Hives: Simple Rash or An Underlying Medical Condition?

woman scratching
woman scratching


If you’ve had red or skin-colored bumps that appeared and disappeared quickly, they’re unlikely to be simple bug bites. Such skin rash could be hives, also known as urticaria.   

Chronic hives are frequently caused by unknown factors affecting approximately 20% of people at some point in their lives. They are a skin reaction characterized by itchy welts that last longer than six weeks and reoccur frequently over months or years. Itching from hives can range from mild to severe and can be extremely uncomfortable and disrupt sleep and daily activities. 

Although there is no cure for urticaria or hives, they can be managed and prevented by identifying and avoiding the triggers. Consider contacting a Clinical Research Organization near you to learn more about the treatment and management of Urticaria. 

In this article, we will go over hives, their causes, complications if left untreated, and their treatments in depth. 

What is Urticaria? 

Hives also known as welts, wheals, or nettle rash, often appear as a raised, itchy rash. There are numerous possible causes, including allergen exposure, a physical trigger, such as pressure from tight clothing, or an underlying health condition.   

Types of Urticaria or Hives: 

Urticaria is divided into two types based on the severity and extent of the rash. 

They are as follows: 

  • Acute urticaria – This occurs when the rash disappears completely within 6 weeks.  
  • Chronic urticaria – This occurs when the rash lasts longer than 6 weeks, often for many years. 

Urticaria vasculitis is a much rarer type of urticaria that causes inflammation of the blood vessels inside the skin. In these cases, the welts are more painful, last longer, and can leave a bruise. 

Who’s Affected by Urticaria? 

Acute urticaria (also known as short-term urticaria) is a common condition that affects approximately one in every five people at some point in their lives. Children, women aged 30 to 60, and people with a history of allergies are frequently affected by the condition. 

Hives are not contagious. However, if it is caused by an underlying infection, then the infection may be contagious. Hives frequently present with the following characteristics: 

  • The distinctive raised skin lesions can appear anywhere on the body. 
  • Lesions frequently appear in clusters. 
  • They are usually itchy. 
  • They can be pink, red, or skin tone. 
  • The coloring may fade if a person presses in the middle. 
  • The bumps usually last no more than 24 hours, but new ones can form. 
  • They can range in size from a pinprick to several inches across. 

What are the Symptoms of Urticaria or Hives? 

Chronic hives symptoms include: 

  • Welts can appear anywhere on the body and can be red, purple, or skin-colored.  
  • Welts that change size, shape, and appear and fade repeatedly. 
  • Itching (pruritus), which can be severe. 
  • Angioedema (painful swelling) around the eyes, cheeks, or lips. 
  • Heat, exercise, or stress-related flares. 
  • Symptoms that last longer than six weeks and reoccur frequently and at any time, sometimes for months or years. 

What Exactly Causes Urticaria? 

Urticaria occurs when a trigger causes a high level of histamine and other chemical messengers released in the skin. These substances cause the blood vessels in the affected area of the skin to dilate and leak, resulting in redness or pinkness. Swelling and itchiness are caused by the extra fluid in the tissues. 

Histamine is produced for a variety of reasons, including: 

  • A food allergy; a reaction to an insect bite or sting. 
  • Cold or heat exposure. 
  • Infection. 
  • Certain medications – such as nonsteroidal anti-inflammatory drugs (NSAIDs) or antibiotics. 

However, in many cases of urticaria, there is no obvious cause. 

Sometimes long-term urticaria may be caused by the immune system mistakenly attacking healthy tissues. However, this is difficult to diagnose. Certain triggers may also aggravate the symptoms. These are some of the triggers: 

  • Alcoholic beverages 
  • Caffeine consumption  
  • Emotional stress  
  • Warm temperature 

How can we Diagnose Urticaria? 

By examining your skin, your physician can diagnose hives and swelling. Allergy tests can help determine what is causing a reaction. Knowing what’s causing your reaction can help you avoid allergens, hives, and swelling. Allergy tests include the following: 

Skin tests: During this test, Your physician will examine your skin for allergens. If your skin becomes red or swollen, it indicates that you are allergic to that substance. A skin prick or scratch test is another name for this type of allergy test. If the hives are chronic, skin testing is rarely performed. 

Blood tests: A blood test looks for specific antibodies in your blood. To combat allergens, your body produces antibodies. The process is part of your immune system, but too much of it can cause hives and swelling. 

How can we Treat or Manage Urticaria? 

Most of the time, hives go away on their own. However, your physician may recommend medications and at-home care to help you feel better and reduce your chances of getting hives again. Treatment options include: 

Allergy medications: Antihistamines are medications that block the effects of histamine on your body. Antihistamines relieve itching caused by hives and help to avoid allergic reactions. Some antihistamines, such as diphenhydramine have a rapid onset of action. Depending on the severity of the hives, your physician may recommend daily OTC or prescription allergy medications, such as loratadine, Allegra, cetirizine, or levocetirizine. 

Allergy shots: For difficult-to-treat chronic hives, your physician may recommend a monthly injection of omalizumab. This medication prevents allergy reactions caused by the body’s allergy antibody, immunoglobin E (IgE). People with severe allergies may produce an excessive amount of IgE, resulting in symptoms such as hives and asthma. 

Home remedies: Take a cool bath or shower, wear loose-fitting clothing, and apply cold compresses to relieve hives. Itching and swelling can be relieved with over-the-counter hydrocortisone cream, such as Cortizone. 

Epinephrine: Severe allergic reactions and swelling can result in anaphylaxis, a potentially fatal condition. Hives, swelling, shortness of breath, wheezing, vomiting, and low blood pressure are all symptoms. To open a swollen airway, people suffering from anaphylaxis require an immediate epinephrine injection. 

Oral steroids: Prednisone, a type of steroid can relieve hive symptoms that do not respond to antihistamines


Hives, also known as urticaria, are a type of rash. It could be caused by an allergy, an underlying health condition, or other factors. Acute hives appear suddenly and disappear within 6 hours, whereas chronic hives can last for months or years. 

If a person is aware of what causes hives, they may be able to avoid them. However, because the cause of hives is not always clear, it is not always possible to prevent them. In some extreme cases, however, strict treatment may be required. As a result, it is essential to monitor your symptoms and communicate your concerns to your doctor so that they can be addressed appropriately. To learn more about the condition and its treatment, contact Clinical Research Organizations conducting Chronic Spontaneous Urticaria Clinical Trials



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