What Are Hives and What Can You Do About Them?

Learn what hives are, when you need to see a doctor and what treatment options are available from Allergy Expert Flavia Hoyte, MD, at National Jewish Health.


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Hives are an intensely itchy rash, generally raised and red, that comes and goes over time.

You can have acute hives where hives will come for a few hours and then go away and not come back or chronic hives which by definition are daily or almost daily for at least six weeks and sometimes up to years even.


How to Identify Hives

Hives are generally red, raised, itchy and they can be pinpoint or more commonly look like a welt, sort of more like a mosquito bite appearance.

And they should not leave behind a mark or a bruise.

If a hive is leaving behind a mark then that is something to mention to a physician.


How to Diagnose Hives

Acute hives which generally come and go within a day or days are most commonly a result of an allergic exposure.

And so generally the most important thing will be the clinical history, so the questions we ask and the clues that a patient gives us helps us to determine what might have caused the hives as part of an allergic reaction.

Chronic hives on the other hand which generally last for six weeks or longer don’t usually have a secondary cause and it’s very disconcerting and frustrating because we’re always looking for that secondary cause, but we will do some basic testing just to rule out anything serious as a secondary cause for the hives.


Treatment Options for Hives

The mainstay of hive treatment is going to be oral antihistamines, some of which are available over the counter and some of which are by prescription.

There are two different kinds of antihistamines, so there’s going to be the more short acting and more potent antihistamine which is oftentimes the one that makes you very drowsy, so it has more side effects, and then the longer acting antihistamine that stays in your system longer, may not be quite as potent, but can have more of an effect for longer. 

If antihistamines are not enough, then generally I would talk to a physician about other options.

And we have many immunomodulators and immune suppressants that can calm the immune system so that revved up immune system causing the hives can be more calm.

In addition, if we find an acute cause for the hives, we’ll generally advise avoidance.

Visit njhealth.org/allergy to learn more about what causes hives.

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