Causes and Treatments of Hives

Rash on the back of a man

Hives, more formally known as urticaria, are pale red, swollen bumps, patches, or welts on the skin varying dramatically in size. Hives may be as small as a pencil eraser, or as large as dinner plate. These irritations are usually itchy, but may also burn or sting. They can appear literally anywhere on the body, including tongue, throat, lips, or ears. They may last only for a few hours or for several days

Many people automatically associate hives with allergic reactions, but this is just one possible cause. Hives may also be caused by insect bites or stings, eating foods with certain chemicals, use of certain medications, exposure to sunlight, stress, sweating, and even from being touched, such as during a massage. The most frustrating hives are those for which doctors cannot identify a cause, a surprisingly common occurrence. An allergy test or diagnostic blood tests may need to be ordered to determine the cause, but results are not always conclusive.

The best way to treat hives is to identify and remove the cause, which is not always possible. As mentioned in the previous paragraph, the cause of hives is oftentimes frustratingly elusive. Antihistamines are the most common form of treatment, though chronic hives may require a long-term medication regimen, which may include steroids or biologics. A severe case of hives may require a shot of epinephrine and emergency medical attention. If hives are accompanied by wheezing, swelling of the tongue or throat, trouble breathing, shortness of breath, and/or dizziness, seek immediate medical attention. For mild hives, it may be safe to use over-the-counter antihistamines until a doctor can be seen, but it is best to speak with a pharmacist before making such a decision.

In addition to any medications a doctor or pharmacist may recommend, a patient experiencing hives may take steps to reduce discomfort at home. Common forms of home treatment for hives may include:

  • Use lukewarm water during hand-washing and showering. Hot water may cause additional irritation.

  • Use mild soap. Forego the scented, exfoliating body wash until hives have subsided, since the added chemicals may cause further irritation, or even be the cause of the hives themselves.

  • Apply cool compresses or damp cloths to the affected areas.

  • Try to work and sleep in a cool room. Heat and/or sweat may worsen hives and make the patient more uncomfortable.

  • Wear loose-fitting, lightweight clothing. The friction from tight-fitting clothing may cause or worsen the hives.

Inform your doctor of any instances of hives, even mild cases. Identifying the cause of hives is vital to preventing future occurrences.

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