When to seek care for hives

Overview

Hives are raised, red or skin-colored bumps or welts on the skin that appear suddenly. They are also called urticaria (ur-tih-KAIR-ee-uh). They can be very itchy and often look like mosquito bites. They usually go away within a few hours or days, but some people get them again and again.

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

Hives can affect anyone, no matter their age or gender. They are more common in people who have allergies, asthma, or eczema.

Symptoms

Common symptoms

• Raised, red or skin-colored bumps or patches (wheals) on the skin.
• Intense itching, sometimes burning or stinging.
• Bumps that can change shape, move around, or disappear and reappear in different places.
• Each bump usually goes away within 24 hours.

Symptoms in children

• Hives in children often look the same as in adults, but children may scratch more.
• Children might also have swelling of the lips, eyelids, or hands.
• Hives can be more dramatic in children, with large welts that come and go quickly.

Symptoms in older adults

• Hives in older adults may be less itchy, but the swelling can be more severe.
• Older adults are more likely to have hives triggered by medications or infections.
• They may have a higher risk of complications like trouble breathing if the throat swells.

Causes

Main causes

• Allergic reactions to foods (like peanuts, eggs, shellfish), insect stings, medications, or latex.
• Infections, especially viral infections like colds or the flu.
• Physical triggers such as pressure on the skin, cold, heat, exercise, or sunlight.
• Stress or strong emotions.
• Sometimes no specific cause is found — this is called chronic spontaneous urticaria (CSU).

Risk factors

• Having allergies, asthma, or eczema.
• Being female — women get hives more often than men.
• Having another condition like thyroid disease or lupus.
• Taking certain medications, such as antibiotics or painkillers.
• Recent infection or illness.

When to see a doctor

See a doctor urgently if:

• If you have trouble breathing, swallowing, or feel dizzy — call emergency services right away.
• If hives appear with swelling of the lips, tongue, or throat — seek urgent care.
• If hives start after taking a new medicine or after an insect sting, especially if you have other symptoms.

Book a routine appointment if:

• If hives last longer than 6 weeks.
• If you have hives often and want to find out what triggers them.
• If over-the-counter treatments are not helping with the itching.
• If you have hives along with other symptoms like joint pain, fever, or swollen lymph nodes.

Diagnosis

Your doctor will usually diagnose hives by looking at your skin and asking about your symptoms. They will want to know when the hives started, how long they last, and if you have noticed any triggers.

Tests that may be done

• Allergy tests (skin prick or blood tests) if a food or other allergen is suspected.
• Blood tests to check for underlying conditions if hives are chronic.
• Sometimes a skin biopsy (taking a small piece of skin) if the diagnosis is unclear.

What to expect at your appointment

The doctor will ask about your medical history, recent infections, medications, and any new foods or products. They may also check for signs of anaphylaxis (a severe allergic reaction). Most people do not need tests — the diagnosis is based on what you describe.

Treatment

Treatment for hives focuses on relieving itching and swelling and avoiding triggers. Most mild hives get better without treatment. For persistent hives, doctors may recommend medications to control the symptoms.

Self-care at home

• Apply a cool, wet cloth or take a cool bath to soothe itching.
• Wear loose, soft clothing to avoid irritating the skin.
• Avoid scratching — keep nails short or wear gloves at night.
• Use fragrance-free moisturizers or calamine lotion to calm the skin.
• Write down when hives happen to spot possible triggers.

Medical treatments

Doctors may prescribe antihistamines (medications that block histamine) to reduce itching and swelling. For severe or chronic hives, they might recommend steroids taken by mouth or other prescription medications that calm the immune system. These treatments must be supervised by a healthcare professional.

Living with this condition

Most people with hives can go about their normal lives. Keeping a diary of triggers can help you avoid flare-ups. If hives are chronic, you may need to take medication regularly to prevent symptoms.

Lifestyle tips

• Identify and avoid triggers such as certain foods, heat, or pressure on the skin.
• Manage stress with relaxation techniques like deep breathing or yoga.
• Avoid hot showers, tight clothing, and harsh soaps.

Diet and exercise

If you have food allergies, avoid those foods. Exercise is safe for most people, but if you get hives after exercise, talk to your doctor — it might be a condition called exercise-induced urticaria. Stay hydrated and eat a balanced diet.

Mental health and emotional wellbeing

Living with chronic hives can be frustrating and stressful. The itching and appearance may affect your mood or sleep. Talk to your doctor if you feel anxious or depressed — they can help you find support.

Prevention

You can reduce the chance of hives by avoiding triggers you know about. For example, if a certain food or medicine causes hives, stay away from it. If you have allergies, follow your treatment plan. Not all hives can be prevented, especially if the cause is unknown.

Complications

If left untreated

• Severe allergic reaction (anaphylaxis) which can be life-threatening — this is rare but serious.
• Angioedema (swelling of deeper layers of skin, often around the eyes, lips, throat) — if the throat swells, it can block breathing.
• Scarring or skin infections from scratching.

Long-term outlook

For most people, hives go away within days or weeks, even without treatment. For those with chronic hives, treatments are very effective and most people get good relief. Hives do not usually cause long-term skin damage or lead to other diseases. With help from your doctor, you can manage them well.

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