Hi ! Thanks for the query. Most of the time urticaria (hives) is manifestation of an allergic reaction triggered by medications, foods, infections, certain physical agents like heat, cold, water, sun, other allergens and systemic illnesses. So the first thing in treatment of is finding the trigger. The work-up includes blood tests, urine, stool to check for parasites, and x-rays of the chest, sinuses and teeth.  A prick or scratch test to test for airborne or food allergens is also in order. If nothing is found on the workup, then the relief is mostly symptomatic with antihistamines.  Sometimes if the urticaria is severe enough, systemic steroids, like prednisone are required, although not for long-term treatment, as they have many side effects. Consult on private chat for treatment recommendations