Causes and Treatments of Hives | Dermatology

Hives (Urticaria)

What are hives?

Urticaria, also known as hives, is the appearance of pale red, swollen bumps or plaques that appear suddenly – either as a result of the body’s reaction to certain allergens or for unknown reasons.

Urticaria usually causes itching, but it may also burn or sting. It can appear anywhere on the body, including the face, lips, tongue, throat, or ears. The hives vary in size (from a pencil eraser to a dinner plate), and they may combine together to form larger areas known as plaques. It can last for hours, or even a day before fading away.

Angioedema resembles urticaria, but the swelling occurs under the skin rather than on the surface. Angioedema is characterized by deep swelling around the eyes, lips, and sometimes the genitals, hands, and feet. The rash usually lasts longer than the rash, but the swelling usually goes away in less than 24 hours.

Infrequently, angioedema in the throat, tongue, or lungs can impede the aviation routes, causing trouble relaxing. This could become life-threatening.

Types of hives

Allergic Reactions:

The most well-known reasons for hives are unfavourably susceptible responses. It can be caused by any allergen you may be allergic to, including:

  • Foods (such as nuts, milk, and eggs)
  • Dust mites
  • Pet dander
  • Pollen
  • Medications (primarily antibiotics, cancer drugs, and ibuprofen)
  • Insect bites or stings

Mild cases of allergic hives are usually treated with long-term or short-term allergy medications and avoiding the trigger.


Anaphylaxis is a severe, life-threatening allergic reaction. In this condition, urticaria is often accompanied by breathing difficulties, nausea or vomiting, severe swelling, and dizziness. Contact to the doctor right away if you suspect anaphylaxis.

Chronic hives: 

Chronic hives are ongoing conditions that do not necessarily have an identifiable cause. Also known as chronic hives, this condition is characterized by frequent hives that can interfere with your lifestyle. Depending on the clinic, these can last between six weeks and several months or years.

You may suspect chronic hives if you have bruising that does not go away within six weeks. Although this type of urticaria is not life-threatening, it can be uncomfortable and difficult to treat. It may also be a symptom of an underlying health problem, such as:

  • Celiac disease
  • Thyroid disease
  • Type 1 diabetes
  • Lupus
  • Rheumatoid arthritis


This type of acute hives is considered mild. This causes excessive scratching or constant pressure on the skin. Dermatographia usually goes away on its own in a short period of time without treatment.

Temperature-induced hives:

Sometimes, changes in temperature can trigger hives in people who are sensitive to such changes. Cold-induced hives may occur from exposure to cold water or air, while body heat from physical activity may cause hives from exercise. Exposure to sunlight or tanning beds may also cause solar cells in some people.

Infection-induced hives:

Both viral and bacterial infections can cause hives. Common bacterial infections causing hives include urinary tract infections and sore throats. The viruses that cause infectious mononucleosis, hepatitis and the common cold often cause hives.

What are the signs and symptoms?

The most common signs (what you see) of urticaria are:

  • Slightly raised bumps that are pink or red.
  • Bruising that occurs alone or in a group, or communicates over a large area.
  • Skin swelling that subsides or disappears within 24 hours in one place but may appear elsewhere.
  • As for the symptoms (what you feel), urticaria is usually itchy. Sometimes they sting or hurt. Some people always get hives in the same place or spots on their bodies. Often these people have a trigger (what causes hives). Every time they are exposed to this trigger, they develop hives.

A dermatologist may call this type of hives fixed, which means immobility. Fixed hives may occur when a person takes a specific drug (stationary drug eruption) or is exposed to much sunlight (fixed solar urticaria).

What causes hives?

Urticaria happens when the body responds to an allergen and deliveries histamine and different synthetic compounds from under the outside of the skin. Histamine and chemicals cause inflammation and fluid build-up under the skin, which causes hives.

Include examples of known triggers:

  • Medications, including some antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ACE inhibitors, used for high blood pressure
  • Foods, such as nuts, shellfish, food additives, eggs, strawberries, and wheat products
  • Infections, including influenza, the common cold, glandular fever, and hepatitis B
  • Bacterial infections, including urinary tract infections and strep throat
  • Intestinal parasites
  • Dust mites
  • Extreme temperatures or changes in temperature
  • High body temperature
  • Pet dander from dogs, cats, horses, and so on
  • Cockroaches and cockroach waste
  • Latex
  • Pollen
  • Water on the skin
  • Scratching
  • Some plants, including nettles, poison ivy, and poison oak
  • Insect bites and stings
  • Some chemicals
  • Chronic illness, such as thyroid disease or lupus
  • Sunlight exposure
  • Exercise

In more than half of the cases, people never find the exact cause. Chronic urticaria may start as an autoimmune response, but it is not clear why it occurs.

Who is at risk?

It is known that allergy sufferers are more likely to have hives. You also may be at risk of developing hives if you take medication or if you are accidentally exposed to things you may be allergic to, such as food or pollen. If you are already sick with an infection or health condition, you may be at greater risk of developing urticaria.

How are hives treated?

In many cases, mild hives do not need to be treated and will go away on their own. If a specific trigger is found, avoiding it is part of treatment. If you feel itchy hives, your doctor may recommend an antihistamine medication to prevent the release of histamine into the bloodstream and prevent its spread.

For chronic hives, your doctor may suggest taking a prescription non-sedating (non-drowsy) or over-the-counter antihistamine every day. However, not everyone responds to the same medications, so it is important to work with your doctor to find the right medication for you.

If non-drowsy antihistamines do not work, your doctor may suggest a stronger antihistamine, another drug, or a combination of drugs. In rare cases, a doctor may prescribe steroid pills or liquid to treat chronic urticaria. This is usually done for a short time (5 days to 2 weeks) to prevent harmful side effects of the steroid.

In case of emergency

Anaphylactic shock and nasty attacks of urticaria or angioedema are rare. But when they do occur, they need immediate medical attention. People with severe allergies should have an injection of epinephrine. Your doctor will teach you how to safely give yourself an injection if you are at risk of developing a severe allergic reaction.

How is urticaria diagnosed?

Your primary care physician can analyze urticaria and expand by taking a gander at your skin. Allergy tests can help determine what triggers a reaction. Realizing the reason can assist you with keeping away from allergens, urticaria, and growing. Include allergy tests:

  • Skin tests: During this test, health care providers test various allergens on your skin. If your skin turns red or swollen, you have an allergy to that substance. This type of allergy test is also called a skin prick or a scratch test. Skin testing is not commonly performed if the urticaria is chronic in nature.
  • Blood tests: The blood test checks for certain antibodies in your blood. Your body makes antibodies to fight allergens. This process is part of your immune system – but if your body is producing too much, it can cause urticaria and swelling.


Complications of urticaria may include:

  • Anaphylaxis (a life-threatening whole-body allergic reaction that causes difficulty breathing)
  • Swelling in the throat can lead to life-threatening airway obstruction


If your child gets urticaria a lot, keep a record of the events that happen right before their outbreak. This will help your child’s doctor find the cause and create a plan to prevent it from returning.

  • Stay away from things you know may trigger urticaria. A more severe reaction may occur next time.
  • Avoid the foods and drugs that have caused urticaria in the past. Read the labels carefully.

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