hives on woman's back

Hives: Symptoms, Causes, and Treatment

Hives, also known as urticaria, are swollen, red, or pale patches on the skin that appear suddenly. Oftentimes, allergies, infections, stress, and other factors trigger the skin condition. They are itchy and can burn or sting. They vary in size and can last from minutes to hours. In some cases, they even become a long-term, chronic condition.

Hives have well-defined borders, having round, oval, or worm shapes. Identifying the triggers helps both prevent and manage urticaria.

We classify hives that occur for less than six weeks as acute urticaria. This type is more common than chronic urticaria, and the triggers are more likely to be identified. Chronic urticaria lasts more than six weeks, and in up to 80-90% of the cases, the underlying cause is unknown.

hives - woman scratching her arm

Urticaria vs Angioedema

Urticaria and angioedema have similar underlying mechanisms. These include the excessive release of histamine and other mediators. If the release of these substances occurs in the superficial dermis, urticaria develops. Angioedema occurs when these inflammatory compounds release in the deeper dermal and subcutaneous tissue.

Angioedema may or not be itchy, but it’s associated with a dull discomfort and a burning sensation. The skin may become swollen and warm.

Angioedema can develop alone or along with hives. This causes a lot of inflammation in the deeper layers of the skin. It’s usually found around the lips, eyes, and sometimes the genitals.

Angioedema tends to last longer than hives. However, the condition is self-limited and resolves within a few days. The same drugs and therapies used for hives are also recommended for angioedema.

In rare cases, angioedema leads to significant swelling of the throat and lungs. This may cause difficulty breathing.

hives - scottish fold cat

What Causes Hives?

In many cases, allergies to various substances trigger hives. These triggers can include pollen, dust, pet dander, latex, and other synthetic chemicals.

Food allergies may also cause hives. These food substances include gluten, cow’s dairy, peanuts, soybeans, and food additives.

Medications, particularly certain antibiotics, non-steroidal inflammatory drugs, and allergy shots can trigger hives.

Stress is yet another common cause of hives too.

Extreme heat temperatures can also cause hives. Heat urticaria may develop in some individuals when temperatures reach 109.4 Fahrenheit.

Exercising may also cause hives. This can be from the heat produced by the body.

Concerning chronic urticaria, the trigger is usually unknown. In some cases, though, autoimmune diseases cause chronic hives.

hives - rubbing cream on hives on hand

How to Treat Hives

The best treatment is to avoid the triggers, however, this is not always easy. This is when over-the-counter and prescription drugs can help.


Antihistamines are the main therapy for hives. They effectively suppress histamine release. Over-the-counter antihistamines are widely available in pharmacies and supermarkets.

It’s important to note you can take these on a regular basis. The second generation of antihistamine (i.e. cetirizine and fexofenadine) is less sedating. You can take these drugs once a day.

The older generation antihistamines (i.e. hydroxyzine and diphenhydramine) have sedating side effects. Leukotriene receptor antagonists such as montelukast are add-on therapies taken as needed. Take these at night before going to bed.

Steroid Drugs

In cases of severe urticaria, oral steroids like prednisone is a short-term treatment.

Steroid creams and antihistamine creams and ointments do not offer benefits.

Monoclonal Antibodies

Although rarely used, the monoclonal antibody drug, Omalizumab, may treat chronic idiopathic urticaria. The drug works by suppressing specific allergic reactions. Doctors recommend this when first-line therapies don’t help.

hives - home remedies essential oil

Home Remedies and Supplements for Hives

There are plenty of home remedies to treat hives. You can also take supplements to reduce inflammation and development.

When washing, use lukewarm water instead of hot water. This avoids aggravating the skin condition.

To reduce inflammation, use gentle, mild soaps without artificial colors and perfumes. We recommend eco-friendly products for personal care and household cleaning. They have fewer chemicals that irritate the skin.

You can even learn how to make your own creams with natural ingredients like coconut oil or cocoa butter. Baking soda and vinegar with essential oils can replace many cleaning products too.

Avoid hot temperatures because hot weather can aggravate your hives. Make sure your bedroom has the temperature set on a cooler side to avoid development.

Avoid any allergens that trigger your breakout. Whether it’s pollen, pet dander, or drugs, do your best to keep out of contact. Allergies are often the cause of hives in children.

You can use natural supplements like witch hazel to treat the condition. It’s available in pharmacies and health food stores. Simply apply the liquid to the affected area of the skin.

Quercetin and evening primrose oil may also help improve hives. This is due to its antihistamine and anti-inflammatory qualities. They can even speed up your recovery.

When Should You See a Doctor About Hives?

You can often manage mild cases of hives with home remedies and over-the-counter drugs. However, if you experience them on a regular basis or become severe, see your doctor.

If you experience dizziness, lightheadedness, wheezing, difficulty breathing, or swelling, call a doctor. This could be from a severe allergic reaction along with the hives.

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