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Read MoreUnderstanding and Managing Hives: A Comprehensive Guide
Medically reviewed by Jerome Albert Ecker | MD, Assistant Professor of Medicine, Duke University - Durham, NC on August 31st, 2023.
Key Takeaways
- Welts typically migrate across the body within 2-4 hours and disappear completely within 24 hours at each location, though new ones may continue appearing elsewhere.
- Acute urticaria resolves within 6 weeks in 80% of cases, while chronic forms lasting longer than 6 weeks affect 0.5-1% of the population and often have no identifiable trigger.
- Second-generation antihistamines like cetirizine 10mg or loratadine 10mg daily are first-line treatment, with doses safely increased up to 4 times normal strength for severe cases.
- Physical triggers including cold, heat, pressure, or vibration cause 15-20% of chronic cases—simple ice cube tests can help identify cold-induced reactions.
- Emergency care is required immediately if swelling affects the face, lips, tongue, or throat (angioedema), as this can progress to life-threatening airway obstruction within minutes.
Hives, also known as urticaria, are itchy welts that can appear anywhere on your skin. They are often caused by an allergic reaction, stress, or viral infections. If you experience hives, it's essential to understand the symptoms, causes, and treatment options to effectively manage this common skin condition.
Symptoms of Hives
When you have an outbreak of hives, you may notice the following symptoms:
Raised, skin-colored, or reddish welts of varying sizes on the skin
Intense itching, often more severe at night
Welts that appear and disappear over minutes or hours
If your hives last for more than 6 weeks or keep coming back, they are considered chronic urticaria and require further evaluation by a healthcare professional.
Angioedema: A Related Condition
Angioedema is another reaction that sometimes occurs alongside hives. It is characterized by swelling under the skin, often affecting the eyes, lips, and occasionally the genitals, hands, and feet. In rare cases, angioedema can cause swelling in the throat, leading to difficulty breathing. If this happens, use an epinephrine auto-injector if prescribed and seek immediate medical attention.
Causes of Hives
Hives develop when skin cells release histamine, triggering an allergic reaction. Common triggers for hives include:
Foods like milk, fish, or nuts
Medications such as aspirin or penicillin
Food additives, including flavorings and preservatives
Insect bites
Extreme temperatures (hot or cold)
Pressure on the skin
Viral infections
Skin contact with allergens
Treatment Options for Hives
The most effective way to treat hives is to identify and avoid the trigger. Additionally, you can take antihistamines to alleviate symptoms. If over-the-counter medications don't provide relief or your hives persist, consult your doctor. They may prescribe steroid pills or stronger antihistamines.
Home Remedies for Hives
To manage hives at home, try the following tips:
Apply cool compresses or wet cloths to the affected areas
Work and sleep in a cool room
Wear loose-fitting, lightweight clothing
If you experience hives along with fever, nausea, stomach cramps, shortness of breath, and a drop in blood pressure after a bee sting, insect bite, or drug injection, it may indicate a life-threatening allergy. Always carry two epinephrine auto-injectors if prescribed, use one as directed, and seek emergency medical care.
For more information on hives and their management, consult the following reputable sources:
The Bottom Line
Most cases resolve spontaneously with antihistamine treatment and trigger avoidance, but chronic cases lasting over 6 weeks need medical evaluation to rule out underlying conditions. Seek immediate emergency care for any facial swelling or breathing difficulties. If you're experiencing persistent welts or want to identify your triggers, Doctronic can provide quick assessment and treatment guidance.
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