hives overview for patients

Overview

Hives, also called urticaria, are raised, itchy bumps on the skin. They happen when your body releases a natural chemical called histamine, which causes small blood vessels to leak fluid into the skin. The bumps can be red or skin-colored, vary in size, and often change shape or move around. Individual hives usually fade within 24 hours, but new ones can appear.

Yes. Hives are very common. Around 15–20 in every 100 people will have hives at least once in their lifetime.

Anyone can get hives, at any age. They are slightly more common in people with allergies, asthma, or eczema. Chronic hives (lasting beyond six weeks) are more common in adults, especially women, but children can get them too.

Symptoms

Common symptoms

• Itchy pink or red raised welts (bumps) on the skin
• Welts that may be tiny or merge into larger patches
• Welts that change shape, move around, or disappear within 24 hours
• A warm or burning feeling in the affected skin
• New welts appearing as old ones fade

Symptoms in children

• The same raised, itchy bumps as adults
• Children may scratch a lot, which can make the skin red and sore
• Hives in children are often linked to a recent infection, such as a cold or tummy bug

Symptoms in older adults

• Hives can look the same but may be less obvious because skin becomes thinner and less elastic
• Older adults may also have other skin conditions that make hives harder to recognise
• Some medicines for other health problems can trigger hives in older adults

Causes

Main causes

• Allergies to foods (like nuts, eggs, shellfish, milk, or wheat)
• Medicines (like antibiotics, aspirin, or some pain relievers)
• Viral or bacterial infections, especially in children
• Insect stings or bites
• Physical triggers: pressure on the skin, cold, heat, sunlight, exercise, or vibration
• Stress or emotional upset
• Pet dander, pollen, or latex exposure
• Sometimes no cause can be found — this is called 'idiopathic urticaria'

Risk factors

• Having allergies, asthma, or eczema
• A recent infection, especially a cold or stomach bug
• A history of hives or allergic reactions
• Certain medical conditions, such as an overactive or underactive thyroid
• Stress or lack of sleep

When to see a doctor

See a doctor urgently if:

• Hives with any sign of an allergic emergency (see above) — call emergency services right away
• Hives that are very painful or keep you from sleeping or working
• Hives that started after taking a new medicine — stop the medicine (unless it is essential) and phone your doctor or pharmacist immediately

Book a routine appointment if:

• Hives that last longer than a few days
• Hives that keep coming back
• Hives that affect your daily life or confidence
• If you suspect a specific food or medicine is triggering hives and you would like help identifying it

Diagnosis

A doctor usually diagnoses hives by looking at your skin and asking questions. You won't often need tests. They'll ask when the hives started, what you were doing, what you ate, what medicines you took, and whether you have any other symptoms. Keep a note of recent activities — it can help.

Tests that may be done

• Usually no tests are needed
• Allergy testing (skin prick or blood test) if a specific allergen is suspected
• Blood tests to check for allergic antibodies or other conditions if hives are chronic
• A skin biopsy (taking a tiny sample of skin) is rarely needed

What to expect at your appointment

Your doctor will examine your skin and review your story. They may ask you to track your hives over the next few weeks. For chronic hives, they may refer you to a dermatologist (skin specialist) or an allergy clinic for further assessment.

Treatment

Treatment depends on how severe and how long the hives last. For most people, avoiding triggers and using simple soothing measures is enough. When hives are itchy or disruptive, doctors may recommend medicines that block the body's allergic response. For chronic hives, a step-by-step approach can bring relief. Always talk to your doctor before starting or stopping any treatment.

Self-care at home

• Cool compresses or a cool bath to calm the itching
• Wear loose, soft, cotton clothing to avoid rubbing the skin
• Pat skin dry after bathing — don't rub
• Avoid heat, tight clothing, and showering in very hot water
• Try to keep cool and reduce stress
• Do not scratch — trim nails and use a cold pack instead
• Note anything that seems to make hives worse and avoid it if possible

Medical treatments

Your doctor may suggest non-drowsy antihistamine medicines to reduce itching and hives. These block histamine, the chemical that causes hives. For stronger flare-ups, doctors might use a short course of corticosteroid cream or tablets, or other medicines that calm the immune system. Oral corticosteroids are usually only used for a short time. If you have severe allergic reactions, your doctor may give you an emergency action plan and prescribe any necessary injectable medicine.

When is surgery considered?

Surgery is not used to treat hives.

Living with this condition

Hives can be uncomfortable and sometimes frustrating, especially when they keep returning. Most people manage well by finding and avoiding their triggers, using soothing home care, and taking prescribed treatments when needed. Even if hives last many weeks, most eventually settle down.

Lifestyle tips

• Keep a diary to track hives and possible triggers
• Use fragrance-free laundry detergents and soaps, which are less likely to irritate skin
• Shower in lukewarm water and avoid harsh soaps
• Manage stress with relaxation, breathing exercises, or gentle activity
• Consider a medical alert bracelet if you have ever had a severe allergic reaction

Diet and exercise

No special diet is necessary unless a specific food has been identified as a trigger. If you suspect a food, talk to a doctor rather than cutting out many foods on your own. Light exercise is fine, though heavy sweating may trigger hives in some people. If exercise causes hives, cool down gently and tell your doctor.

Mental health and emotional wellbeing

Living with itchy, unpredictable hives can be stressful and can affect sleep, mood, and confidence. It's normal to feel frustrated or anxious. If hives are affecting your mental health, speak to your doctor. If you are in a crisis, contact your local crisis support line or go to your nearest emergency department.

Prevention

If you know what triggers your hives, avoiding that trigger is the best prevention. When no cause is found, it's not always possible to prevent hives, but treatment can keep symptoms under control.

Vaccines

There is no vaccine that specifically prevents hives. Some immunisations are important for people with allergies, but discuss this with your doctor.

Screening programmes

There is no routine screening for hives. Testing is only done if there's a specific suspicion.

Complications

If left untreated

• For ordinary hives, leaving them untreated is usually harmless and they clear on their own.
• The main complication is that severe allergic reactions can be dangerous if not treated quickly.
• Chronic hives may affect sleep and quality of life if not managed.

Long-term outlook

The outlook for hives is very good. Most attacks fade within a few days. Even chronic hives, which can last months or years, often improve over time. With the right support and treatments, most people can keep hives under control and live normally.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.