What do hives look like?

Hives may appear as:

Small raised bumps
Large swollen patches
Round, oval or irregular welts
Rings or map-like shapes
Areas with pale centers
Red, pink, purple, brown or skin-colored swelling

They often itch intensely and may sting or burn. Pressing a hive can sometimes make its center temporarily turn pale.

Hives may occur anywhere on the body.

What is angioedema?

Angioedema is deeper swelling that may occur with hives. It commonly affects the eyelids, lips, hands, feet or genital area.

Call emergency services immediately if swelling affects the tongue or throat or if the person develops:

Difficulty breathing
Wheezing
Trouble swallowing
Dizziness or fainting
Rapidly worsening facial swelling

These symptoms may indicate a serious allergic reaction.

What causes hives?

Potential triggers include:

Foods
Medication
Insect bites or stings
Infection
Heat or cold
Pressure on the skin
Exercise or sweating
Sunlight
Water
Contact with certain substances

In chronic spontaneous urticaria, hives occur repeatedly without a clearly identifiable external trigger. This type may involve immune-system activity rather than a traditional allergy.

How are hives diagnosed?

Diagnosis is based on the appearance, duration and pattern of the welts. Photographs can be helpful because the rash may disappear before your appointment.

Your provider will ask about medications, foods, illnesses, physical triggers and accompanying symptoms. Allergy testing or bloodwork is recommended selectively rather than automatically for every patient.

A skin biopsy may be considered when individual spots remain longer than 24 hours, bruise or are more painful than itchy.

How are hives treated?

Treatment may include:

A nonsedating oral antihistamine
Adjusting the antihistamine dose under medical supervision
Avoiding an identified trigger
A short course of another medication for a severe flare
Omalizumab or another immune-targeted treatment for persistent chronic hives

Do not increase medication doses without guidance.

Cool compresses, loose clothing and avoiding overheating may reduce discomfort.

Schedule a hives consultation

Recurring hives can interfere with sleep and daily activities even when no allergy is found. The Dermatology Clinic can evaluate the pattern, exclude other conditions and develop a plan to control itching and prevent flare-ups. Contact us today to get scheduled.