Hives are also referred to as urticarial. They are red, pink, or flesh-colored raised itchy skin rash that is mostly found on the skin, which sometimes stings or hurt. Mostly hives are caused by an allergic reaction to a medication or food or a reaction to an irritant in the environment. In many cases, hives are an acute (temporary) problem that may be alleviated with allergy medications. Most rashes go away on their own. However, chronic (ongoing) cases, as well as hives accompanied by a severe allergic reaction, are larger medical concerns. Hives aren’t contagious and affect around 20 percent of people at some time in their life.


Hives are caused when an allergic reaction occurs; the body then releases a protein called histamine. When histamine is released, the tiny blood vessels known as capillaries leak fluid. The fluid accumulates in the skin and causes a rash.


Hives symptoms are different for every individual; it depends on the person and the situation. They can show up anywhere on your body. Signs of hives include:

  • Red raised welts or bumps on the skin.
  • Blanching (the center of the hive turns white when pressed).
  • Itchy skin.
  • Swelling (angioedema).


1) Allergic Reactions: The most common causes of hives are allergic reactions. These can be caused by any allergen you might be sensitive to, including:

  • Foods (such as nuts, milk, nuts, shellfish, food additives, eggs, strawberries, and wheat products)
  • Pet dander( dog cats, horse)
  • Pollen
  • Dust mites
  • Insect bites or stings
  • Medications (primarily antibiotics, cancer drugs, and ibuprofen)

Mild cases of hives caused by allergies are typically treated with long- or short-term allergy medications and avoidance of the trigger.

2) Anaphylaxis: Anaphylaxis is a severe, life-threatening allergic reaction. These hives are often accompanied by breathing difficulties, nausea or vomiting, severe swelling, and dizziness.

3) Chronic hives: Chronic hives are ongoing cases that don’t necessarily have an identifiable cause. This condition is marked by recurring hives that can interfere with your lifestyle and can last between six weeks and several months or years.

You may suspect chronic hives if you have welts that don’t go away within six weeks. While not life-threatening, this form of hives can be uncomfortable and difficult to treat. They may also be a symptom of an underlying health problem, such as:

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

4) Dermatographism: This form of acute hives is considered mild. Excessive scratching or continuous pressure on the skin causes it. Dermatographism usually clears up on its own in a short period of time without treatment.

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

6) Infection-induced hives: Both viral and bacterial infections can cause hives. Common bacterial infections causing hives include urinary tract infections and strep throat. Viruses that cause infectious mononucleosis, hepatitis, and colds often cause hives.


1) Physical Examination

The doctor will physically examine the body and ask you a number of questions to try to understand what might be the cause of the signs and symptoms. Asking the patient to keep a diary to keep track of:

  • Their activities
  • Any medications, herbal remedies, or supplements they take
  • What eat and drink
  • Where hives appear and how long it takes a welt to fade
  • Whether the hives come with painful swelling

2) Blood or skin test

The doctor may have the patient undergo these tests if physical examination and medical history suggest the hives are caused by an underlying problem.

3) Biopsy. A piece of skin is taken and looked at under a microscope. This is often not needed unless your doctor is not sure if you have hives or something else.


Treatment for acute hives includes:

1) Non-sedating antihistamines taken regularly for several weeks.

Taking non-sedating antihistamine pills daily helps block the symptom-producing release of histamine. They have few side effects. Examples include:

•         Loratadine (Claritin)

•         Fexofenadine (Allegra)

•         Cetirizine (Zyrtec)

•         Desloratadine (Clarinex)

2) Patients with angioedema may need to see an allergist, an immunologist, or a dermatologist. Angioedema can cause potentially serious breathing difficulties.

3) If there is swelling of the tongue or lips, or if breathing becomes difficult, the doctor may prescribe an epinephrine auto-injector, for example, EpiPen, in case of emergencies.

4) Patients should avoid known triggers, if possible.

Treatment for chronic hives includes

1) Antibiotics, for example, Dapsone, can reduce redness and swelling.

2) Omalizumab, or Xolair is an injectable drug that blocks immunoglobin E, a substance that plays a role in allergic responses. It can reduce symptoms of chronic idiopathic urticaria, a type of hives of unknown origin that can last for months or years.

3) Acupuncture might be effective and safe for chronic urticaria in relieving symptoms,


Chronic hives can go on for months and years. They can interfere with sleep, work, and other activities. The following precautions may help prevent or soothe the recurring skin reactions of chronic hives:

  • Wear loose, light clothing.
  • Avoid scratching or using harsh soaps.
  • Soothe the affected area with a bath, fan, cool cloth, lotion, or anti-itch cream.
  • Keep a diary of when and where hives occur, what you were doing, what you were eating, and so on. This may help you and your doctor identify triggers.
  • Avoid known triggers.
  • Apply sunscreen before going outside.


1) If you develop hives often, keep a record of events that happen just before they break out. This will help your child’s doctor find the cause and make a plan to keep them from coming back

2) Stay away from things you know can trigger you to get hives.

3) Avoid foods and medicines that have triggered hives in the past. Read labels carefully.

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