Can Hives Occur Anywhere Else
Hives can also cause deeper swellings in the skin and mucosa, this is called angioedema. These swellings are often bigger, last longer, may itch less, sometimes hurt or burn and respond less well to antihistamines. Large swellings over joints, for example, can cause pain that feels like arthritis, even if the joint is not involved. Angioedema most frequently affects the face and lips. Although hives and facial swelling can be uncomfortable and cosmetically embarrassing, they are not usually dangerous. Information on angioedema is available on the ASCIA website.
How Are Hives Diagnosed
A doctor can diagnose hives and help you find the cause. They might recommend you keep a food diary to find out if there is any link between food and your hives.
You might be sent to an allergist, a doctor who specializes in treating allergies, for additional testing. This might include blood work and urine tests to look for chemicals in your body that might tell the allergists whats causing your hives.
You might also have a skin biopsy, especially if your allergist suspects vasculitis causing your hives. Hives that have lasted for longer than 6 weeks will likely necessitate testing for underlying chronic conditions.
Sometimes, a specific cause isnt found. In this case, your hives will be diagnosed as idiopathic urticaria. The word idiopathic means unknown. In this case, your doctor will still be able to help you with a treatment plan, but you wont be able to tell what to avoid to prevent hives in the future.
Treatment for hives will depend on the severity of your hives and on the cause. For instance, youll need to avoid the cause of your hives if it has been found.
Your doctor will work with you to find the right treatment for you. Common options include:
There Are Two Types Of Urticaria:
- Acute urticaria are hives that last six weeks or less
- Chronic urticaria happens when hives last or recur for more than six weeks
Acute urticaria in a child can be caused by infections, foods, medications, insect bites or blood transfusions. When a child develops acute hives, the first thing that usually comes to mind is, What did she or he eat that caused this rash? However, most cases of childhood hives are a result of infections. Some infections that can cause hives in children include respiratory viruses , strep throat, urinary tract infections, hepatitis, infectious mononucleosis and many other viral infections.
In an infant or a toddler who is being introduced to new foods, think about food allergy as a possible cause of the hives, especially peanuts, tree nuts, eggs, cows milk, and fish or shellfish. If your child develops hives while or shortly after playing outdoors, look at their skin for any signs of insect bites, especially fire ants in our area. When a child develops hives while taking a medication, the hives could have been caused by the medication, but this gets tricky if the child is taking an antibiotic, since the hives could also have been caused by the initial infection for which she was taking that antibiotic.
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How Do Dermatologists Treat Hives
When treating hives, the goals are to:
Control the itch
Prevent new hives
Avoid whats causing the hives
Your treatment plan will be tailored to your needs and may include one or more of the following:
To improve your outcome, your dermatologist may give you self-care tips to follow. To see what dermatologists frequently recommend, go to: Hives: Self-care.
Related AAD resources
Image 1: Used with permission of DermNet NZImage 2: Getty Images
ReferencesAntia C, Baquerizo K, et al. Urticaria: A comprehensive review: Epidemiology, diagnosis, and work-up. J Am Acad Dermatol. 2018 79:599-614.
Antia C, Baquerizo K, et al. Urticaria: A comprehensive review: Treatment of chronic urticaria, special populations, and disease outcomes. J Am Acad Dermatol. 2018 79:617-33.
Grattan CEH, Saini SS. Urticaria and angioedema. In: Bolognia JL, et al. Dermatology. . Mosby Elsevier, China, 2018:304-19.
Hide M, Takahagi S, et al. Urticaria and angioedema. In: Kang S, et al. Fitzpatricks Dermatology. McGraw Hill Education, United States of America, 2019:684-785.
Wong HK. Urticaria. In: Medscape Last updated 9/16/2020. Last accessed 8/1/2021.
Yosipovitch G and Kwatra SG. Chronic urticaria. In: Living with itch: A patients guide. The Johns Hopkins University Press. United States, 2013: 56-9.
How Long Do Symptoms Last
As mentioned, acute hives will usually disappear within 24 hours. It might seem like longer, though, because new hives may appear when old ones go away. In total, you could be dealing with hives for six weeks.
If you have chronic hives, however, the hives will last for longer than six weeks. They may be recurring and may come up at seemingly random times over the course of many months or years.
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What Are Hives Or Urticaria
Hives or urticaria are a type of rash consisting of itchy, swollen, red welts. The itching may be mild or severe. Foods, medications, infections, exercise, scratching, alcoholic beverages, emotional stress and many other factors may worsen hives. The condition affects an estimated 20 percent of the population at one time or another in their lives.
Hives Symptoms: What They Look Like
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You likely know hives for the way they appear on your skin: Theyre red, swollen welts that can sometimes be accompanied by itchiness or pain. There are a variety of possible causes for hives . They could be the result of allergies in response to foods, medication, or an infection, or they could be from another trigger, like exercise, heat, stress, or alcohol.
Red bumps on the skin can seem like a somewhat generic description. Couldnt that indicate a number of possible skin issues? How can you know if its hives youre experiencing and not something else? Heres what to know about hives and their unique symptoms.
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Should I Worry About A Severe Allergic Reaction
Chronic hives are usually not associated with any serious allergic reactions. These emergencies, also called anaphylaxis, are dangerous, potentially life-threatening allergic reactions requiring medical treatment. Hives resulting from anaphylaxis often occur with other symptoms, such as difficulty breathing, dizziness, and swollen eyelids, lips, and tongue. If you experience any of these symptoms along with hives, call 911 immediately.
Chronic hives can be difficult to live with, but there are effective treatment options to help manage symptoms. Identifying and avoiding triggers is also key to managing chronic hives. And after making a positive diagnosis, your doctor will suggest one or several treatments that may be beneficial to you.
Care Advice For Hives
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When Should I Call The Doctor
Hives and swelling typically get better without treatment. Call your healthcare provider if you have:
- Hives or swelling that last more than a week.
- Infected-looking bumps .
- Recurring hives that come back every few months.
- Severe itching.
- Signs of anaphylaxis, including wheezing, shortness of breath or vomiting.
- Swollen lips or eyes.
How Are They Treated
The most important treatment is avoiding the things that cause your hives, if your doctor finds out what is causing them. Your doctor may have you take medicines called antihistamines, if needed. Many of these are available without a prescription. Sometimes your doctor may have you take more than the normal dose, but this should only be done under his or her supervision. Sometimes other prescription medicines also are used to treat hives.
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Common Questions & Answers
Whats important to know is that hives can affect anyone. While some people may carry a higher risk for hives, you can get them no matter your age or gender. Heres what you should know about the common condition, including why you get hives, how to deal with them if you do, and how to prevent them from coming again .
When To Seek Help
If a person has flare-ups of hives for 6 weeks or longer, the American Academy of Dermatology Association recommends visiting a board-certified allergist, dermatologist, or primary care doctor.
If someone experiences severe hives inside their mouth or airways that affect breathing, call 911 or the number of the nearest emergency department. This could be a sign of a severe allergic reaction, or anaphylaxis, which can make it hard to breathe.
Symptoms of anaphylaxis include:
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Complications Of Hives: Chronic Hives And Others
Have you struggled with hives that come and go for six weeks or more? Youve got what experts call chronic hives, and they can be exhausting especially because they can cause changes in your sleep, performance at work or school, and social life. The impact chronic hives can have on somebodys quality of life is well studied, Friedman says.
While many of the triggers are the same as acute hives , chronic hives have several different causes, including autoimmune issues and long-standing infections. In some cases, you might have to undergo extra testing to determine the cause and unfortunately in many cases, a definitive cause will not be identified.
The good news is that while treatment generally starts in the same manner as for acute hives, doctors do have additional medications and, in some cases, tests they can use to help diagnose and treat chronic hives. Youll just have to make sure you put patience on your side, as it can often take several years for improvements to happen.
Other potential complications of either acute or chronic hives can include:
Check If You Have Hives
DR P. MARAZZI/SCIENCE PHOTO LIBRARY https://www.sciencephoto.com/media/694159/view
This image shows white skin with the hives rash. The rash is on a child’s leg and hand. Their groin, in the top left of the photo, is not affected by the rash.
The skin on most of their thigh is pink, raised and bumpy. At the side of their thigh are deep creases in the skin.
Their hand is pink with some red patches between their thumb and finger and at their fingertips.
Elizabeth Nunn / Alamy Stock Photo https://www.alamy.com/stock-photo-an-urticarial-rash-caused-by-an-allergic-reaction-to-penicillin-111762116.html?pv=1& stamp=2& imageid=261CE1C1-DA64-4EAE-8D55-1794DA842BD3& p=278658& n=0& orientation=0& pn=1& searchtype=0& IsFromSearch=1& srch=foo%3dbar%26st%3d0%26pn%3d1%26ps%3d100%26sortby%3d2%26resultview%3dsortbyPopular%26npgs%3d0%26qt%3dGDR5M4%26qt_raw%3dGDR5M4%26lic%3d3%26mr%3d0%26pr%3d0%26ot%3d0%26creative%3d%26ag%3d0%26hc%3d0%26pc%3d%26blackwhite%3d%26cutout%3d%26tbar%3d1%26et%3d0x000000000000000000000%26vp%3d0%26loc%3d0%26imgt%3d0%26dtfr%3d%26dtto%3d%26size%3d0xFF%26archive%3d1%26groupid%3d%26pseudoid%3d%26a%3d%26cdid%3d%26cdsrt%3d%26name%3d%26qn%3d%26apalib%3d%26apalic%3d%26lightbox%3d%26gname%3d%26gtype%3d%26xstx%3d0%26simid%3d%26saveQry%3d%26editorial%3d1%26nu%3d%26t%3d%26edoptin%3d%26customgeoip%3d%26cap%3d1%26cbstore%3d1%26vd%3d0%26lb%3d%26fi%3d2%26edrf%3d0%26ispremium%3d1%26flip%3d0%26pl%3d
This image shows light brown skin with the hives rash.
Conditions Related To Hives
Hives can sometimes be a symptom of or be mistaken for other skin problems. Similarly, certain conditions and other things can trigger hives. The following are related to hives for at least one of these reasons:
More than 50 percent of cases of chronic hives are believed to occur alongside an autoimmune disease. The following autoimmune diseases can trigger chronic hives:
- Type 1 Diabetes Long-lasting chronic hives could be an early indicator of type 1 diabetes.
- Lupus Its not very likely, but lupus can cause hives, possibly because of the existence of certain antibodies, sunlight, or response to some medications. Hives typically will go away within 24 hours, but if they last longer, it could be a condition called urticarial vasculitis.
Hives Are Rarely Due To A Serious Underlying Disease
Whilst a clear cause of hives in not obvious in many cases, causes may include:
- Infection from a virus is the most common cause of hives in children, especially if they last for more than 24 hours.
- Contact allergy to plants or animals may cause localized hives.
- Allergic reactions to food, medicines or insect stings can appear as hives. They usually occur within one to two hours of exposure and disappear in most cases within six to eight hours.
An allergic cause for hives should be suspected if episodes are rare, short-lived and occur under specific circumstances, for example:
- Only when exercising.
- Always within two hours of a meal.
- When symptoms involving other organs occur around the same time, such as stomach pain, vomiting, difficulty breathing or dizziness.
- If hives occur with swelling of the tongue or throat, difficulty breathing or low blood pressure, anaphylaxis should be suspected. Urgent administration of adrenaline and medical assessment is required. Information about anaphylaxis is available on the ASCIA website.
Ongoing hives lasting days at a time are almost never allergic in origin, with the exception of some cases of allergy to medicines. Stress is a very rarely the cause of hives but may make the symptoms worse.
In some people hives are caused by physical triggers, including cold , heat, sunlight , vibration, rubbing or scratching of the skin , and delayed pressure , stress, alcohol, spicy food or coffee may cause symptoms.
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Swelling Can Be A Medical Emergency
Along with hives, some people develop swelling deep in their skin or the moist tissue that lines the mouth/lip, eyelids, or other areas. This swelling is called angioedema.
Angioedema is usually harmless however, it becomes a life-threatening emergency if it causes:
Swelling in your mouth or throat
Angioedema can also cause noticeable swelling on the lips, eyes, and other parts of the body. It usually goes away in a few days. Until the swelling subsides, you may feel uncomfortable.
Swelling can be a medical emergency
If swelling develops in your mouth or throat or you have or difficulty breathing, get immediate medical care or go to the nearest emergency room.
What Are Hives Symptoms Causes Diagnosis Treatment And Prevention
If youve never experienced a bout of hives, consider yourself lucky. Roughly 20 percent of people do get hives at some point in their lives, making it a very common ailment. Hives can be a source of physical and mental anguish, especially if they appear frequently and continue happening for months or years.
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How Do Dermatologists Diagnose Hives
A dermatologist can often diagnose hives by looking at your skin.
To find out why you have hives, your dermatologist will ask questions. Knowing why you have hives may help you avoid the cause, which can prevent new hives.
Hives have many causes, so it can be a challenge to find the cause. You can help your dermatologist by taking time to answer these questions before your appointment:
How often do you get hives?
How long do the hives last?
Do the hives itch or feel painful?
When you get hives, do you have other symptoms like feeling lightheaded or nauseous?
It can also be helpful to think about what you were doing a few hours before you developed hives. For example, can you answer the following questions?
What did you eat?
Did you take a medication, including one that you can buy without a prescription, such as ibuprofen?
Have you been feeling stressed?
Did a bug bite or sting you?
Were you out in sunlight, cold, or heat?
Did you sweat a lot?
Were you wearing tight clothes or carrying a purse or backpack?
Tell your dermatologist if you develop hives hours after eating red meat , gelatin, or dairy products
Hives can be a sign of alpha-gal syndrome, a food allergy that can develop after being bite by the lone star tick. This tick is found in many U.S. states.
During your appointment, your dermatologist will also ask about your medical history. Be sure to mention any recent medical treatments, including radiation therapy or a blood transfusion.
What Are The Symptoms Of Hives
Hives are characterized by red or pale-colored welts on the skin, which typically come and go throughout the day, says Sourab Choudhury, DO, a dermatologist and the chief medical officer at the Dermatology Specialists, a private dermatology practice in New York City. Sometimes they itch, burn, or sting.
Usually the welts will be surrounded by clear edges. They may look similar to bug bites, but hives generally will appear and disappear more quickly. They may itch, sometimes severely, and theyre not always the same size or shape. They may be as small as the tip of a pen or as large as a dinner plate. When you press the center of a hive bump on the skin, it likely will turn from red to white, which is known as blanching.
Hives may appear on the body grouped together and take over a large area of the skin, or as a couple of individual welts that show up here and there. They can appear anywhere on the body, though some people get them in the same spot over and over again .
Generally, youll know you have hives simply by seeing the hives themselves. If you experience other symptoms, such as swelling in the eyes, lips, or inside of the throat, or if you have trouble breathing, you should call 911 or see a doctor immediately, says Sapna Palep, MD, a dermatologist at Spring Street Dermatology in New York City. These symptoms indicate you may be experiencing a serious allergic reaction called anaphylaxis.
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