Hives, or urticaria, are red, extremely itchy areas of swollen skin called wheals that can range in size from pin-size dots to large patches. These wheals may be circular or irregular in shape, but with distinct edges.
Hives are common: up to 20 percent of the population is affected at some time, and the disorder is especially common for people who have had other allergic reactions, such as hay fever. Hives come without warning and may disappear in less than two hours, but they can last as long as a day or two, or recur on and off for months.
Symptoms of Hives
- Sudden onset of itching of varying intensity, with swelling of the skin’s surface into red or skin-colored welts or blisters, called wheals
- Hives normally appear first on covered areas of the skin (e.g., trunk, chest, upper arms and legs) and can also appear on the ears, hands, feet and face.
- Wheals (flat-topped bumps) may change shape, develop a white center, or suddenly disappear without cause in a matter of minutes or hours.
What Causes Hives?
Hives are an allergic reaction that can be caused by a variety of environmental factors. Tension and emotional stress can also trigger hives, as can something you’ve eaten, touched, or inhaled.
Antibiotics are a common cause. Penicillin is the classic trigger and can induce the condition even if someone has taken the antibiotic many times before without any problem. Aspirin is another offender, as is the coating used on multivitamins and other pills. Reactions to food additives, specific foods, cosmetic ingredients, and animal dander may be involved. Some people develop hives after taking a hot shower, bath, or Jacuzzi, while others develop them after being out in the sun, or exposed to cold wind or water.
Viral infections may cause hives, as can other infections. Many people are surprised to find that they develop hives after an exercise session. While you may search for an exact cause for your hives, remember that in more than half of the cases, an exact cause is never discovered.
What If You Do Nothing?
Hives generally will go away on their own within several hours.
Home Remedies for Hives
- Try over-the-counter remedies. Antihistamines are the mainstay of hive relief. The best way to relieve the itching and swelling of hives is to take an oral antihistamine such as Benadryl or Chlor-Trimeton. Remember, however, that most antihistamines will produce drowsiness, so follow package directions.
- Ice them. For temporary relief of itching and swelling of small hives, rub ice directly over the hives for several minutes. This will slow the release of itch-causing histamines.
- Soak and soothe. Add colloidal oatmeal to a tepid bath and soak in the water for 15 minutes to temporarily soothe your skin. Cold compresses and calamine lotion can also help relieve the itching.
- Analyze your diet. Temporarily remove or permanently eliminate foods from your diet that regularly cause hives to develop. Some of the prime offenders often include shellfish, dairy products, nuts, pork, strawberries, chocolate, tomatoes and oranges.
- Do not scratch or rub the hives.
- Avoid breaking the blisters.
- Use cool compress.
- Wear comfortable clothes.
- Find your allergen. This may be easier said than done, and unfortunately, many people never find the exact cause of their problem because there are multiple trigger factors.
- Avoid areas populated by bees. If you are at risk for an allergic reaction to bee stings, you are a potential candidate for anaphylactic shock, a life-threatening situation that can lead to suffocation, loss of consciousness, and death. Be sure to carry a special anaphylaxis emergency kit with you at all times.
Beyond Home Remedies: When To Call Your Doctor
Contact your physician immediately if you develop hives in your throat and breathing becomes difficult. Also call your doctor immediately if you develop hives after taking a medication for some other condition—especially if you also experience dizziness, wheezing, and/or breathlessness. The next dose may bring on a more dangerous swelling in the throat and could lead to anaphylactic shock.
If you develop hives after being stung by a bee or other biting insect, contact your physician, who can determine if you are allergic to stings and can recommend appropriate treatment.
Also call your physician if the hives become uncomfortable, if the hives are severe, or if they do not respond to treatment after six weeks.
What Your Doctor Will Do
Your physician will analyze your diet, medication, and review any recent sickness. For chronic hives, laboratory studies may be performed. For itching hives, a prescription antihistamine may be given for rapid relief. Your physician may also prescribe corticosteroid drugs to treat severe hives.
The Complete Home Wellness Handbook
John Edward Swartzberg, M.D., F.A.C.P., Sheldon Margen, M.D., and the editors of the UC Berkeley Wellness Letter
Updated by Remedy Health Media