Hives or urticaria, is an allergic skin reaction causing reddish pink or skin colored raised rashes or welts. These rashes are extremely itchy and may sometimes sting and be painful. Most commonly hives are triggered by an allergic reaction to food or medication or as exposure to irritants in the external environment through touch or inhalation. 

Generally acute hives (hives that appear suddenly) are not severe and are self limiting. They do not need any immediate medical interventions. However, in rare cases hives can be severe or chronic, requiring medical attention. Read further to know about the causes, symptoms, and management of hives.

Causes of hives

Acute hives:

  • Allergic reaction to medications, food, pollens, cosmetics, insect bites, and animal dander.
  • Non  allergic causes such as infections or illnesses, wearing excessively tight clothes, irritation due to excessive sweating, exposure to extreme temperatures, and stress.
  • Certain medications such as antibiotics, anticancer drugs, and ibuprofen.

Chronic hives - Ongoing hives are hives extending for more than 6 weeks and occurring without an identifiable cause. These hives are generally indicative of some underlying medical condition such as:

  • SLE (systemic lupus erythematosus)
  • Celiac disease
  • Type 1 diabetes
  • Thyroid disease
  • Rheumatoid arthritis

Symptoms of hives

Hives typically present as rashes or welts on the skin and have following characteristics:

  • Small or large round, ring-shaped, or random shapes
  • Reddish pink or same color as the skin that turn white when pressed
  • Itchy and cause irritation
  • May appear in batches 
  • May change shape or grow larger
  • May remain localized to affected part or spread all over the body
  • May disappear or reappear over the course of the outbreak

Management of hives

  • Mild cases of hives are usually self remitting. Individual hives may last for half an hour to a day. Avoiding the trigger often suffices and generally these hives do not require any prescription medications. However,  long- or short-term allergy medications may be recommended to provide relief from irritation and itching.
  • Alternatively you may also follow certain remedies that provide relief such as avoiding hot water, avoiding itching which may aggravate the hives, take a cool or lukewarm bath with baking soda.
  • Severe cases of hives may trigger an anaphylaxis reaction which is a life-threatening emergency and needs immediate medical attention. In cases of anaphylaxis, the hives are often accompanied with severe swelling, breathing difficulties, dizziness, nausea or vomiting. 

Precautions to prevent hives

  • If you are aware of your allergies, avoid exposure to the allergens
  • Keep allergy shots handy
  • Avoid being in extreme temperatures and high-humidity areas 
  • Wear comfortable and loose clothing if you have recently had a hives outbreak

Take home message - Hives can be itchy, irritable, and sometimes painful. But they usually are not severe. However, they can be dangerous if accompanied with anaphylaxis, for which prompt treatment is crucial.

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