Hives, medically known as urticaria, are itchy, raised welts that develop on the skin. On lighter skin tones, they often appear pink, red, or skin-colored. On darker skin, they may be the same tone as your skin, slightly lighter, or darker.
While hives can sting or be painful, they’re usually a reaction to allergens like certain foods, medications, or environmental irritants. Most cases are temporary and respond well to over-the-counter allergy medication. However, chronic or severe hives can signal a more serious health issue.
What Triggers Hives?
Hives are most commonly the result of an allergic reaction. When your body detects an allergen, it releases histamines into the bloodstream—these are chemicals that help protect you from perceived threats. Unfortunately, histamines can also cause symptoms like itching, swelling, and the appearance of hives.
Common allergens that may trigger hives include:
- Pollen
- Certain medications
- Specific foods
- Animal dander
- Insect bites or stings
But allergies aren’t the only cause. Hives can also be triggered by:
- Stress or anxiety
- Tight clothing
- Physical activity or exercise
- Infections or underlying illnesses
- Temperature extremes (hot or cold)
- Excessive sweating
In many cases, the exact cause of hives isn’t always clear.
Who Is at Risk?
If you have known allergies, you’re more likely to experience hives. You may also be at higher risk if:
- You’re on certain medications
- You’re unknowingly exposed to allergens like food or pollen
- You’re already fighting off an infection or have an underlying health condition
Common Symptoms
Chronic hives can present in various ways, including:
- Clusters of raised welts (weals) anywhere on the body
- Welts that may be red, purple, or the same color as your skin
- Changing shapes and sizes of welts that come and go
- Persistent itching (pruritus), often intense
- Painful swelling (angioedema), especially around the eyes, cheeks, or lips
- Flares that are triggered by stress, heat, or exercise
- Symptoms that last more than six weeks and frequently return, sometimes for months or even years
How Are Hives Treated?
The first step is getting an accurate diagnosis. Most doctors can identify hives through a physical exam by observing the telltale welts on your skin. If an allergy is suspected, they may also run blood or skin tests to determine the trigger.
For mild cases not related to a specific allergy or illness, prescription treatment might not be necessary. Your doctor may recommend:
- Over-the-counter antihistamines, such as Benadryl (diphenhydramine) or Zyrtec (cetirizine)
- Avoiding scratching or irritating the affected area
- Steering clear of hot water
- Taking cool or lukewarm baths with colloidal oatmeal or baking soda
When to Seek Emergency Care
While chronic hives aren’t typically life-threatening, they can significantly impact your quality of life. You should consult a healthcare provider if:
- Your hives are severe
- They last longer than a few days
- You experience frequent flare-ups
Important: If hives are part of a severe allergic reaction (anaphylaxis), seek emergency care immediately. Warning signs include:
- Trouble breathing
- Dizziness
- Swelling of the lips, tongue, mouth, or throat
Understanding what’s behind your hives is key to finding the right treatment and relief. While many cases are mild and short-lived, others might need a closer look—especially if symptoms persist or intensify.
