Hives are red, itchy welts that can occur on various parts of the body or diffusely. They occur when the immune system releases chemicals, such as histamine, into the bloodstream, causing itching, swelling, and other symptoms. These hives, also known as urticaria, can vary in size and cause significant discomfort. Even though hives often disappear on their own, chronic hives (lasting more than 6 weeks) can be a symptom of an underlying condition that can be controlled with treatment after a specialist diagnoses the cause.
What causes hives?
Foods, medications, or other allergens can trigger hives. These triggers result in acute hives, which are self-limited once the source leaves the body. However, chronic hives are triggered by various insults to the immune system, including stress, infections, thyroid disease, or autoimmune disorders, to name just a few. In some cases, they appear without any known cause.
The most common factors that trigger hives include:
Allergic reactions: Various allergens such as pollen, pet dander, dust mites, foods, and medications can trigger allergic reactions. When the body encounters an allergen, it releases histamine, which causes the characteristic swelling and itching associated with hives.
Infections: Upper respiratory infections or urinary tract infections can also lead to the development of hives.
Stress: Stress rashes often take the form of hives and can develop anywhere on the body or face.
Sunlight: Solar urticaria is a rare allergic reaction to sun exposure that causes hives.
Cold: Cold urticaria is a rare allergic reaction to cold temperatures that causes hives.
Heat: Cholinergic urticaria is a rare form of hives triggered by an elevation in body temperature, breaking a sweat, or exposure to heat.
Water: Aquagenic urticaria, also known as water allergy, is a form of urticaria in which hives develop after contact with water, regardless of its temperature.
Pressure: Pressure urticaria is a type of hives that can appear after pressure is applied to the skin.
When To See a Physician
Hives typically disappear after 24 to 48 hours if they are due to an allergic trigger. If they are severe, covering a significant portion of your body, or persist for more than a week, you should schedule an appointment with a doctor. At Valley ENT, our allergists/immunologists can diagnose and recommend treatments for hives.
Diagnosing Hives
To diagnose what’s causing your hives, a specialist examines the welts and asks about your medical history, including any allergies you may already have. Allergy testing can identify specific allergens that trigger acute hives. Your allergist/immunologist may recommend laboratory tests to determine if an underlying condition is associated with your welts, especially if they are chronic. The tests may show signs of infection or autoimmune disorders.
Treating Hives
Treatments for hives are designed to control your itching, prevent the development of new hives, and avoid triggers if they’re known. Our specialists tailor a treatment plan to meet your needs and may include one or more of the following:
Antihistamines: Antihistamines are the first line of treatment for hives. These medications work by blocking the action of histamines, thereby reducing itching and swelling.
Corticosteroids: Your physician may prescribe corticosteroids for severe or persistent hives. These medications help reduce inflammation and suppress the immune response.
Immunotherapy: In cases where specific allergens cause hives, your doctor may recommend immunotherapy. This treatment involves gradually exposing the patient to increasing amounts of the allergen to build up tolerance and reduce the severity of allergic reactions.
Avoiding triggers: Identifying and avoiding triggers is crucial to managing hives. We advise patients to keep a diary of their activities, what they eat, and exposure to potential allergens to help pinpoint the cause of their hives.
Home remedies: Applying cool compresses to the affected area, taking oatmeal baths, and using over-the-counter anti-itch creams can help alleviate discomfort.
Being prepared will help you get the most out of your appointment. Please bring a list of medications you're currently taking and any pertinent test results—such as labs or imaging—to your appointment. Additionally, let your provider know of any drug allergies or medical conditions you have or for which you are being treated and if you've had any prior surgical procedures.
Visit Our Allergy/Immunology Specialists
Our team of board-certified allergy/immunology specialists at Valley ENT understands the factors involved in developing an effective plan to treat and manage hives. If you’re dealing with persistent or recurring hives, schedule a consultation with one of our specialists.