- 10 ways to get relief from chronic hives
- Causes of Hives
- When to Get Emergency Help
- Treatment of Hives
- When to Call the Doctor
- Auckland DHB Clinical Immunology and Allergy
- 9 Natural Remedies for Hives Treatment
10 ways to get relief from chronic hives
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. Some triggers that can cause long-lasting hives are shown below.
Trigger When hives appear Foods: Many foods can cause hives, including peanuts and other nuts, eggs, and shellfish. Hives typically appear within 1 hour of eating the food. Foods (if you have latex allergy): If you already have a latex allergy, bananas, chestnuts, kiwis, or mangos can trigger hives. Hives appear 12 to 24 hours after you eat the food. Additives: Colorings and preservatives used in foods, vitamins and other supplements, spices, cosmetics, skin care products, toothpaste, or other products can trigger hives. Hives usually appear within 12 to 24 hours. Medications: Many medications, including antibiotics, aspirin, and ibuprofen, can be triggers. Hives can occur immediately, days, weeks, or years after you start taking a medication. Cold Hives or an itchy rash appear when you start to warm up after being in cold water or outdoors in the cold. Hives can also appear almost immediately when you go into an air-conditioned building or walk near a freezer case. Heat Hives tend to develop within minutes. Ultraviolet light (sunlight, tanning beds) Hives often appear within minutes. Vibration (very rare cause) Itching and swelling develop when you’re exposed to any vibration. Adrenalin: Stress, exercise, heat, and hot showers, are a few things that cause your body to release adrenalin. Hives appear quickly and last for 30 to 60 minutes. Pressure on your skin: Tight-fitting clothes, sitting, or a purse strap can apply enough pressure to cause hives. Hives can occur when pressure is applied to the skin or appear 4 to 24 hours later. Water (very rare cause) Hives often appear within 1 to 3 minutes of water touching your skin. Touch a plant, animal, or chemical: Stinging nettle, jellyfish, cinnamon, sorbic acid, or latex are common triggers. Usually within minutes, hives (and sometimes difficulty breathing) occur.
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. Here are some ways to get temporary relief:
- Avoid overheating.
- 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.
- Prevent dry skin by using a fragrance-free moisturizer several times a day.
The pressure of a purse strap can cause chronic hives where the strap rests on your body.
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
- Add another medication to your treatment plan
- Prescribe a different medication Before changing your treatment plan, be sure you’ve followed the original treatment plan.
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.
Related AAD resources
Hives: Symptoms, causes, and treatment
Welts on skin due to cold temperature could be hives
American Academy of Dermatology. “Basic Dermatology Curriculum: Urticaria.” Module last accessed December 14, 2018.
Antia C, Baquerizo K, et al. “Urticaria: A comprehensive review, Treatment of chronic urticaria, special populations, and disease outcomes.” J Am Acad Dermatol. 2018;79:617-33.
Kaplan AP. “Urticaria and angioedema.” Fitzpatrick’s Dermatology in General Medicine (seventh edition). McGraw Hill Medical, New York, 2008: 330-43.
Hives, also called urticaria (yer ti CARE ee uh), are red, itchy, raised bumps or welts on the skin. They may be small, like mosquito bites, or many inches wide. Hives can appear alone, in a group or can connect with each other to cover bigger areas. When pressed, the center of the hive turns pale. They can be made worse by scratching.
Hives often appear suddenly on any part of the body. They may appear in one place, go away in a few hours and then come back in another place. In severe cases, hives may come and go for several weeks. For most people, they are not serious.
About 1 out of every 5 people has hives at some time in his or her life.
Causes of Hives
Hives are the body’s response to an irritation (Picture 1). The cause (trigger) may be non-allergic or allergic.
Non-allergic hives are the most common type. Usually, their exact cause is unknown. Some causes of non-allergic hives are:
- Viruses and infections
- Temperature extremes – hot and cold
- Sunlight – sunlamps or direct sunlight
- Pressure – skin that is rubbed very hard or scratched or clothes are too tight-fitting
- Emotional stress
Allergic hives have a known cause, but are less common. Some causes of allergic hives are:
- Foods – especially peanuts, eggs, tree nuts, milk or shellfish
- Medicines – antibiotics and pain medicines
- Plants – grass and weeds
- Insect stings or bites
- Animal dander
- Chemicals – soaps, detergents and lotions
When to Get Emergency Help
If your child has trouble breathing, swallowing or talking, nausea or vomiting, or swelling of the mouth or lips, get emergency treatment immediately. These are early symptoms
of anaphylaxis, which can be life-threatening. Call 9-1-1 or take your child to the nearest emergency department.
Treatment of Hives
The goal of treatment is to control the itching and avoid things that may trigger hives to get worse or come back.
For mild hives:
- Give an over-the-counter (OTC) antihistamine. Your child’s health provider can recommend which one to use and how much to give.
- Take a cool bath, shower or apply a cool compress. Wet a washcloth or towel with
cold water, wring it out and place it on the child’s hives.
- Distract your child from itching by playing a game, singing a song or reading (Picture 2).
For more severe hives:
- Your child’s health provider may prescribe an antihistamine or a steroid (such as prednisone), or give your child an injection of epinephrine.
- If your child’s health provider is concerned about a severe form of allergic reaction (anaphylaxis), a prescription for an EpiPen® (epinephrine auto-injector) is usually given. The EpiPen® should be used right away and as directed if symptoms of anaphylaxis occur. There is no way to know when a trigger will cause a severe reaction, so it is important the EpiPen® is always available. Once an EpiPen® is used, call 9-1-1 or take your child to the nearest emergency department.
To stop hives from getting worse:
- Avoid scratching or rubbing the skin.
- Dress your child in loose-fitting clothes to relieve hives caused by pressure.
- Do not use harsh soaps on the skin and for washing clothes.
- If your child is sensitive to cold, have him or her wear warm clothes and avoid contact with cold water.
- If your child is sensitive to the sun, be sure he or she uses sunblock and wears long sleeves and pants.
- Everyone should wash hands after touching pets.
Although hives can be frustrating, they are usually not life-threatening. It is important to stay calm so your child does not become more anxious and uncomfortable.
If your child develops hives often, keep a record of events that happen just before they break out. This will help your child’s doctor find the cause and make a plan to keep them from coming back.
- Stay away from things you know can trigger your child to get hives. A more severe reaction may occur the next time.
- Avoid foods and medicines that have triggered hives in the past. Read labels carefully.
When to Call the Doctor
Call your child’s doctor if:
- The prescribed antihistamine medicine does not relieve the itching.
- The hives or itching becomes worse or new symptoms develop.
- Your child develops hives after being stung by an insect or after taking a new medicine or eating a certain food. He may need an EpiPen® to treat a more serious reaction next time.
Holter Monitor (PDF)
HH-I-82 11/89, Revised 11/17, Nationwide Children’s Hospital
Auckland DHB Clinical Immunology and Allergy
What is urticaria?
Urticaria (also known as hives) is an itchy rash that can appear like welts, which comes and goes in a seemingly unpredictable fashion.
Sometimes, if you scratch the skin, you may notice it comes up in a raised red line. This is called dermatographism.
Urticaria is actually quite common with one out of three people getting it at some stage in their life.
The skin swelling seen in urticaria is due to the release of chemicals such as histamine from mast cells and basophils in the skin, which causes small blood vessels to leak. The welts can be a few millimetres or several centimetres in diameter, coloured white or red, often surrounded by a red flare, and frequently itchy. Each wheal (or weal) may last a few minutes or several hours, and may change shape. Wheals may be round or form rings, a map-like pattern or giant patches.
The surface wheals may be accompanied by deeper swelling of eyelids, lips, hands and elsewhere. The deeper swelling is called angioedema and may occur with or without urticarial wheals (10%).
Did you know? 80% of cases of hives occurring in adults are not due to allergy
This is particularly true for hives that are recurrent or chronic (occurring on a daily basis). Hives due to allergy more often comes on in sudden discreet attacks after food only. Non-allergic hives can come and go any time of the day, and often occurs overnight or first thing in the morning too.
Causes of chronic or recurrent hives
Recurrent or chronic hives can be caused by different factors. Sometimes one of these factors can cause urticaria by itself, but sometimes a combination of multiple factors is needed.
Also, these factors can be intermittent, causing hives only sometimes. This can make it confusing when trying to identify the cause. Here is a list of some common causes:
- Autoimmune causes – this is where the body’s immune system tends to activate itself and cause the hives. This is quite a common cause of hives. It is important to note that it is very rare that this signifies any significant other autoimmune disease though. A thyroid test should be done however.
- Medications – commonly codeine or non-steroidal anti-inflammatory drugs NSAIDS like ibuprofen, diclofenac, Voltaren, Nurofen and aspirin. Many cough and cold remedies can contain NSAIDs. One in three adults with recurrent hives will intermittently and unpredictably react to NSAIDs and aspirin. If this happens all NSAIDs and aspirin must be avoided. Patients may need an alternative for analgesia, and an Arcoxia challenge can be considered.
- Stress and any extraordinary or emotional recent events in a person’s life may trigger or maintain hives.
- Infections including viruses and bacteria. This often causes hives during or after the infection for a few days.
- Time of menstrual cycle.
- Physical triggers may include pressure, cold, heat, sunlight, exercise and, rarely, water. Dermatographism or “skin writing” is marked by the appearance of weals or welts on the skin as a result of scratching or firm stroking of the skin. Seen in 4–5% of the population, it is one of the most common types of urticaria, in which the skin becomes raised and inflamed when stroked, scratched, rubbed, and sometimes even slapped.
Treatment of chronic or recurrent urticaria (hives)
The first step is diagnosis of the cause, which involves accurate, detailed discussion between doctor and patient, with particular emphasis on the multiple factors listed above. Sometimes, just understanding the role of these multiple factors with intermittent effects, helps a patient understand the nature of hives and can provide a feeling of control over the situation.
- For patients with recurrent or even daily hives it is best to take regular antihistamines. This can be once daily, but often twice daily is needed. They should be non-sedating such as loratadine or cetirizine. If hives occur mainly at night or early morning, they should be taken before bed. Sometimes higher doses of regular antihistamines are required for urticaria than the doses used in other conditions. In general, these higher doses are well tolerated and side-effects are rare.
Avoid the causes
- Looking at the factors in the list above to see if any of these can be modified.
Does chronic urticaria go away?
For people who have chronic urticaria (hives every day for more than six weeks), this problem always goes away eventually. It does tend to take months to completely resolve. 50% of long term cases resolve by one year and 30% resolve the year after. Milder cases will often go away sooner.
9 Natural Remedies for Hives Treatment
Let’s talk about the best part of this article — how to get rid of hives naturally, as well as how to prevent them in the first place!
1. Be Patient and Don’t Irritate
Hives treatment may not be needed if hives are mild. If you wait a short time, they can disappear on their own without any intervention. If you want to do something to help them go away faster and to reduce itching and swelling, make sure that you do not take any hot baths or showers while you have hives. Also, avoid wearing any tight-fitting clothing because this can further irritate the area where you have hives. (14) This all applies to babies or toddlers with hives as well. Make sure you don’t bathe a child with hives in water that is too hot and keep their clothing loose-fitting and breathable.
2. Address Allergies
First off, if you think you know what caused your hives, then avoid further contact or consumption with whatever it is. If you suspect that your hives are being caused by a particular food you’re eating or a certain pet you currently have in your home, then it is a good idea to get some allergy testing done. Allergy testing can reveal your hive triggers, which you can then avoid (as much as possible) and you can greatly prevent the likelihood of another undesirable hives rash. (15) Keeping a food diary can also help a hive sufferer to pinpoint any food allergies.
3. Calm the Inflammation
To calm hives and help them vanish that much quicker, make sure you’re not using any products on your body that will only make the inflammation and itching worse. You don’t want to be using anything harsh on your body right now. This includes soaps and other body care products, as well as the detergent you use on your clothing. Opt for natural products free of unhealthy synthetic fragrances and other aggravating ingredients. Another simple way to calm hives is to take a cool bath or shower. You can also use a cool compress on the hives to help relieve any itching. (16)
4. Oatmeal Bath
Natural hives treatment can come in the form of a calming oatmeal bath. Simply add a cup or two of uncooked oats into a stocking or cheesecloth. Tie it up with a rubber band so the oats can’t leak out. Put the oats under the running water as your bath fills up. Your bath will be infused with oatmeal’s skin-calming goodness. Oats are known for their ability to calm skin inflammation, thanks to their naturally high salicylic acid content. Taking an oatmeal bath for hives can help calm these unwanted eruptions for both adults and children. Just make sure the water is warm — not too hot or too cold — since temperature extremes can just make hives worse. (17)
5. Stress Reduction
Can stress cause hives? The answer is definitely “yes.” Hives and stress can go hand-in-hand. When you experience excessive short or long term stress, it takes a toll on body’s immune system. Since the stress is throwing off your immune system, your body responds by internally sending out histamine to fend off your current health problem, which in this case is stress. Histamine release doesn’t make stress go away, but it can cause hives to start popping up in various places. Basically, this is an allergic reaction to stress and your body is sending out visible signals (hives) to let you know that it’s time to chill out. (18)
The very best way to get rid of stress hives is to remove as much stress from your life as possible. There are so many effective ways to reduce stress on a daily basis. Find what works best for you and make it a part of your routine. Exercise is always one of my stress boosters. Other great ideas for stress hives treatment, and hives treatment in general, include yoga, massage, journaling and prayer.
6. Baking Soda
Making a paste of baking soda and water can help to calm hives and also prevent new ones from popping up. Baking soda is known as nahcolite, which is part of the natural mineral natron. Natron contains large amounts of sodium bicarbonate. It has been used since ancient times as a soother and cleanser. Mix a teaspoon of baking soda with some cold water to create a paste and then rub it on the affected area. Let it dry completely before washing it off. You can do this a few times a day, if needed. Relief is typically immediate from this easy hives treatment.
7. Witch Hazel
Dabbing witch hazel on hives several times per day while hives are present can help to calm the inflammation and itching. Witch hazel is a skin-healing liquid with strong antioxidant and astringent properties. You can also try my recipe that includes witch hazel, along with many other natural anti-hive ingredients: DIY Rash Cream with Aloe & Lavender.
Quercetin and evening primrose are two supplements for hives that will calm and get rid of your hives faster. (19) Quercetin is a natural antihistamine and an anti-inflammatory. Test tube studies have revealed that quercetin prevents immune cells from releasing histamines, which cause allergic reactions like hives. (20) Other studies have also shown that quercetin, a natural medicine and phytochemical, is as effective at fighting allergies as some prescription medications, all with little to no side effects. (21) Other supplement recommendations include vitamin B12, vitamin C, vitamin D and fish oil. (22)
Acupuncture is another option for natural hives treatment, especially for chronic hives. It is a holistic health technique that stems from Traditional Chinese Medicine practices. Trained practitioners stimulate specific points on the body by inserting thin needles into the skin. When it comes to hives, acupuncture aims to provide immediate relief from the swelling and itching. Acupuncture also tries to get to the root of the hives, including any underlying imbalances or triggers that are causing the hives. Some common acupuncture points for hives include Spleen 10 (SP 10) and Large Intestine 11 (LI 11). One double-blind study placebo-controlled study treated 40 patients with chronic urticaria using either real acupuncture or “sham acupuncture” for three weeks. The subjects treated with real acupuncture experienced partial remissions of symptoms after three weeks. The effectiveness of the acupuncture treatments appeared to increase with each additional treatment. (22)
Related: Top 7 Benefits of Green Tea: The No. 1 Anti-Aging Beverage
Seek urgent medical attention for yourself or your child if hives are severe and/or cover a large area of your body, or if you have other symptoms, such as difficulty breathing or a fever. Chronic urticaria or chronic hives should be evaluated by an allergist or immunologist to determine proper hives treatment.
Angioedema is a similar skin issue to hives, but it usually last longer than hives. Swelling is under the skin instead of on the surface. With angioedema, a person typically has deep swelling around the eyes and lips and, sometimes, of the genitals, hands and feet. In rare cases, angioedema of the throat, tongue, or lungs can block the airways, making it hard to breathe. This can be life threatening. (23)
In rare cases, hives or angioedema can be early symptoms of anaphylaxis. Anaphylaxis requires immediate medical attention. If you suspect you are having an anaphylactic reaction, seek urgent medical treatment. Without proper treatment, anaphylaxis can be deadly.
Always check with your doctor before using any natural remedies if you are taking medication or being treated for any ongoing health condition(s).
Final Thoughts on Hives Treatment
Hives are an unpleasant inflammatory skin condition that 20 percent of the population will experience at some point in time. Thankfully, hives typically are not serious, and hives treatment is available. With some simple natural remedies, you can calm a hives outbreak on yourself or your child quite quickly. Inexpensive, common household items like oatmeal, witch hazel and baking soda are really effective at calming the itching and redness that usually accompany hives. If your child experiences hives, you should make sure you aren’t using any harsh body care products on his or her skin. You should also avoid hot baths and tight-fitting clothes. I hope that you won’t experience hives anytime soon, but if you do, a natural hives treatment will really come in handy.