What are hives | Causes | Different types | Diagnosis | Treatment | Prevention
Hives, also known as urticaria, are a common skin condition that affects many people.
They can be uncomfortable, itchy, and even painful at times but they usually are harmless.
However, they can sometimes indicate an underlying medical condition or allergy.
In this article, we will discuss hives in detail so that you know what hives are, how to diagnose hives, how to treat hives, and tips for preventing hives from happening again.
What are hives?
Hives are a condition that causes an itchy rash.
The rash can be anywhere on the body, and it usually comes and goes quickly.
Hives often occur as a food allergy after you eat or drink something you are allergic to and also when you touch something you’re allergic to, but they can also be caused by stress, infection, or other factors.
The symptoms of hives are characterized by red, itchy bumps or welts that can look like small bubbles or patches.
They can also be accompanied by more serious symptoms such as swelling of the throat, shortness of breath, anxiety, and more.
Hives are most often caused by an allergic reaction to something you have come in contact with and their effects range from minor discomfort to life-threatening asthma attacks.
Treatment for hives will depend on the type you experience, with some hives treatments including antihistamines, steroid injections, topical corticosteroids, and more.
If left untreated hive symptoms could worsen over time which leads to chronic hives.
What causes hives?
There are many different causes for hives, but the most common is an allergic reaction.
When your body comes in contact with something you’re allergic to, it triggers the release of histamine which can cause a rash and this reaction is called contact dermatitis.
This chemical can cause hives symptoms like itching, swelling, and redness. Other causes of hives include stress, infection, sun exposure, and more.
The most common causes are as follows:
Medications
Over-the-counter medications and prescription drugs can both cause hives. Some of the most common are NSAIDS (nonsteroidal anti-inflammatory drugs), antibiotics, and sulfa drugs.
Food
Some foods are more likely to cause hives than others. These include shellfish, nuts, eggs, milk, and soy products.
Infection or environmental agent (chemicals)
Infections such as a cold or the flu can trigger hives, as well as exposure to certain environmental agents like pollen, pet dander, and latex.
Dermatographic urticaria
Also known as skin writing, this form of hives cause is rare and it’s triggered by pressure or trauma to the skin, which can lead to hives.
Red welts appear where the skin has been scratched, slapped, or stroked. This type of hives usually goes away on its own within an hour.
Pressure or delayed pressure
This form of hives cause is triggered by pressure on the skin, like when you sit for too long or wear tight shoes.
The reaction is usually delayed about 6 hours after the action can last up to 3 days.
The difference between this and dermatographic urticaria is that the welts do not appear soon after the action and the hives typically stay for longer.
Cholinergic or stress
Cholinergic or stress hives are triggered by adrenaline and can be brought on by physical or mental stress.
Symptoms include redness, itching, hives rash, and more.
The causes below are all cholinergic or stress-induced hives causes:
Cold-induced hives
This type of hives is caused by exposure to cold temperatures.
The hives usually start in one area and then spread out over the body. It can also cause a burning sensation.
Solar urticaria
This rare form of hives is caused by exposure to sunlight. Symptoms include red, itchy welts on areas that have been exposed to the sun.
This hives cause can last about an hour, once you are out of the exposure to the sun, or up to several days.
Water-induced
This form of hives is caused by coming into contact with cold or warm water. Symptoms include red, itchy welts on the skin appear after 1 to 15 minutes after exposure.
Exercise
Exercise hives can be brought on by any type of exercise, but it is more common in people with allergies to certain foods. Symptoms include hives rash, itching, swelling in the throat or mouth.

What are the different forms of hives?
There are several different types of hives that we will break down below:
Allergic reactions
This is the most common type of hives and it’s caused by an allergic reaction to something you come in contact with.
Anaphylaxis
This is the most serious form of hives and it can be a life-threatening allergic reaction. This type of hives is caused by a severe allergic reaction that lead to breathing difficulties, chest pain, dizziness, and more.
Autoimmune
It’s caused by your immune system attacking healthy cells instead of harmful ones, which results in hives that come and go over time. It can be caused by autoimmune diseases like celiac disease, type I diabetes, and rheumatoid arthritis.
Chronic hives
Chronic hives, also called chronic urticaria, are hives that last longer than six weeks, which is the time it takes for hives to go away on their own. Chronic hives can be caused by stress, certain medications, or even an underlying health problem.
Nonallergic hives
This hives cause is much less common than hives that are caused by an allergic reaction. These hives can last for days or weeks at a time and it can be caused by medications releasing more histamine.
Dietary histamine poisoning
This form of hives is caused by eating spoiled fish. Symptoms include hives although it should be noted these hives do not have wheals, which is a red, swollen, mark on the skin.
Dermatographism
This is a rare form of hives that is caused by pressure or trauma to the skin.
Temperature (heat)
This form of hives is induced by exposure to cold or hot temperatures, which can lead to hives rash and hives bumps.
Infection-induced
This hives cause is triggered by an infection like the flu or a cold, which can lead to hives in areas that are affected. This form of hives can be induced by either a viral infection or bacterial infection.
How do you diagnose hives?
Doctors have several recourses when diagnosing hives. First, they will likely look at the affected area and this is usually enough for a diagnosis.
They also have the option to take a skin allergy test, where they see what allergens you are allergic to, or even a blood test to check for other illnesses.
The doctor will also determine if you are suffering from acute urticaria, also called acute hives, which disappears within 6 weeks, or chronic urticaria, also called chronic hives, which lasts longer than 6 weeks.
It is very important that if you are experiencing hives symptoms and they continue to get worse, we encourage you to visit your doctor, healthcare provider, or dermatologist as soon as possible because hives can develop into chronic hives.
How do you treat hives?
There are a few different hives treatments that your doctor may prescribe, which include antihistamines, corticosteroids, and other medications.
It is important to take the medication as prescribed and do not stop taking it without speaking with your doctor first.
Some hives treatments can cause side effects like drowsiness or weight gain. You can also avoid itching or even touching the area so as not to spread or worsen the hives.
An oatmeal bath is also an option, just be sure to NOT use hot water as it can exacerbate your condition.
Can hives be prevented?
There are a few hives prevention tips that we can provide. The first is to identify what your triggers are and try to avoid them if possible.
Secondly, always carry an EpiPen, which is a shot of epinephrine, or other epinephrine injection with you in case of anaphylaxis.
And finally, see your doctor if you have chronic hives so they can help you find the underlying cause and treat it.
Summary
Hives are a common skin condition that is often caused by an allergic reaction, but there are several different forms of hives including infection-induced hives, temperature-induced hives, and nonallergic hives.
Hives can be diagnosed through various methods including a physical examination and skin allergy testing or blood tests.
If the hives do not go away on their own, a doctor may prescribe an antihistamine or even an oatmeal bath to relieve your symptoms.
The best way to reduce and prevent your symptoms is to know which allergen triggers these reactions and avoid it.
Thank you for reading our article, if you have any more questions we recommend you talk to your doctor, healthcare provider, dermatologist, or pharmacist.
If you are experiencing these symptoms, we recommend you see a doctor for medical care.
If you are suffering from an anaphylactic reaction and are having difficulty breathing, please seek medical attention immediately as this is a medical emergency.
References, Studies and Sources:
- Exercise-induced Urticaria: Prevention, Causes and Treatment
- Trusted Health Education from Family Physicians | familydoctor.org
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