Urticaria - hives; Wheals
Hives are raised, often itchy, red bumps (welts) on the surface of the skin. They can be an allergic reaction to food or medicine. They can also appear without cause.
When you have an allergic reaction to a substance, your body releases histamine and other chemicals into the blood. This causes itching, swelling, and other symptoms. Hives are a common reaction. People with other allergies, such as hay fever, often get hives.
Angioedema is swelling of the deeper tissue that sometimes occurs with hives. Like hives, angioedema can occur on any part of the body. When it occurs around the mouth or throat, the symptoms can be severe, including airway blockage.
Many substances can trigger hives, including:
Hives may also develop as a result of:
Often, the cause of hives is not known.
Symptoms of hives may include any of the following:
Your health care provider can tell if you have hives by looking at your skin.
If you have a history of an allergy causing hives, for example, to strawberries, the diagnosis is even clearer.
Sometimes, a skin biopsy or blood tests are done to confirm that you had an allergic reaction, and to test for the substance that caused the allergic response. However, specific allergy testing is not useful in most cases of hives.
Treatment may not be needed if the hives are mild. They may disappear on their own. To reduce itching and swelling:
If your reaction is severe, especially if the swelling involves your throat, you may need an emergency shot of epinephrine (adrenaline) or steroids. Hives in the throat can block your airway, making it difficult to breathe.
Hives may be uncomfortable, but they are usually harmless and disappear on their own.
When the condition lasts longer than 6 weeks, it is called chronic hives. Usually no cause can be found. Most chronic hives resolve on their own in less than 1 year.
Complications of hives may include:
Call 911 or your local emergency number if you have:
Call your provider if the hives are severe, uncomfortable, and do not respond to self-care measures.
To help prevent hives avoid exposure to substances that give you allergic reactions.
Habif TP. Urticaria, angioedema, and pruritus. In: Habif TP, ed. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 6th ed. Philadelphia, PA: Elsevier; 2016:chap 6.
James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM. Erythema and urticaria. In: James WD, Elston DM, Treat JR, Rosenbach MA, Neuhaus IM, eds. Andrews' Diseases of the Skin. 13th ed. Philadelphia, PA: Elsevier Saunders; 2020:chap 7.BACK TO TOP
Review Date: 4/16/2019
Reviewed By: Michael Lehrer, MD, Clinical Associate Professor, Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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