Hives are itchy welts on the skin. They can be caused by:
- An allergic reaction
- A physical trigger, such as cold, water, or pressure
- A medical condition, such as an infection or autoimmune disease
These welts, also called wheals, may be red, pink, white, or skin-colored. Just as they vary in color, hives come in many shapes. Some appear as tiny spots or blotches. Others look like thin, raised lines. Hives also show up on the skin in many sizes. They can be as small as a pinprick, large as a dinner plate, or any size in between.
Regardless of what they look like, hives tend to appear and clear within a few hours. Some people have one flare-up and never get hives again. It’s also possible to have many flare-ups.
If you continue to get hives daily or almost every day for six weeks or longer, you have chronic hives. The medical term for this is “chronic urticaria." When you have chronic hives, the most effective treatment often depends on the type of the hives you have and your medical history.
When you have flare-ups for six weeks or longer, here’s what dermatologists recommend
Make an appointment to see a board-certified dermatologist, allergist, or primary care doctor.
Most people who have hives are otherwise healthy, but it’s still helpful to see a doctor. A thorough medical exam can help rule out possible causes, such as an infection or medication, which could be causing your hives. It’s also possible for a disease, such as a thyroid condition, rheumatoid arthritis, or diabetes to cause hives. If signs indicate that this may be the cause, medical testing can find or rule out these causes. While medications and medical conditions can cause hives, there are many other causes, including foods, insect bites, and pressure on the skin. Sometimes, it’s not possible to find the cause. If that happens, your dermatologist can still recommend lifestyle changes and prescribe medication that can help reduce your flare-ups.
Keep track of your flare-ups. While it’s not always possible to find the cause, keeping track of your flare-ups may help you figure out what triggers your hives.
Take photos of your hives. When your see your dermatologist, you may not have hives. Taking pictures can help your dermatologist make sure you have hives. Other skin conditions can look like hives.
Relieve the itch at home. Itch is common in people who have chronic hives.
Stay calm. Stress can trigger hives. If you feel stressed often, healthy ways to reduce your stress include, exercising every day, meditating, and practicing mindfulness.
Know that treatment can be effective when the cause(s) of your hives remains unknown. It’s helpful to find out what’s causing your hives, but sometimes, a cause cannot be found. About 50% of people who have chronic hives never find out what’s causing their flare-ups. Even when you cannot find the cause, treatment can help you clear your skin and prevent new flare-ups.
Follow your treatment plan. For treatment to be effective, it’s essential to follow the treatment plan your doctor creates for you. Treatment may fail to work when you take medication less often than prescribed. For example, if your dermatologist prescribes a daily antihistamine and you only take it when you have a flare-up, you may continue to get hives.
Tell your dermatologist if treatment fails to work. If you are following your treatment plan exactly as instructed, you may still have flare-ups. Hives can be stubborn, but treatment can still work. To give you relief, your dermatologist may: Increase the dose of a medication
Understand that extensive allergy testing rarely helps. Many people believe that their hives would go away if they could just find out what’s causing the flare- ups. Even when the cause remains unknown, treatment can clear your skin and keep it clear.
Know that chronic hives may go away on their own. About half the people who have chronic hives will stop having flare-ups within 1 year.
With so many possible causes, it’s easy to feel overwhelmed. The good news is that treatment can keep hives under control. Sometimes, it just takes time to find the treatment that works for you.