If you’ve ever experienced the raised, itchy welts that signify hives, you’re not alone. About 20% of people get hives at some point.
“Hives are a skin reaction that can be red or skin-colored and can show up anywhere on the body,” says Rena Daiza, M.D., a family medicine physician at Henry Ford Health. “They are usually harmless, but in some cases can be more serious.”
It’s important to understand and recognize when hives are just a mild, temporary reaction and when they might be a cause for concern.
Symptoms of Hives
Hives, also called urticaria, fall into two categories. They can be an acute reaction that flares up quickly, then resolves, often within 24 hours. Or they can be chronic. Chronic hives stick around or flare up repeatedly for six weeks or more.
In either case, common symptoms include:
- Itching
- Raised welts that may be red or skin colored
- Swelling under your skin, on your lips or inside your mouth or throat
What Causes Hives?
“Hives are often triggered by exposure to an allergen,” explains Dr. Daiza. “In response, the body releases histamines, chemicals that cause the itching, swelling and other allergic reactions.”
Triggers for hives are varied and can include:
- Allergies (including to food, pets and plants)
- Extreme cold or heat exposure
- Fragrance (such as in perfume or scented lotions)
- Infections
- Insect bites
- Medications (including antibiotics)
- Stress or anxiety
- Topical medications (like pain relievers)
It’s not uncommon to be unable to identify a specific trigger for your hives. In the case of chronic hives, triggers can be trickier to spot. Chronic hives aren’t typically an allergic reaction. Instead, they can be the result of other medical conditions, including lupus and leukemia.
How to Treat Hives
Most cases of acute hives respond well to simple, at-home remedies. Dr. Daiza recommends taking an oral antihistamine, applying a cold compress to the affected area or using a soothing lotion (such as Calamine or hydrocortisone). These methods can reduce swelling and help relieve discomfort and itching.
For hives that are an allergic reaction to something you ate or came into contact with, it’s important to identify the trigger. If you can’t figure it out on your own, seeing an allergist can help. With testing to pinpoint allergens. Knowing—and avoiding—your triggers can help prevent hives.
When Do Hives Need Medical Attention?
Sometimes, hives are a symptom of a more severe, potentially even life-threatening, allergic reaction. Symptoms that warrant a trip to the emergency room include:
- Difficulty breathing or swallowing
- Dizziness or fainting
- Rapid heartbeat
- Swelling of the lips, tongue, throat or face
- Tightness in the chest or throat
“These can be signs of an anaphylactic reaction and require immediate medical attention,” says Dr. Daiza. If you have an EpiPen for severe allergic reactions, use it, and then get to the ER for treatment.
If you’re experiencing chronic hives that aren’t serious, but also aren’t going away, Dr. Daiza recommends talking to your primary care provider. They can help identify and treat the problem or refer you to an allergy specialist if needed.
Reviewed by Rena Daiza, M.D., a family medicine physician who sees patients at Henry Ford Health in Bloomfield Township.
