Hives

Overview

Hives (also called urticaria) are raised, itchy bumps or welts on the skin that can appear suddenly and fade within a few hours or days. They are a common skin reaction, not a sign of a serious illness in most cases.

Yes, hives are very common. Around 1 in 5 people will have hives at some time in their life.

Anyone can get hives, but they are more likely in people with allergies, asthma, or a family history of hives. They can appear at any age, from young children to older adults.

Symptoms

Common symptoms

• Itchy, raised bumps or welts on the skin
• Welts that vary in size and may join together to form larger areas
• Red or skin-colored bumps with a pale center
• Bumps that change shape, move around, or disappear and reappear within hours
• A burning or stinging feeling in some cases

Symptoms in children

• Same itchy welts, often on the face, lips, or body
• Might be harder to tell if the child is very young – look for scratching or fussiness
• Hives can appear suddenly after a viral infection or certain foods

Symptoms in older adults

• Hives may last longer and require more careful management
• The skin may be drier, which can make itching more intense
• Some medicines for other conditions can cause hives as a side effect

Causes

Main causes

• Allergies to foods (such as peanuts, eggs, or shellfish)
• Medicines (such as antibiotics or painkillers)
• Infections, especially viral infections in children
• Insect stings or bites
• Physical triggers like heat, cold, pressure, or sunlight
• Stress or emotional upset
• Unknown triggers – many cases have no clear cause

Risk factors

• A personal or family history of allergies, eczema, or asthma
• Recently had an allergic reaction or infection
• Exposure to known triggers like certain foods or environmental allergens
• Some long-term conditions like thyroid disease or lupus

When to see a doctor

See a doctor urgently if:

• If you have any symptoms of a severe allergic reaction (anaphylaxis) – call your local emergency number immediately
• If hives come with fever, joint pain, or a general feeling of being unwell
• If hives develop after a new medicine and are affecting your mouth or throat

Book a routine appointment if:

• If hives last longer than 6 weeks (chronic hives)
• If they keep coming back and the trigger is unclear
• If the itching is severe and affects your sleep or daily life

Diagnosis

A doctor usually diagnoses hives by looking at your skin and asking about your symptoms and possible triggers. In most cases, no tests are needed.

Tests that may be done

• In some cases, allergy tests are done to find a trigger
• A blood test may be ordered if a condition like thyroid disease or lupus is suspected
• If you have had a serious allergic reaction, your doctor may recommend tests to check for food or medicine allergies

What to expect at your appointment

Your doctor will ask about when the hives started, what you were doing, what you ate, and which medicines you take. They may also check your breathing and examine your skin. You may be referred to a skin specialist (dermatologist) or an allergy specialist if the cause is unclear or the condition is chronic.

Treatment

For most hives, the main goal is to relieve itching and avoid triggers. Mild hives often clear without any treatment. If needed, medicines called antihistamines are commonly used and are safe for most people.

Self-care at home

• Use a cold compress or cool, wet cloth on itchy areas
• Take a cool or lukewarm bath – avoid hot water
• Wear loose, soft clothing
• Avoid scratching – keep nails short and consider wearing cotton gloves at night
• Avoid known triggers like certain foods, heat, or pressure

Medical treatments

Your doctor may suggest a non-drowsy antihistamine to reduce itching and swelling. For more stubborn hives, treatment options include creams or ointments to soothe the skin, or a short course of a stronger medicine called an oral corticosteroid to reduce inflammation. Always follow your healthcare provider's advice and do not take more than the recommended amount. If your hives are caused by a medicine, your doctor may help you find a safe alternative.

Living with this condition

Hives can be annoying, but most cases are short-lived. Keeping a diary of your symptoms and possible triggers can help you and your doctor find patterns. If your hives are chronic, try to stick to a simple skin care routine and avoid scratching to protect your skin.

Lifestyle tips

• Learn to relax – stress can make hives worse, so find activities that help you unwind
• Avoid very hot showers or baths
• Choose gentle, fragrance-free soaps and moisturisers
• Wear breathable fabrics like cotton
• Keep your home cool and avoid overheating

Diet and exercise

There is no special diet for hives unless a food trigger is identified. Maintain a balanced diet with plenty of vegetables, fruits, and water. Gentle exercise can help reduce stress, but if heat or sweating triggers your hives, cool down afterwards and choose a cooler time of day.

Mental health and emotional wellbeing

Living with itchy, visible hives can be frustrating and stressful. It is normal to feel self-conscious or anxious. If hives are affecting your mood or sleep, talk to your healthcare provider. They can help you manage symptoms so you can feel more in control.

Prevention

In many cases, you can prevent hives by avoiding known triggers. Once you know what causes your hives, steer clear of those foods, medicines, or physical conditions. If stress is a trigger, regular relaxation may reduce flare-ups.

Complications

If left untreated

• For most hives, there are no serious complications, but severe itching can lead to skin damage from scratching
• In rare cases, hives can be a sign of an ongoing allergic reaction that may cause breathing problems – this is a medical emergency
• Chronic hives can affect sleep, work, and quality of life if not managed

Long-term outlook

The outlook for hives is generally very good. Acute hives usually settle within a week, and chronic hives often improve within a few months to a year. With the right treatment and trigger avoidance, most people can keep symptoms under control. Even if the cause is unknown, hives are not a sign of a dangerous condition in themselves, and there are many safe ways to manage them.

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