DefinitionHives are small, itchy, red swollen areas on the skin. The swelling occurs singularly or in clusters. Hives tend to fade after a few hours, but new ones can appear. Most cases go away within a few days. However, some last a few weeks or longer.
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CausesHives are often caused when the body releases a chemical called histamine. Histamine is released during an allergic reaction. Many people, though, get hives without being exposed to something they are allergic to.While the cause is unknown in some cases, these factors may cause hives:
- Foods , most commonly:
- Fresh berries
- Reaction to allergy shots (desensitization shots)
- Insect bites or stings
- Cold or heat
- Thyroid disease— hypothyroidism orhyperthyroidism
- Vasculitis (inflammation of the blood vessels)
Risk FactorsFactors that may increase your risk of hives include:
- Exposure to an allergen—something that causes an allergic reaction
- Exposure to an allergen that triggered hives in the past
SymptomsSymptoms of hives can vary from mild-to-severe:
- Excessive swelling of the eyelids, lips, or genitals
- Difficulty breathing or swallowing— Call for emergency services right away if you are having these symptoms.
DiagnosisYou will be asked about your symptoms and medical history. A physical exam will be done. You may need to see a doctor who specializes in skin disorders (dermatologist) or allergies (allergist). Your bodily fluids and tissues may be tested. This can be done with: x-rays.
TreatmentThe best way to treat hives is to find and then avoid the cause.If the cause can't be found, there are medications to reduce symptoms or treat hives:
- Leukotriene antagonists
- Oral steroid medications for hives resistant to other treatments
- Anti-inflammatory medications
- Immunosuppressant medications
- Ultraviolet light therapy
- Prescription epinephrine (adrenalin) injections for cases when swelling affects the airways
PreventionThe best way to prevent hives is to avoid the allergen that caused you to get hives in the past.
American Academy of Allergy, Asthma, and Immunology
American Academy of Dermatology
Canadian Dermatology Association
Dibbern DA Jr. Urticaria: selected highlights and recent advances. Med Clin North Am. 2006;90:187-209. Review.
Gambichler T, Breuckmann F, Boms S, Altmeyer P, Kreuter A. Narrowband UVB phototherapy in skin conditions beyond psoriasis. J Am Acad Dermatol. 2005;52:660-670. Review.
Guldbakke KK, Khachemoune A. Etiology, classification, and treatment of urticaria. Cutis. 2007;79:41-49. Review.
Hives. American Academy of Dermatology website. Available at: http://www.aad.org/dermatology-a-to-z/diseases-and-treatments/e---h/hives. Accessed September 30, 2014.
Kaplan Allen P.Chronic urticaria: pathogenesis and treatment. J Allergy Clin Immunol. 2004; 114(3): 465-474.
Tips to remember: allergic skin conditions. American Academy of Allergy, Asthma, and Immunology website. Available at: http://www.aaaai.org/patients/publicedmat/tips/allergicskinconditions.stm. Accessed September 30, 2014.
Urticaria. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated September 11, 2014. Accessed September 30, 2014.
- Reviewer: Marcin Chwistek, MD
- Review Date: 08/2014
- Update Date: 09/30/2014
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