Hives

What are hives?

Hives (also known as urticaria) is a skin rash characterised by raised welts that appear on the skin. These welts are usually red, pink or even flesh-coloured1and can range from the size of a pinhead to that of a dinner plate. Welts can be circular, oval or ring-shaped,3and can last for a few minutes to a few days or weeks.

Any part of the body can be affected by hives, but the most common areas are the torso, throat, arms and legs. Hives can be triggered by many things, including an allergic reaction,5with as many as 20% of the population developing hives at some point in their life.

While hives are usually nothing to be concerned about, they can be serious if they are associated with symptoms of a serious allergic reaction such as breathing difficulties.

Hives can be acute (lasting a short time) or chronic (lasting more than six weeks) The most common symptoms of hives include:

  • raised circular wheals or welts that resemble mosquito bites

  • wheals that are red on the outside and white in the middle

  • wheals that appear in batches or clusters with a new batch appearing as an older one fades away

  • wheals that last for a few minutes, or come and go for a few days or even weeks

  • itching

What causes hives?

The rash associated with hives is caused by your body producing a protein called histamine, which is usually used to fight off viruses and bacteria.9Most of the time, the exact trigger that causes this reaction isn’t known. However, things that may trigger hives include:

  • an infection (e.g. bacterial, viral or parasitic)

  • a disease of the immune system

  • sting or bite from an insect

  • an allergic reaction to an animal or plant

  • food, including spicy food, food additives, coffee or alcohol

  • medication such as antibiotics, aspirin and codeine

  • dye that is injected in some imaging tests

  • cold air or water

  • heat and sunlight

  • exercise and sweating

  • stress

Who is at risk of hives?

Anyone can get hives, but those who are most at risk are people with known allergies. You may also be more at risk if you are taking medication regularly, or already have an infection or underlying health condition.

How are hives treated?

Most of the time, treatment isn’t required for hives. However, if the rash gets worse or becomes chronic antihistamines may be required. If these are unable to control your symptoms, speak to your doctor as you may need stronger medication.

Lifestyle remedies you can try to relieve the symptoms include:

  • avoiding wearing clothing that may irritate the area

  • avoiding hot water

  • using a cold compress to reduce swelling

  • taking cool or lukewarm baths with baking soda or colloidal oatmeal to reduce the itch

If you know what your trigger is you should take steps to avoid it where possible, to help prevent future cases. However, more than one thing may trigger your hives, so avoiding one trigger may not necessarily prevent you from getting hives again.

Complications of hives

Sometimes hives can cause deeper swelling in the deeper layers of skin, called angioedema. If this occurs around a joint, it can cause pain that resembles arthritis. However, the most common area this occurs is around the face and lips. If this causes swelling of the tongue and airway, making breathing difficult, it may be a medical emergency and you should call for an ambulance (000).

Angioedema may be an early sign of an anaphylactic reaction if it was caused by food or medication.

When should you see your doctor?

You should visit your doctor if your hives last longer than six weeks, or if your symptoms worsen. If your baby gets hives repeatedly, you should also visit your doctor as this may indicate an allergy to something they are being fed.

If you experience an anaphylactic reaction with hives, you should call for an ambulance (000) immediately as this is a medical emergency.

Your local MediADVICE Pharmacist is available to help you manage your health. Speak to your MediADVICE Pharmacist about your symptoms so we can recommend products and medications that may be suitable for you, or refer you to a doctor if necessary.

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General advice only – this information should not replace the information provided to you by your health care professional. If symptoms are severe or persist, please speak to your health care professional. Information current as of date of publishing.
[1] Healthline, Hives, https://www.healthline.com/health/hives
[2] Australasian Society of Clinical Immunology and Allergy, Hives (Urticaria), https://www.allergy.org.au/patients/skin-allergy/urticaria-hives
[3] Better Health Channel, Hives, https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/hives
[4] Better Health Channel, Hives, https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/hives
[5] Healthline, Hives, https://www.healthline.com/health/hives
[6] Australasian Society of Clinical Immunology and Allergy, Hives (Urticaria), https://www.allergy.org.au/patients/skin-allergy/urticaria-hives
[7] Healthline, Hives, https://www.healthline.com/health/hives
[8] Better Health Channel, Hives, https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/hives
[9] Healthdirect, Hives, https://www.healthdirect.gov.au/hives
[10] Healthdirect, Hives, https://www.healthdirect.gov.au/hives
[11] Better Health Channel, Hives, https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/hives
[12] Healthline, Hives, https://www.healthline.com/health/hives
[13] Australasian Society of Clinical Immunology and Allergy, Hives (Urticaria), https://www.allergy.org.au/patients/skin-allergy/urticaria-hives
[14] Mayo clinic, Hives and angioedema, https://www.mayoclinic.org/diseases-conditions/hives-and-angioedema/symptoms-causes/syc-20354908