How Do You Know You Have Hives

Care Advice For Hives

Facts You Should Know About Hives

• Hives are red, itchy, raised welts on the skin that appear in varying shapes and sizes each one characteristically lasts no longer than 6-12 hours.
• Although hives are very common, their cause is often elusive.
• Hives can change size rapidly and move around, disappearing in one place and reappearing in other places, often in a matter of hours.
• Ordinary hives flare up suddenly.
• Occasionally hives are produced by direct physical stimulation by environmental forces like heat, cold, and sunlight.
• Treatment of hives is directed at symptom relief until the condition goes away on its own.
• Antihistamines are the most common treatment for hives.
• Hives typically are not associated with long-term or serious complications.

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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Questions To Ask And Be Prepared To Answer At Your Appointment

If you see your doctor about a rash or skin problem you suspect might be hives, your doctor will likely ask questions to help identify the problem, starting with how long youve been experiencing symptoms. That will help determine if you have acute hives, chronic hives, or something else, Choudhury says.

He or she may also ask:

• What are your symptoms, and when did they begin? Have you done anything or taken any medication that has made the symptoms better or worse?
• How large are the hives? Where on the body have they appeared?
• How long does it take for a welt to go away?
• Are the hives painful or accompanied by swelling?
• What other medications and supplements do you currently take? Did you recently start taking any of these?
• Have you recently: Had an infection ? Experienced any difficulty breathing, feelings of nausea, or light-headedness? Tried a new food? Returned from a trip to a new place?
• Do you know if anyone else in your family has experienced hives?

Youll also want to be prepared to ask your doctor questions at your appointment to help you better understand whats going on. Plan to ask:

• Whats causing my symptoms?
• What tests will you need to do?
• How long will the hives last?
• What are the treatment options? And what side effects do each of these treatments come with?
• Is it necessary that I take prescription medication? Is there an over-the-counter version I can use instead?
• Will this treatment interfere with my existing health issues?

When To See A Doctor About Hives

Sometimes, though, hives arent something you should handle yourself. Pay attention to other symptoms to know how you should respond. If you experience dizziness, trouble breathing, or swollen lips, eyes, and tongue along with the hives on the skin, consider it an emergency. You may be experiencing anaphylaxis, which is a serious allergic reaction, and you should call 911 immediately.

If youre not having difficulty breathing, it still may be a good idea to seek professional medical help, though you dont need to visit the emergency room if the rash isnt accompanied by life-threatening symptoms. These are a few indications that its time to see a doctor:

• If the rash does not go away and lasts longer than six weeks, which could indicate youre dealing with chronic hives
• If the welts are causing discomfort
• If an individual welt lasts longer than 24 hours and is accompanied by pain

Dr. Choudhury says if any of these symptoms occur, its appropriate to see a doctor for a formal diagnosis. You should schedule an appointment with your primary care doctor first. At that appointment, he or she may refer you to a dermatologist or an allergist. Both dermatologists and allergists are experts in treating hives, Choudhury says.

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Where Do Hives Develop On The Body

Hives can develop anywhere on your skin. For most people, hives appear on one or more of these areas:

• Abdomen

• Upper arms

• Upper legs

If you have hives, they may appear in one area like your back or cover much of your skin.

Hives can also develop on soft, moist tissue that lines your eyelids, mouth, and other areas. The medical name for this moist tissue is mucous membrane.

Some people always get hives in the same place on their body

This usually happens when something triggers hives like medication, stress, or sunlight.

When hives develop in the same place every time, this is called fixed hives.

What Are The Signs & Symptoms Of Hives

The hallmark red raised welts are the main sign of hives. The welts can:

• have a pale center
• change shape and location in a matter of hours
• be tiny or as big as a dinner plate
• itch, sting, or cause a burning sensation

Someone who also has angioedema might have puffiness, blotchy redness, swelling, or large bumps around the eyes, lips, hands, feet, genitals, or throat. Other symptoms can include nausea, vomiting, or belly pain.

Rarely, a person with hives and angioedema can also get anaphylactic shock. Signs of anaphylactic shock include breathing trouble, a drop in blood pressure, dizziness, or a loss of consciousness .

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What Are The Different Kinds Of Hives

Hives fall into two categories on the basis of the time they have been present:

• acute urticaria and
• chronic idiopathic urticaria .

Since hives are so common and acute urticaria, by definition, resolves spontaneously, physicians do not generally expend much time or expense to evaluate the cause of hives of less than eight weeks’ duration.

Those Itchy Red Welts Can Be Brought On By More Than Just Pet Dander And Pollen

Susan Bard, MD, is a board-certified general and procedural dermatologist with the American Board of Dermatology and a Fellow of the American College of Mohs Surgery.

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If you break out in hives, medically known as urticaria, your skin itches and is covered in red or skin-colored welts, but it’s not always clear what might have triggered them.

Hives can appear anywhere on the body, including your face, torso, arms, legs, and back, according to the American College of Allergy, Asthma, and Immunology . They may range in size from as tiny as a pencil tip to as large as a dinner plate. Hives typically crop up when you have an allergic reaction to a substancelike pet dander, pollen, or latextriggering your body to release histamine and other chemicals into your blood. That’s what causes the itching, swelling, and other symptoms, per the ACAAI.

Acute hives are those that clear up within six weeks and chronic hives are those lasting more than six weeks, per guidelines published in 2016 in the journal Allergy, Asthma and Immunology Research. Whether someone falls into the category of acute or chronic hives, there are some concrete causes of those pesky red bumps.

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What Are The Types Of Hives And Angioedema

There are different types of hives and angioedema, including:

• Acute: Hives or swelling that last for less than six weeks are considered acute, meaning they come on suddenly. Allergic reactions to certain foods or medications often cause acute hives and swelling.
• Chronic: When hives linger for more than six weeks, the condition is chronic. In 95% of chronic conditions, nobody knows what causes them, though it is thought to be autoimmune in nature.
• Physical: Some people develop hives and swelling in specific situations. Hives might pop up when youre in the cold, heat or sun. Some people react to vibrations or pressure, or exercise and sweating. Physical hives usually appear within an hour after exposure.

How Long Do They Last

Hives show up quickly and fade within hours. Once faded, they leave no marks other than scratches from itching. However, new hives may show up after the original hives have gone away. For most people, the hives will come back for only a few days to a few weeks. In some people, hives may come back every day or every few days for months to years.

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What Questions Should I Ask My Doctor

If you develop hives or swelling , ask your healthcare provider:

• Why did I get hives and swelling?
• When should the hives and/or swelling go away?
• Should I get an allergy test?
• What steps can I take to prevent getting hives or swelling in the future?
• Whats the best treatment to reduce itching?
• Whats the best way to get rid of hives?
• Should I look out for signs of complications?

Hives and swelling are your bodys way of responding to a substance that it doesnt like. These reactions are a bit uncomfortable, but are not always serious. You may develop hives alone, hives with swelling, or just swelling. Most of the time, these reactions go away in a day or two. If you are prone to hives or swelling, talk to your healthcare provider about getting an allergy test. Once you know what triggers your allergies, you can take steps to avoid your triggers.

Last reviewed by a Cleveland Clinic medical professional on 04/22/2020.

References

Can Stress Cause Hives

Hives can also develop as a result of sun or cold exposure, infections, excessive perspiration, and emotional stress. The reason why stress seems to precipitate an outbreak of hives in many people is not completely understood but is likely related to the known effects of stress on the immune system. In many cases, the cause of hives in a given individual cannot be identified.

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How To Recognize Hives

This article was co-authored by Alan O. Khadavi, MD, FACAAI. Dr. Alan O. Khadavi is a Board Certified Allergist and a Pediatric Allergy Specialist based in Los Angeles, California. He holds a BS in biochemistry from the State University of New York at Stony Brook and an MD from the State University of New York Health Science Center at Brooklyn. Dr. Khadavi completed his pediatric residency at Schneider Childrens Hospital in New York, and then went on to complete his allergy and immunology fellowship and pediatric residency at Long Island College Hospital. He is board certified in adult and pediatric allergy/immunology. Dr. Khadavi is a Diplomate of the American Board of Allergy and Immunology, a Fellow of the American College of Allergy, Asthma & Immunology , and a member of the American Academy of Allergy, Asthma & Immunology . Dr. Khadavi’s honors include Castle Connollys list of Top Doctors 2013-2020, and Patient Choice Awards “Most Compassionate Doctor” in 2013 & 2014.There are 11 references cited in this article, which can be found at the bottom of the page. This article has been viewed 42,365 times.

Should You See A Doctor

If you have long-term hives or rashes, talking to a doctor such as an allergist or dermatologist may help you uncover their cause and determine the best course of treatment.

Hives or rashes may be the result of an allergic reaction or medical condition that warrants immediate medical treatment.

See a doctor if your skin condition is accompanied by any of these symptoms:

• difficulty breathing

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Testing And Diagnosis Of Hives

Your childâs doctor will look at your childâs skin to diagnose hives. It can be challenging to find the cause, so your doctor will ask about recent illnesses, medication, foods your child has eaten and other possible causes. Your childâs doctor may also order one or more of the following tests:

Causes Of Widespread Hives

• Viral Infection. The most common cause of hives all over the body is viral infections. Research has confirmed this. Other symptoms such as a fever, cough or diarrhea are also present. The hives may last 3 days. This is not an allergy.
• Bacterial Infection. Some bacterial infections can also cause hives. A common example is Strep. Hives are also seen with bladder infections.
• Drug Reaction. An example is a penicillin rash. Most rashes that start while taking an antibiotic are viral rashes. Allergy tests are normal 90% of the time. Only 10% turn out to be a drug allergy.
• Food Reaction. May be an allergy or a coincidence. If the food is a high risk one , consult an allergist. Hives from foods usually resolve in 6 hours. Hives from infections last for days. Only 3% of hives are due to a food.
• Bee Sting. Widespread hives after a sting may be part of a serious allergic reaction. Need to consult an allergist.
• Anaphylactic Reaction . The sudden onset of hives with trouble breathing or swallowing. This is a severe allergic reaction to an allergic food or drug. Most often begins within 30 minutes of swallowing the substance. Always within 2 hours of exposure.
• Unknown. Over 30% of the time, the cause of hives is not found.

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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.

Some People Have Greater Risk Of Developing Any Type Of Hives

While anyone can develop hives, you have a greater risk if you:

• Are a woman of African American heritage

• Have atopic dermatitis

• Smoke cigarettes

If you have long-lasting or widespread hives, seeing a dermatologist can help you feel more comfortable. Seeing a dermatologist is also a good idea to make sure that what you have really is hives.

Find out how dermatologists diagnose and treat hives at: Hives: Diagnosis and treatment.

Related AAD resources

ImagesImage 1: Used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.

Image 2: Images used with permission of JAAD Case Reports.

• JAAD Case Reports 2021 11:137-8.

Image 3. Image used with permission of the Journal of the American Academy of Dermatology.

• J Am Acad Dermatol 2006 5428-46.

ReferencesAntia C, Baquerizo K, et al. Urticaria: A comprehensive review: Epidemiology, diagnosis, and work-up. J Am Acad Dermatol. 2018 79:599-614.

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.

Hymes SR, Strom EA, et al. Radiation dermatitis: Clinical presentation, pathophysiology, and treatment. 2006. J Am Acad Dermatol. 2006 54:28-46.

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Can Hives Be Prevented

Simple changes to your lifestyle may be able to help you prevent hives from reoccurring in the future. If you have allergies and you know which substances are likely to cause an allergic reaction, your doctor will suggest that you avoid any possible exposure to these factors. Allergy shots are another option that may help you reduce the risk of experiencing hives again.

Avoid being in high-humidity areas or wearing tight clothing if you have recently had a hives outbreak.

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.

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