- Hives vs Rash – What’s the difference between them?
- What are hives?
- What is a rash?
- How to Tell the Difference Between Hives and Other Types of Skin Rashes
- Heat rash or prickly heat
- What causes heat rash?
- What is the difference between prickly heat and urticaria?
- Self-help: what you can do
- When you should see a doctor
- 5 Skin Disorders You Might Mistake for Hives
- How to identify an allergic reaction
- How to immediately treat a reaction
- Skin 911: How To Treat Burns, Peeling, Rashes, Hives
- Is It Hives or Something Else?
- An Allergic Reaction
- A Variety of Causes
- Oral and Topical Medications
Hives vs Rash – What’s the difference between them?
The main difference between hives and a rash is that hives are a particular type of rash, characterized by swollen, pale-red or skin-colored bumps on the skin that appear and disappear quickly, and tend to “blanch” (which means turn white) when pressed. Hives are also known as urticaria.
Hives are a type of rash, but there are many other different ways rashes present. Both hives and rashes tend to be itchy.
What are hives?
Hives are an outbreak of swollen, pale red bumps that appear suddenly on the skin. These bumps are sometimes called wheals or welts, and they may be circular or irregular in shape and range in size from pin-size dots to large map-like patches.
They can appear anywhere on the body, including the face, lips, tongue, throat, or ears. Their edges are distinct, and the area of skin affected by the hive is smooth and elevated above the surrounding area of skin (reflecting the fluid collected in the layer of skin below the surface).
Angioedema is similar to hives, but the swelling occurs deeper within the skin instead of on the surface, so the swelling is more noticeable and worrying. Occasionally, angioedema can be life-threatening, because the swelling can occur around the throat, tongue or lungs and restrict breathing. Other common areas affected by angioedema include the eyes, lips and sometimes the genitals, hands, or feet. See your doctor as soon as possible if you develop angioedema.
Some wheals may look different from others, for example, some may be red, whereas others may be pale; some may be rounded, whereas others may be flat on top. Hives are usually incredibly itchy and they characteristically change in size and shape and may join together to form larger areas known as plaques. Sometimes they disappear for a few hours only to reappear in a different formation later.
Most people think hives are caused by an allergy, but in fact, most cases of hives occur for non-allergic reasons, although allergies are a common cause. Other causes of hives include:
- Blood transfusions
- Certain foods: The most common foods implicated are nuts, chocolate, fish, tomatoes, eggs, fresh berries, and milk. Fresh foods cause hives more often than cooked foods
- Chemicals in certain foods (such as additives and preservatives)
- Infections (eg, colds, infectious mononucleosis, hepatitis, urinary tract infections, and strep throat)
- Insect bites or stings
- Medications (such as aspirin, NSAIDs , ACE inhibitors, codeine, sulfa drugs)
- Physical stimuli, such as pressure, cold, heat, exercise or sun exposure
- An underlying internal disease (such as thyroid disease, cancer, or hepatitis).
Hives (urticaria) are usually classified as acute (lasting less than six weeks) or chronic (lasting more than six weeks). Some cases are mild, while others are severe. Scratching, alcoholic beverages, exercise, and stress may worsen hives.
The most frequently recommended treatment for hives is antihistamines. These work by blocking the effect of histamine, which is a chemical in the skin that can cause inflammation, swelling, and itching. Cold compresses or anti-itch salves may also help ease symptoms.
What is a rash?
A rash is an irritated area of skin. Most rashes are characterized by small bumps of skin, are itchy and look red. Sometimes the skin may be broken from scratching. In some types of rashes, blisters may form.
Rashes may be a symptom of an underlying medical problem and some people are more likely than others to develop rashes. Other common causes of rashes include:
- Chemical exposure
- Insects, spiders, or jellyfish
- Irritating substances
- Medications (eg, amoxicillin, sulfa drugs)
- Plants (eg, poison ivy)
Some rashes develop suddenly, whereas others form over several days. Treatments vary, depending on what caused the rash in the first place but may include moisturizers, lotions, corticosteroids creams (which relieve redness and swelling) and antihistamines (which relieve redness and itching).
If your rash doesn’t go away within a few days, you have other worrying symptoms, or is very severe, see your health care provider.
Hives is a skin rash that breaks out when you have an allergic reason to something. Known in the medical field as “urticaria,” hives outbreaks may be brought on by consuming certain foods, being stung by certain insects, by taking certain medications, or just by being around certain chemicals. In some cases, extreme temperatures can even result in a hives outbreak. Hives can appear anywhere on the body, and may vary in severity. Some hives outbreaks only last hours or a day, while chronic hives can last for over 6 weeks.
While it’s important to be wary of hives outbreaks, it is also important not to jump to the conclusion that you have hives every time you break out into a rash. Make sure to know what symptoms to look out for, so you can tell if what you are experiencing is hives or something else.
How to Tell the Difference Between Hives and Other Types of Skin Rashes
- Your skin has broken out in an itching, swelling rash: This is a trademark sign of hives. While you should still consult with an experienced medical professional for confirmation, a persistent itchy rash is the hallmark of almost any hives outbreak.
- Your skin has broken out in fluid-filled blisters and bumps: This is not hives. If this is what you are experiencing, think back to whether you have recently spent a lot of time outside in the sun. If you have, chances are what you’re experiencing is a heat rash. These occur as a result of prolonged exposure to the sun, and are often aggravated by clothing that blocks sweat ducts and causes friction. While more severe heat rashes can lead to infections, most clear up on their own, and can be treated by cooling the skin to prevent swelling.
- Your skin has broken out in blotchy red and white bumps or welts: This is likely hives, and chronic hives, to be specific. If you notice your skin is covered with bumps that have a red center and clear edges, you should seek treatment for hives as soon as possible.
- Your skin has broken out in a red rash that stings or burns: While this kind of rash might look similar to hives, chances are it’s actually contact dermatitis. Unlike hives, which can occur just from being around an allergen, this kind of rash does not occur unless you come in direct contact with a trigger. The biggest difference, however, is that where hives itch, contact dermatitis stings.
- The rash in your skin is moving: There is a good chance this is hives, as hives outbreaks often start in one area and spread somewhere else.
- Your face and cheeks are red and flushed: This is a condition known as rosacea. Unlike hives, this kind of rash is limited to your face, and usually affects the cheeks and forehead most. It’s characterized by redness and pimple-like bumps, and while it cannot be cured, it can be controlled with certain medications.
- You experienced a rash after eating something: There is a good chance this is hives, as so many hives rashes occur because someone ate or was exposed to something they are allergic to.
- Your skin is inflamed, dry, and scaly: While this condition may appear similar to hives, chances are it’s actually eczema. While the two rashes may look similar and may be found anywhere on the body, eczema is characterized by dry irritated skin, and is thought to be linked to an overactive immune system.
- Your rash has lasted at least 6 weeks: This is hard to say. While a rash lasting 6 or more weeks could easily be chronic hives, it could also be another skin problem, like pityriasis rosea. It is essential to seek medical help if you experience a rash that lasts this long, in order to mitigate the chance that it is something more serious.
In general, hives tend to be comprised of smaller bumps, making up a larger rash. Individual lesions and disparate pustules tend to signify something else altogether, which may require you to seek the assistance of a dermatologist.
Itchy Skin? Call Today.
If you have frequent skin rashes which you believe may be chronic hives, you should contact Center for Allergy and Asthma of Georgia today. Our board certified Georgia allergists provide experienced hives testing, and may be able to recommend treatments to help improve your condition.
Call now at (404) 994-3574, or fill out our contact form online. Same day appointments are available. Se habla español.
Heat rash or prickly heat
Prickly heat, or heat rash, is an itchy skin rash with small red spots all over the affected areas. It is common in Australia in hot and humid areas.
What causes heat rash?
Heat rash or sweat rash is caused by a blockage and inflammation of sweat ducts during times of exposure to heat and high humidity. These blocked sweat ducts cause sweat to divert into adjacent tissue thus producing the itching and prickling sensations associated with the condition. Doctors call this condition miliaria.
- Tiny red spots, which usually appear on areas of the body where sweat collects, such as the armpits, back, under the breasts, chest, groin, crooks of elbows and knees, and the waist. The spots also occur where clothing causes friction on the body.
- Irritating itch and prickling sensation.
- Redness and mild swelling of the affected area.
What is the difference between prickly heat and urticaria?
Urticaria is characterised by hives (weals) or swelling deeper in the skin, whereas the rash of prickly heat consists of small red spots over the affected areas. Both are intensely itchy.
Self-help: what you can do
Treating heat rash is simple and usually does not require medical assistance.
- Wear light, loose-fitting soft clothes. Avoid clothing that traps heat and moisture. Natural fabrics such as cotton are best.
- It is important not to overheat in bed at night, and sleeping under a sheet and a cotton blanket will help.
- Don’t use plastic mattresses or mattress protectors; use a sheepskin underlay if possible.
- Stay in cool or air-conditioned, or well-ventilated environments. Use a fan if necessary.
- Take frequent cool baths or showers. Dry yourself thoroughly and dust bland types of powder (such as unperfumed talcum powder) on body creases and affected areas, and use an antiperspirant.
- Apply calamine lotion or prickly rash lotions to soothe the affected areas, but avoid using ointments or creams — they keep the skin warm and moist and may make the condition worse.
- Ask your doctor or pharmacist about low-dose steroid cream or lotion.
When you should see a doctor
You should seek medical attention if:
- The rash persists longer than a few days.
- The rash is accompanied by fever or chills.
- Lymph nodes are swollen in the groin or armpits.
- The rash becomes filled with pus.
- The rash occurs regularly.
5 Skin Disorders You Might Mistake for Hives
Self-diagnosis of skin disorders is never an easy task. It’s made more difficult when different conditions have similar symptoms. Hives, for example, come in two types — acute and chronic — and are usually caused by your body releasing histamine in reaction to an allergy. Histamine is an organic compound in your body responsible for triggering the inflammatory process. With hives, the histamine causes fluid to release from the blood vessels and makes the skin swell .
It can be easy to mistake hives for other disorders because the allergy triggers can be difficult to find. Another problem with diagnosing hives is that the symptoms are relatively generic — red, itchy welts on your skin are a common symptom among many skin disorders.
Hives can be caused from allergens as well as physical and environmental factors such as stress, heat, sunlight or water. Untreated, the symptoms can last from a couple hours up to six weeks. As we’ll see throughout this article, many skin disorders share these causes and triggers, so close attention to detail is key when figuring out the mystery of your skin disorder.
Because blood and allergy tests exist to confirm hives at the doctor’s office, and antihistamines are readily available over the counter, determining the diagnosis and appropriate treatment might seem easy. However, since many of these disorders show the same symptoms and have different treatment methods, it’s important to be aware of the similarities and differences between them. So, read on to learn about five common skin disorders that may look and feel a lot like hives.
Having an allergic reaction on your face—or any kind of irritation—thanks to a new skin-care product is bad enough. But then comes the after. How are you supposed to move on with your life with this tender, red skin that’s acting like you owe it an apology?
Despite the shade your face might be giving you at that particular moment, dermatologists do have some tips for soothing that irritation and safely reintroducing your favorite products to your daily lineup. And, when you’re ready to try something new, they’ve got you covered there, too.
How to identify an allergic reaction
As SELF explained previously, there are actually two types of contact dermatitis: irritant and allergic. If something is causing irritant contact dermatitis—commonly referred to as just “irritation”—it’s affecting the stratum corneum, the protective top layer of skin that keeps things like irritants and allergens out.
But if a product leaves you with allergic contact dermatitis, it’s causing an allergic response involving cells in your skin that are part of your immune system, Jennifer Mancuso, M.D., a board-certified dermatologist at the University of Michigan, tells SELF.
In general, “how look and feel is actually very similar,” Nada Elbuluk, M.D., clinical assistant professor of dermatology and director of the Skin of Color Center and Pigmentary Disorders Clinic at USC Keck School of Medicine, tells SELF. Both types of contact dermatitis can cause symptoms such as burning, stinging, itchiness, scaling, flaking, and redness. But there may be some differences between them, the American Academy of Dermatology (AAD) explains.
For instance, if you’re experiencing a mild case of irritant contact dermatitis, you’ll likely have dry skin and patches of redness, itchiness, and flakiness immediately on contact or after a few hours. At the more extreme end of the spectrum, you could develop more intense burning and even blisters, Temitayo Ogunleye, M.D., assistant professor of clinical dermatology at the University of Pennsylvania Perelman School of Medicine, tells SELF. Your symptoms will usually become more severe with repeated exposure to the irritating product.
But if your contact dermatitis stems from an allergy, your symptoms are likely to be more severe, including intense burning, itching, excessive dryness, and a red rash that often spreads beyond the area where the product was applied, Dr. Ogunleye says. You could also develop hives, a type of raised and itchy rash associated with allergic reactions.
When an allergy is the cause, the reaction is more likely to develop after repeated uses because your skin needs to become sensitized to whatever ingredient is causing the reaction, Dr. Mancuso explains. So, the reactions usually don’t develop immediately; it could be days or weeks before you see one. This makes it more difficult to trace back to the source of the reaction: It could come from something you’ve been using a for a while and, therefore, assumed you had no issue with, for example. But, if you’re using a new product with an ingredient that you previously became sensitized to in a different product, then you could have a reaction the first time you use the new product.
How to immediately treat a reaction
No matter which kind of reaction you’re having, the first thing you should do is stop using the product. If you’re experiencing any symptoms like swelling in the face or eyes, difficulty breathing due to swelling in the throat, or confusion, you should seek immediate medical care, as these could be signs of a life-threatening allergic reaction. And if you’re not sure what you’re dealing with exactly, it’s crucial to check in with a dermatologist.
Skin 911: How To Treat Burns, Peeling, Rashes, Hives
I did something really stupid recently. I took a spur of the moment trip to Los Angeles, California (that wasn’t stupid, that was fun) to celebrate a dear friend’s 30th birthday. On the day I was due to take a red eye back to Dulles, the birthday girl wanted to head towards the beach. I hadn’t had a chance to see the ocean yet this trip and I was game. It was a beautiful sunny day with the kind of light breeze that keeps you from feeling too hot. I stripped down to my bikini, applied an SPF 30, laid out on my stomach, and proceeded to pass out…for two hours.
If you’ve ever had the distinct pleasure of meeting me, you’ll know that not only am I fair, I’m so pale that many of the most loved make up brands don’t make a foundation light enough for my skin. I like to call it alabaster — it sounds prettier than ghostly white. My usual sun tanning schedule in order to prevent burning includes a high SPF every twenty minutes as I flip on each side and add in another 20 minutes in the shade per hour. So 40 minutes in the sun and 20 minutes in the shade with three sunscreen applications during a single hour. I only managed the first application.
Needless to say, I got absolutely fried. I haven’t burned myself like that since before I graduated high school and I’m pushing thirty. I’ve never been so uncomfortable on a plane ride in my life.
There are few key ways to care for skin that’s been compromised. I say compromised because treating a sunburn is almost identical to skin that’s had a chemical peel or skin that’s had an allergic reaction (hives and rashes aren’t cute). The advice I humbly offer can apply to the face or body.
And I mean this both internally and externally. After a burn or peel, the skin becomes dry and cracked, as it is preparing to remove itself. Grab a good moisturizer with aloe. It’ll help cool the skin and reduce the inflammation. I slathered myself in Coola’s Radical Recovery After Sun Lotion every couple of hours. It helped reduce redness and calm my backside quickly so that sitting was no longer painful.
For the face, Alchimie Forever Kantic Calming Cream delivers a big boost of antioxidants for a hydrated glow without overstimulating the skin.
As far as internally goes, you know the drill: drink tons of water. It helps promote health of the new skin that’s forming. And after the damage you (and I) did, don’t you want it to be in tip top shape? (Yes.)
Can’t Touch This
Skin peeling sucks. But for the love of anything, do NOT touch that skin. The area damaged by the sun heals itself by forming a new layer of skin to replace the damaged, dead skin layer. The epidermal reaction to a peel is exactly the same. It is how you get that baby-soft, wrinkle-free skin. Throughout the process, the new skin is fragile and the old skin that is peeling acts as a shield against more UV rays and pollutants. If you peel the dead skin, you could expose your new, still too-delicate skin before it is ready. You could trigger tenderness, bleeding, scarring, and infection. So… let’s not, yes?
If you truly cannot deal with the itching (I definitely can’t) but don’t want to damage the skin by scratching, go old school and ice it. Place ice in a thin piece of cloth (I used my Makeup Eraser. Hooray for dual-purpose products!) and place it on the areas that you are desperate to claw at. It’ll soothe the skin quickly so you (and your skin) can relax again.
Everybody’s Free (To Wear Sunscreen)
Protect your frail-skinned self from the damage that happened in the first place (or from making a situation so very much worse). Do what Baz Luhrmann tells you and wear sunscreen.
Personally, I prefer the lovely non-sunscreen-y scents of the Coola Citrus Mimosa Sunscreen Sport Spray for my body. It makes me smell like a favorite beverage of mine while offering me the protection I should have been using all along. For my face, Skinceuticals Physical UV Defense SPF 50 options are amazing, because I cannot stand the feel of anything on my skin in this humidity and they feel completely weightless.
As with most things related to the overall health and aging of your skin, prevention of further damage is key. Don’t go without your sunscreen, and make sure you’re reapplying. If you are considering a peel or other type of deep re-texturizing treatment, check first with your favorite esthetician or dermatologist to learn about recovery time and what actions you should be taking after your treatment.
Is It Hives or Something Else?
Itching, swelling, and red and white welts are all signs you may have hives — or chronic idiopathic hives, if the welts appear consistently for six weeks or more and have no known cause. While any skin rash might seem to you to be an allergic reaction or hives, the reality is there are numerous skin disorders that can be mistaken for chronic hives.
How to Tell if It’s Chronic Hives
If you notice a persistent, itchy skin rash, seeing a dermatologist is a good first step toward confirming a diagnosis and finding relief. “Giving a complete medical history and undergoing a physical exam are the best ways to determine what’s causing the rash or hives, and if there is a more serious skin disorder behind it,” explains Joseph L. Jorizzo, MD, a professor of dermatology at Weill Cornell Medical College in New York City and Wake Forest Baptist Health University School of Medicine in Winston-Salem, North Carolina.
Hives can appear anywhere on the body, and they can change shape, travel, and disappear and reappear within short periods of time. Hives can also appear as bumps or swollen red or skin-colored welts or “wheals” with clear edges and a red center that when pressed turns white. While the cause of chronic hives is typically unknown, some common triggers include certain foods, medications, insect bites, pet dander, viral or bacterial infections, and reactions to physical stimuli like temperature and sun exposure.
5 Skin Disorders Often Confused With Hives
Hives can be mistaken for other skin disorders, such as:
Heat rash. This skin condition occurs in hot, humid weather and can be aggravated by clothing that causes friction or blocks sweat ducts. The rash of fluid-filled blisters and bumps can be itchy and sensitive. Cases of heat rash can range from mild to severe, where the bumps contain pus or affect the deeper layer of the skin. Unlike chronic hives, heat rash typically clears on its own and can be treated by cooling the skin and reducing sweating.
Contact dermatitis. This is a common condition in which something that touches the skin causes a red rash. The reaction may be caused by an allergy to an ingredient in makeup or a particular metal in jewelry, or by continuous contact with an irritant such as soap or bleach. But whereas hives cause an itchy reaction, most people who experience contact dermatitis feel more of a stinging or burning sensation, and the reaction appears only where the skin has come in contact with the trigger.
Rosacea. Unlike hives, which can occur anywhere on the body, rosacea is limited to the face and is characterized by redness on the cheeks, nose, chin, or forehead. Small, visible blood vessels and pimple-like bumps on the face, as well as watery or irritated eyes, are other common symptoms. Rosacea cannot be cured, but it can be controlled with the use of certain medications.
Eczema. The symptoms of eczema generally vary from person to person and can be found all over the body. Causing red, inflamed, dry, scaly, and intensely itchy skin, eczema can be difficult to distinguish from hives. As with chronic hives, the exact cause of eczema is unknown, but it’s thought to be linked with dry, irritated skin and an overactive immune system. The treatment is different from that for hives, which is why it’s important to have a doctor diagnose the skin disorder you have and recommend proper treatment.
Pityriasis rosea. This common skin disease causes a splotchy red rash that appears on the body and typically lasts around six to eight weeks, although sometimes much longer. Unlike chronic hives, pityriasis rosea usually disappears on its own without treatment.
More Serious Skin Problems
The main feature distinguishing chronic hives from more serious skin disorders is whether the welts are filled with fluid. If the red bumps are itchy, inflamed, and filled with fluid, the condition is most likely hives. If they’re hard and filled with other material besides fluid, and if after a skin test the lesions have a brownish color, there’s most likely an underlying problem.
“A lesion that looks like a hive can be circled,” says Dr. Jorizzo. “If the individual lesion lasts longer than 24 hours, more serious urticarial lesions such as urticarial vasculitis or an urticarial lesion of bullous pemphigoid must be excluded by biopsy.”
So if you experience hives or hivelike symptoms, it’s important to see your doctor to determine the source, if possible, and discuss the appropriate treatment.
Hives (urticaria), also known as welts, is a common skin condition with an itchy rash of pink to red bumps that appear and disappear anywhere on the body. An individual lesion of hives typically lasts a few hours (up to 24 hours) before fading away, and new hives can appear as older areas disappear.
Physicians arbitrarily divide hives into acute (new or periodic episodes lasting fewer than 6 weeks) and chronic (periodic episodes lasting more than 6 weeks). Though many people have a single episode of acute hives that goes away within a few days to weeks, some individuals may have chronic hives that persist intermittently for years. More often than not, the offending agent is never identified in those who suffer from chronic hives.
Hives can be triggered by many things, including:
- Medications, especially aspirin, ibuprofen, naproxen, narcotic painkillers, and antibiotics Infections with viruses, bacteria, or fungi
- Environmental allergies such as insect bites, pollen, mold, and animal dander
- Physical exposures such as heat, cold, water, sunlight, and pressure
- Medical conditions including some blood diseases and cancer
- Food allergies such as from strawberries, eggs, nuts, and shellfish
In many cases, the causative agent is not identified despite extensive testing. This is referred to as idiopathic urticaria. In approximately 50% of idiopathic urticaria outbreaks, hives are most likely caused by a reaction from the person’s own immune system (autoimmune reaction).
An Allergic Reaction
Hives are the common term for a skin condition known as urticaria. These red, swollen, and itchy welts appear suddenly on the skin’s surface in reaction to the systemic or topical stimulation of the immune system. This reaction leads to the release of histamine—a substance found in the mast cells of skin that causes fluid to leak from blood vessels into the surrounding tissues. Hives are often difficult to describe because they can be large or small, in irregular patches or circular, raised areas, and they can appear anywhere on the skin. They can even change their appearance within hours, disappearing and reappearing in different locations.
Hives are usually the result of a reaction to food, medication, or an infection. Hives can also appear after direct stimulation of the skin, such as vigorous scratching that produces a welt, intense pressure from tight clothing, or exposure to cold water, bright sunlight, or a hot shower.
Most cases of hives are acute, occurring over a day or two up to a few weeks and then disappearing. If hives continue beyond a period of six weeks, however, they are considered chronic. In these cases, a thorough evaluation by an allergist or immunologist is warranted.
Hives are a relatively common occurrence and usually do not pose a medical danger to patients. However, hives can appear during a serious allergic reaction that requires immediate attention. When the skin reaction of hives is accompanied by swelling of the face, eyelids, or mouth or difficulty breathing, immediate treatment is needed to avoid a serious anaphylactic
A Variety of Causes
In some cases, the cause of the hives is clear. Perhaps they appear following a viral infection or are noticed after taking an antibiotic. It can be frustrating for doctors and patients to determine the cause of hives. In most cases, a cause is never found. Equally frustrating, hives can appear in many forms and disappear and reappear in different locations without warning.
Although all cases of hives have some elements in common, there are several varieties of hives that occur from seemingly unrelated conditions. Hives can be a sign of an allergic reaction to a food or drug or can result from an infectious disease, such as an upper respiratory infection or mononucleosis. Hives can also be caused by a physical stimulation of mast cells under the skin’s surface, causing an exaggerated swelling with the scratching of skin or rubbing of tight clothing. For some people, a hot shower or intense physical exercise can lead to the appearance of hives. Exposure to extreme cold can also cause hives. Even exposure to direct sunlight can cause hives in patients who are prone to this reaction.
Oral and Topical Medications
Most cases of hives disappear on their own without requiring treatment. In cases that persist or cause intense itching, hives can be treated with oral or topical antihistamines. Antihistamines work by stopping the histamine reaction that causes the redness, swelling, and itching. There are several nonprescription antihistamine medications available, including diphenhydramine, clemastine, and chlorpheniramine, as well as prescription-only antihistamines, such as hydroxyzine and cyproheptadine. However, these antihistamines may cause significant drowsiness, making concentration and driving difficult if not dangerous. Antihistamines that are less sedating, such as fexofenadine, cetirizine, or loratadine, are sometimes combined with a sedating antihistamine for oral therapy. Topical creams and lotions with antihistamines or corticosteroidsare also available, although they are not as effective as oral medications. In severe cases, oral corticosteroids may be used for a short period of time to help loratadine control the immune reaction. Ask your pharmacist if you have questions about hives and the prescription and over-thecounter medications used to treat this skin condition.