Hives are small, itchy, red swellings on the skin. The swelling occurs singularly or in clusters. Hives tend to fade after a few hours, but new ones can appear. Most cases go away within a few days. However, some last a few weeks or longer.
Hives are often caused when the body releases a chemical called histamine. Histamine is released during an allergic reaction. Many people, though, get hives without being exposed to something they are allergic to.
While the cause is unknown in some cases, these factors may cause hives:
Foods, most commonly:
- Fresh berries
- Reaction to allergy shots (desensitization shots)
- Insect bites or stings
- Cold or heat
- Thyroid disease ( hypothyroidism, hyperthyroidism)
- Vasculitis (inflammation of the blood vessels)
A risk factor is something that increases your chance of getting hives. Tell your doctor if you have any of these:
- Exposure to an allergen (something that causes an allergic reaction)
- Exposure to an allergen that triggered hives in the past
Symptoms of hives can vary from mild-to-severe:
- Excessive swelling of the eyelids, lips, or genitals
- Difficulty breathing or swallowing— Call 911 if you are having these symptoms.
The doctor will ask about your symptoms and medical history, and do a physical exam. You may need to see a doctor who specializes in skin disorders (dermatologist) or allergies (allergist). The following tests will be done:
The best way to treat hives is to find and then avoid the cause.
If the cause can't be found, there are medicines to reduce symptoms or treat hives:
H1-blocking medicines like:
- Diphenhydramine (eg, Aler-Cap, Benadryl Allergy)
- Hydroxyzine (eg, Vistaril)
- Fexofenadine (eg, Allegra)
- Loratadine (eg, Claritin)
- Acrivastine (eg, Semprex)
- Cetirizine (eg, Zyrtec)
- Doxepin (eg, Prudoxin, Sinequan, Zonalon)
- Levocetirizine (eg, Xyzal)
H2 blocking medicines like:
- Cimetidine (eg, Tagamet HB)
- Ranitidine (eg, Zantac)
- Famotidine (eg, Pepcid)
- Leukotriene antagonists like Montelukast
- Oral steroid medications (eg, prednisone ) for hives resistant to other treatments
- Anti-inflammatory medicines
- Immunosuppressant medicines
- Ultraviolet light therapy
- Prescription epinephrine (adrenalin) injections for cases when swelling affects the airways
The best way to prevent hives is to avoid allergen that caused you to get hives in the past.
American Academy of Allergy, Asthma, and Immunology
American Academy of Dermatology
Canadian Dermatology Association
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Last reviewed September 2013 by Marcin Chwistek, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.