Understanding Hives: Signs, Symptoms, and Treatment

Around 20 percent of Americans know what it feels like to get hives. You’re going about your day, and all of a sudden, you’re overcome with itchiness. Then, when you look in the mirror, you notice red bumps have randomly appeared on your body.

Hives can be an uncomfortable and sometimes distressing skin condition, but with the right knowledge and treatment, hives can be effectively managed.

Let’s discuss the signs, symptoms, and available treatments to help you better understand and manage hives.

What Are Hives?

Hives, also known as urticaria, are a type of skin condition characterized by red, itchy welts or raised bumps that can appear on the skin and vary in shape and size. 

Hives can occur anywhere on the body and typically last for a few hours to several days, though chronic hives can last longer than six weeks. Hives are a common dermatological issue, affecting people of all ages.

Common signs and symptoms of hives include:

  • Red, Raised Bumps: Hives normally appear as red or pink raised bumps on the skin. The welts can vary in size, from small dots to larger patches. Hives can also grow, as smaller areas merge to form even larger areas of raised skin.
  • Intense Itchiness: As one of the most prominent symptoms of hives, itchiness can range from mild to severe and is usually the main reason people seek medical attention.
  • Swelling: Hives can cause deep swelling, known as angioedema, making welted areas (usually around the eyes, lips, tongue, hands, and feet) feel warm and tender to the touch.
  • Rapid Onset: Hives can develop suddenly and appear within minutes. They may come and go, making their exact causes or “triggers” difficult to pinpoint.
  • Reappearing Symptoms: Hives can be a reoccurring problem for some people. They may disappear and reappear periodically. In some cases, hives can become a chronic issue.
  • Triggered by Allergens: Hives can often be triggered by allergic reactions, such as from certain foods, medications, insect stings, or environmental factors like pollen. 
  • Stress-Induced: Stress and anxiety can worsen hives or even trigger them in some people. This is known as stress-induced hives, or “stress hives.”
  • Physical Urticaria: Some people may experience hives triggered by physical factors such as pressure changes, cold or heat. These are referred to as physical urticaria.
  • Underlying Health Conditions: In some cases, hives may be associated with underlying health conditions, such as autoimmune disorders or thyroid problems.

Treatment for Hives

Determining the best treatment for hives depends on the severity and underlying cause of your condition. 

Here are some common approaches to manage and alleviate hives:

  • Over-the-Counter (OTC) Antihistamines: Non-prescription antihistamines such as loratadine (found in Claritin), cetirizine (found in Zyrtec), or diphenhydramine (found in Benadryl) can help relieve itching and reduce the severity of hives. Follow the recommended dosages and consult with a healthcare professional before using these medications.
  • Prescription Antihistamines: In cases of severe or chronic hives, a healthcare provider may prescribe stronger antihistamines, often in combination with other medications. Prescription antihistamines include Azelastine, Carbinoxamine, Cyproheptadine, Desloratadine, Emedastine, Hydroxyzine, Levocabastine, and Levocetirizine.
  • Corticosteroids: For severe hives that do not respond to antihistamines, your doctor may prescribe corticosteroids such as Prednisone to help reduce inflammation and itching.
  • Epinephrine (Adrenaline): Epinephrine is a life-saving intervention used in cases of anaphylactic reactions, which are a life-threatening form of hives. Epinephrine should be administered by a medical professional or an individual trained to use an epinephrine auto-injector.
  • Autoimmune or Chronic Urticaria Management: For people with autoimmune or chronic urticaria, management may involve taking medications like Omalizumab or Cyclosporine to help control the condition.

When to Seek Emergency Care for Hives

In most cases, hives are not a medical emergency and can be managed with the treatments mentioned above. 

However, the following are situations where immediate medical attention is warranted for hives:

  • Anaphylaxis: If your hives are accompanied by severe symptoms such as difficulty breathing, swelling of the face or throat, rapid pulse, or a drop in blood pressure, it may indicate anaphylaxis, which is a life-threatening allergic reaction. If you or someone you know is experiencing anaphylaxis, call 911 or seek emergency care immediately.
  • Hives and Fever: If you experience hives with a high fever, it may indicate an underlying infection or other serious medical condition, and you should consult with a healthcare professional.
  • Hives and Difficulty Breathing: If hives ever cause difficulty breathing or wheezing, seek immediate medical attention.
  • Hives and Swelling Around the Eyes or Lips: Swelling around the eyes or lips, especially if it impairs vision or breathing, requires immediate medical evaluation.
  • Hives Persisting for Several Days: If your hives last for more than a few days, or if they repeatedly occur without an apparent cause, meet with a healthcare provider to receive a thorough evaluation.

Tips for Preventing Hives

Although it’s not always possible to prevent hives, especially when they are triggered by unknown factors, you can take several steps to reduce your risk and manage the condition effectively.

Here are four tips for preventing hives:

  • Identify and Avoid Triggers: If your hives are triggered by a specific allergen, you should identify and avoid that trigger. You may have to change your diet, avoid certain medications, or address environmental factors, like stress, that may be contributing to your hives.
  • Allergy Testing: If you suspect that your hives are caused by allergic reactions, your doctor may recommend allergy testing to identify the specific cause.
  • Lifestyle Modifications: Sometimes our lifestyle can be the biggest trigger for hives. Reducing stress, maintaining a healthy diet, staying hydrated, and getting regular exercise can help reduce the severity and reoccurrence of hives.
  • Medication Safety: Be cautious with new medications. Discuss any concerns with your healthcare provider, especially if you have a history of allergies or hives.

If you experience hives, consult with a healthcare professional to receive an accurate diagnosis and personalized treatment plan. With proper care, you can find relief from hives and live a comfortable, symptom-free life. 

And remember that if you ever experience severe symptoms like difficulty breathing or anaphylaxis, seeking immediate medical attention is crucial for your safety and well-being.

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