What are the causes of hives? How can hives be treated and prevented? Get the answers to these questions and more in this comprehensive guide on hives.

Understanding Hives (Urticaria)

Hives, also known as urticaria, are red, raised bumps on the skin that can be intensely itchy. Approximately 1 in 5 people will experience hives at some point in their lives. Hives can appear anywhere on the body and can range in size from small, mosquito-bite-like bumps to several inches wide. The appearance of hives may vary, but they often share common symptoms.

Signs and Symptoms of Hives

People with hives may have a single hive or groups of hives that cover large areas of the body. Hives can move around on the body, starting in one place and then moving to another. They may go away quickly or come and go for weeks or even months. Swelling of the skin, particularly on the lips, ears, eyelids, fingers, or toes, is also a common symptom of hives. In rare cases, hives can be part of a more severe allergic reaction called anaphylaxis, which can cause the airway to swell and make breathing difficult, a life-threatening situation that requires immediate medical attention.

Causes of Hives

Hives are caused by the release of a chemical called histamine in the body. This can happen due to allergies or other triggers, such as:

• Viruses or infections (e.g., cold, strep throat, urinary tract infection)
• Emotional stress (e.g., anxiety, anger, fear, sadness)
• Exercises that increase body temperature
• Vibrations (e.g., from using a lawn mower, horseback riding, mountain biking)
• Extreme temperatures (too hot or too cold)
• Sunlight or tanning beds
• Pressure on the skin (e.g., from tight clothing, rubbing, scratching)
• Allergic reactions to foods, medications, or other substances

Treating Hives

The treatment for hives depends on the severity of the itching. Even with treatment, hives can last for days or weeks. The main goals of treatment are to control the itching and avoid triggers that may cause the hives to reappear.

Treating Mild Hives

For mild hives, the following treatments may be effective:

• Taking an over-the-counter (OTC) antihistamine, such as loratadine (Claritin®), fexofenadine (Allegra®), cetirizine (Zyrtec®), or levocetirizine (Xyzal®)
• Cooling the skin using an ice pack, cold bath, or cold shower
• Avoiding known triggers, such as animal dander or fragrances

Treating Severe Hives

For severe hives, the following treatments may be necessary:

• Taking a higher dose of antihistamines or steroids, such as prednisone
• Seeing a doctor or healthcare provider, who may prescribe additional medications, such as Xolair® shots (injections), if the hives are chronic

Preventing Hives

To prevent hives from recurring, it can be helpful to keep a record of events that occurred before the hives appeared. This can help you and your healthcare provider identify and avoid potential triggers. Additionally, you can help prevent hives by:

• Avoiding scratching or rubbing the skin
• Washing with mild, fragrance-free products
• Reducing stress and anxiety through relaxation techniques or other coping methods
• Wearing loose, comfortable clothing

When to Seek Emergency Help

If you or your child experiences hives along with any of the following symptoms, it is important to seek emergency medical attention immediately:

• Trouble breathing, swallowing, or speaking
• Swelling of the mouth or tongue
• Nausea or vomiting

These symptoms may indicate a life-threatening allergic reaction called anaphylaxis, which requires prompt treatment with an epinephrine auto-injector (such as EpiPen®, Auvi-Q®, or Adrenaclick®) and immediate medical care.

Living with Hives

Living with recurring hives can be challenging, especially when the cause is unknown. Keeping a record of events that precede the appearance of hives can help you and your healthcare provider develop a plan to prevent future outbreaks. By avoiding triggers, managing symptoms, and seeking appropriate medical treatment, many people with hives can find relief and improve their quality of life.