Hives welts

Overview

Hives, also called welts or urticaria, are raised, red or skin-coloured bumps on the skin that are often very itchy. They happen when your body releases a chemical called histamine, which makes small blood vessels leak fluid under the skin.

Yes, hives are very common. About 1 in 5 people will have hives at some point in their lives.

Anyone can get hives, but they are more common in children and in people who have allergies, asthma, or eczema.

Symptoms

Common symptoms

• Raised, red or skin-coloured welts (bumps) that can be small or large
• Intense itching, which may feel worse at night
• Swelling that comes and goes, often in different areas
• Welts that may join together to form large, flat areas of raised skin
• A burning or stinging sensation

Symptoms in children

• Same welts and itching as adults
• May also have a fever if hives are caused by an infection
• Children may scratch more, which can break the skin and lead to infection

Symptoms in older adults

• Hives may be less itchy but can last longer
• More likely to be caused by medications or underlying health conditions
• Swelling of the lips or eyelids may be more common

Causes

Main causes

• Allergic reactions to foods (like nuts, eggs, shellfish, or strawberries)
• Medications (such as antibiotics, painkillers, or aspirin)
• Insect stings or bites
• Infections – especially viral infections like the common cold
• Physical triggers – pressure on the skin, cold or heat, sunlight, exercise, or water
• Stress or anxiety

Risk factors

• Personal or family history of allergies, asthma, or eczema
• Having a known food or drug allergy
• Recent infection or illness
• Being female (chronic hives are more common in women)

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms listed above, call your local emergency number immediately.
• If hives appear quickly after eating a new food or taking a new medicine, seek urgent medical advice.

Book a routine appointment if:

• If hives keep coming back for more than 6 weeks
• If the itching is very severe and affects your sleep or daily activities
• If you are unsure what is causing your hives

Diagnosis

Your doctor will ask you about your symptoms – when they started, how long they last, and what you were doing or eating before they appeared. They will look at your skin and ask about your medical history.

Tests that may be done

• Usually no tests are needed for acute hives.
• For chronic hives, your doctor may do a blood test to check for underlying health conditions.
• If a specific allergy is suspected, allergy tests (skin prick or blood test) may be arranged.

What to expect at your appointment

Your doctor will likely reassure you and give advice on managing the itch. They may suggest an antihistamine medicine from your pharmacy or prescribe one. They will ask you to avoid any known triggers.

Treatment

Hives often clear up on their own without treatment. The main goal of treatment is to relieve the itching and swelling. For people with frequent or severe hives, medicines can help keep symptoms under control.

Self-care at home

• Apply a cool, damp cloth or ice pack wrapped in a towel to the itchy areas for 10–15 minutes.
• Wear loose, soft, cotton clothing to avoid irritating the skin.
• Take a lukewarm bath – not hot – and add colloidal oatmeal or baking soda to soothe the skin.
• Moisturise your skin with a gentle, fragrance-free moisturiser.
• Try not to scratch – keep your nails short and consider wearing gloves at night.

Medical treatments

Your doctor may recommend antihistamine medicines, which you can get from a pharmacy or on prescription. These help block the histamine that causes the welts. For more severe or chronic hives, your doctor might prescribe stronger antihistamines, a short course of corticosteroid tablets, or other medicines that calm the immune system. Always follow your doctor’s advice and do not take more than the recommended dose.

Living with this condition

Hives can be uncomfortable but they rarely cause serious problems. Keep a diary of when hives appear, what you ate, what you were doing, and any stress you felt. This can help you spot triggers.

Lifestyle tips

• Avoid known triggers – for example, certain foods, heat, or tight clothing.
• Keep your home cool, especially at night.
• Use gentle, unscented soaps, laundry detergents, and skin products.
• Find healthy ways to manage stress, such as deep breathing, meditation, or talking to a friend.

Diet and exercise

There is no special diet for hives unless you have identified a specific food trigger. If you think a food is causing your hives, try keeping a food diary and speak to your doctor. Exercise can trigger hives in some people; if this happens, talk to your doctor about how to manage it.

Mental health and emotional wellbeing

Chronic hives can be frustrating and may affect your confidence or sleep. It is normal to feel worried or annoyed. If hives are making you feel anxious or depressed, talk to your doctor. They can offer support and, if needed, refer you for further help.

Prevention

If you know what triggers your hives, avoiding that trigger is the best way to prevent them. For example, if you get hives from cold, dress warmly. If stress is a trigger, relaxation techniques may help. For many people, no trigger is found, and it is not always possible to prevent hives.

Complications

If left untreated

• Severe allergic reaction (anaphylaxis) – this is rare but life-threatening and needs immediate emergency care.
• Chronic hives can cause poor sleep, fatigue, and skin damage from scratching.
• Scratching can break the skin and lead to infection.

Long-term outlook

Most hives go away on their own within a few days. Even chronic hives often improve over time, and treatment can keep symptoms under control. With the right care, people with hives can live a full, active, and healthy life.

Find support

Local organisations

• NHS Website ↗ · UK

Helplines

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