What Are Hives?

Hives (or urticaria) are raised bumps, welts, or blotches on the skin that can be red, pink, or skin-colored and may sting, itch, or burn. They can vary in size and shape and sometimes join to form larger areas called plaques. Hives are typically an overreaction of the immune system that occurs by coming in contact with an allergen. Allergens that trigger hives tend to be food-related or environmental irritants. Allergens are not the only trigger for hives. They can also flare up with heat or cold-related sensitivities or due to stress.

Hives can last for up to 24 hours before fading. For some people, hives can last days or several weeks. Hives that occur at least twice a week and last longer than 6 weeks are known as chronic urticaria. Acute urticaria are hive flare-ups that last less than 6 weeks.

Signs and Symptoms

There are several signs and symptoms of hives. Often, hives flare up and come and go over a short period. In other cases, hives can become more chronic and flare up over 6 weeks or more. Hives can appear anywhere on the body and come in various shapes and sizes. Common symptoms include:

• Raised welts or bumps on the skin that appear red, pink, or flesh-colored
• Itchy skin
• Hives blanch (the center of the hives become pale when pressed)
• Swelling under the skin causing puffiness (angioedema)
• Painful swelling of the lips, eyes, and throat

Chronic hives have many similarities to hives that are not chronic (acute hives). Additional symptoms include:

• Shift shapes and sizes
• Flare-ups every few days for days, weeks, or even years
• Occur along with heat, exercise, and stress

In rare cases, hives can develop into a severe allergic reaction known as anaphylaxis. Common symptoms of anaphylaxis include:

• Difficulty breathing
• Confusion
• Swelling of the lips, tongue, and throat
• Rapid heart rate
• Wheezing
• Slurred speech
• Cyanosis (bluish skin)
• Dizziness, light-headedness, fainting
• Nausea or vomiting
• Heart palpitations
• Diarrhea
• Abdominal pain or cramping
• Cough
• Hives and generalized itching

Causes

Hives typically develop when you ingest or are exposed to an allergen that causes an abnormal immune response. There are several allergens or irritants that can cause hives. Whatever the trigger, your body responds by releasing chemicals called histamines into your bloodstream. Histamines help your body fight chemical or biological “invaders” in various ways, including by making you sneeze or itch.

The most common causes for your body to release histamines include:

• Food allergies
• Environmental allergies (pollen, pet dander, dust, smoke, chemicals, etc.)
• Hot or cold temperatures
• Insect bites
• Physical activity or exercise
• Sweating
• Certain medications
• Stress
• Infection
• Virus
• Wearing tight clothing

What Triggers Hives?

There are many things that can trigger hives.

Common triggers include:

• Food allergies
• Environmental allergies (pollen, pet dander, dust, smoke, chemicals, etc.)
• Hot or cold temperatures
• Insect bites
• Physical activity or exercise
• Sweating
• Certain medications
• Stress
• Infection
• Virus
• Wearing tight clothing

Can Hives Spread by Scratching?

Yes, hives can spread by scratching. To prevent hives from spreading, it is important not to scratch or itch the hives. Sometimes using a cold compress or anti-itch cream on the hives can numb or soothe the itching.

Risk Factors

There are several risk factors for developing hives, both environmental and genetic. People who already have allergies are at an increased risk of developing hives and may be triggered by environmental irritants or food allergens. Additionally, having an autoimmune disorder or family history of an autoimmune disorder, such as lupus, may increase your risk of developing hives.

How Do You Get Rid of Hives Fast?

There are several treatment options for getting relief from hives. The fastest way to reduce the itch or swelling that comes with hives is to use a cold compress, anti-itch medications, or allergy medications (antihistamines).

Treatment Options

Most of the time, hives resolve without treatment. But for instances that hives do not go away or recur for days or weeks, there are several treatment options. The most common treatment options include allergy medications, allergy shots, at-home treatments, oral steroids, and epinephrine. Treatment is dependent on the severity and frequency of your hives.

Allergy Medications

Antihistamines are one of the most effective treatments at reducing the itching and swelling from hives. Antihistamines can be taken orally (in pill form) or may be applied as a topical cream to the affected skin. Some allergy medications are by prescription only, while others are over-the-counter. Consult with your doctor to determine which allergy medication is best for you.

Allergy Shots

Allergy shots are sometimes recommended for chronic hives. Treatment typically consists of a series of shots over time that help to block, or significantly reduce, the allergic reactions. Allergy shots do this by keeping your immune system from producing lgE, which is often overproduced in people with allergies.

At-Home Treatments

Effective at-home treatments consist of using a cold compress, taking a cool bath or shower, and wearing loose-fitting clothing. Additionally, over-the-counter antihistamine cream or hydrocortisone can help reduce itching and swelling.

Oral Steroids

If symptoms do not respond to antihistamines or topical steroids, oral steroids, such as corticosteroids or prednisone, can help relieve the symptoms.

Epinephrine

If you experience an acute severe allergic reaction known as anaphylaxis, an immediate epinephrine injection (EpiPen) is necessary to treat symptoms. Anaphylaxis can be a life-threatening condition and have symptoms such as shortness of breath, swelling of the lips, mouth or throat, wheezing, rapid heart rate, vomiting, and low blood pressure.

Learn More about Hives

Hives are a treatable condition. Symptoms can be painful and uncomfortable, but there are several effective treatment options available that can offer relief from your symptoms. Consult with your healthcare provider to determine what treatment option is best for you. Find an urgent care near you.