Symptoms of chronic hives include: Batches of welts (wheals) that can arise anywhere on the body. Welts that might be red, purple or skin-colored, depending on your skin color. Welts that vary in size, change shape, and appear and fade repeatedly.
Chronic hives occur almost daily for more than six weeks and are typically itchy. Each hive lasts less than 24 hours. They do not bruise nor leave any scar. They typically do not have an identifiable trigger.
Usually hives only affect the skin, but sometimes they can be part of a serious allergic reaction. When this happens, you may have other symptoms such as dizziness, stomach cramps, swelling, or trouble breathing. If you think you are having a serious allergic reaction, go to the emergency room.
If you have hives along with fever, nausea, stomach cramps, shortness of breath, and a drop in blood pressure after a bee sting, insect bite, or drug injection, that can be a sign of a life-threatening allergy.
Seek ER treatment if the rash is accompanied by any of the following: Shortness of breath. Skin peeling away or blisters in the mouth.
Hives can be a sign of several other medical or autoimmune conditions, including thyroid or liver diseases, chronic infections, or lupus. Most people with one of these conditions will have other symptoms apart from the hives.
If you need a stronger antihistamine, your dermatologist may prescribe doxepin. Corticosteroid: When hives are severe, a medication like prednisone can reduce the inflammation and itch. For milder hives, your dermatologist may prescribe a corticosteroid that you apply to your skin to help relieve the itch.
Acute hives — Most cases of hives are acute and will not last beyond a few days to one week or two. Triggers of acute hives can include the following: Infections – Infections can cause hives in some people. In fact, viral infections cause more than 80 percent of all cases of acute hives in children.
Avoiding the allergen trigger is the only way to prevent a reaction. Gan Su, DO, an emergency medicine physician at Medical City Arlington, says the main signs that should send you running to an emergency room with an allergic reaction include: Hives all over your body. Breathing problems.
Hives rarely cause emergencies. But sometimes they can cause throat swelling and trouble breathing. If your throat is swelling or you are having trouble breathing or are wheezing, call 911. Once you are getting medical care, you will be given a shot of epinephrine (adrenaline) to stop the reaction.
Take an Over-the-Counter Antihistamine
Antihistamines, the ones you buy in the pharmacy aisle, are the go-to medicines to get rid of hives. Benadryl (diphenhydramine) helps by blocking the production of histamine. It works great but can make you drowsy, so it's best to take it before you go to sleep.
Infection or medical treatment can trigger hives
Some people get hives when they develop an infection like strep throat, a urinary tract infection, or COVID-19. Others get hives when they have a medical treatment like radiation therapy or a blood transfusion.
The most common autoimmune conditions seen with hives include thyroid disease, rheumatoid arthritis, and Type 1 diabetes.
The wheals generally appear in clusters, with one cluster getting worse as another gets better. Most wheals disappear without a trace within a few hours, only to be replaced by a new one elsewhere on the skin.
Relieve the itch at home.
Wear loose-fitting, cotton clothes. Apply a cold compress, such as ice cubes wrapped in a washcloth, to the itchy skin several times a day—unless cold triggers your hives. Use anti-itch medication that you can buy without a prescription, such as an antihistamine or calamine lotion.
Diphenhydramine and hydroxyzine are the most commonly used H1-blocking antihistamines for urticaria. They act more rapidly than the minimally sedating H1-blocking antihistamines (see below).
Most cases of hives go away within several days to a couple of weeks. If they last six weeks or longer, you may have autoimmune hives. This happens when your immune system mistakenly targets healthy tissue — in this case, triggering a skin reaction.
For a severe attack of hives or angioedema, you may need a trip to the emergency room and an emergency injection of epinephrine — a type of adrenaline.
Some infections that can cause hives in children include respiratory viruses (common cold), strep throat, urinary tract infections, hepatitis, infectious mononucleosis (mono) and many other viral infections.
Hives are sometimes worse at night. Some evidence suggests that mast cells, the cells responsible for releasing histamine, are sensitive to circadian rhythms, which may explain it. 3 Allergens in bedding or temperature changes in the room could also be a factor.
First and foremost, don't scratch your itch! Hives can be extremely itchy, and the natural instinct would be to scratch the area that is bothering you. But scratching hives can make them more inflamed and cause them to spread.
Many people with urticaria are more bothered by their hives in the evening. There are a few reasons why this is the case: Hormones in your body such as cortisol that help to control inflammation and itch are more abundant in the morning than in the afternoon and can be almost completely gone in the evening.
Hives do not last long, taking only 2–3 hours to fade. However, more can appear, which makes the symptoms last longer. Acute hives can develop and resolve on their own within 6 weeks, while chronic hives can last much longer.