in the absence of a bite. Allergies can be triggered by chemical traces left when insects crawl on the skin or simply exist in large numbers in a particular region. Most children experience reactions in the spring and summer months when insect populations are usually most active.
Exposed areas of skin on the legs and arms are common sites for papular urticaria. Outbreaks can also occur on the neck, chest, back, and occasionally the face. Clusters of red papules tend to erupt at once and can cover a fairly large area of skin, although individual bumps are rarely larger than 0.5 inch (about 1.25 cm) in diameter. The bumps can turn into pus-filled blisters a day or two after they appear and become extremely itchy.
Most cases of mild or rare papular urticaria do not require a trip to the doctor’s office. Parents can treat their children at home with over-the-counter anti-inflammatory ointments, such as hydrocortisone creams. Calamine lotions and similar emollients can soothe itchy sensations, and oral antihistamines help children feel comfortable enough to rest at night. If your skin symptoms don’t resolve or recur frequently, a doctor can evaluate the situation and recommend other treatment options.
A physician may decide to prescribe a high-strength topical corticosteroid in severe cases of papular urticaria. Antibiotics may also be needed if the blisters have been ruptured and infected. Doctors can also help patients and their parents understand what triggers symptoms and what they can do to reduce the risk of future outbreaks. In many cases it helps to use insect repellent sprays outdoors and to wear clothing that leaves the skin less exposed. Parents may also be encouraged to wash carpets, bedding, and furniture thoroughly and to consider spraying their homes with nontoxic insecticides.
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