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What might have triggered the hives on this woman's face? Explore more images of skin conditions.
©iStockphoto.com/Karen SquiresDealing with hives can feel like you've been a feast for a swarm of mosquitoes. As if the intense itching weren’t enough, hives can also burn and sting. But what causes these uncomfortable bumps to appear?
Hives, medically known as "urticaria," can be either acute or chronic. Acute hives last less than six weeks, while chronic hives persist beyond six weeks. Acute hives are usually easier to treat because they often have clear causes. Chronic hives, though rarer, are more difficult to diagnose and treat [source: American Academy of Dermatology].
While most hives tend to resolve on their own, some may persist. It's a good idea to consult your family doctor or a dermatologist. Doctors can run various tests, such as blood tests and allergy skin tests, to help identify the cause of your hives [source: Mayo Clinic].
At times, what you believe to be hives might actually be its relative, angioedema. The key difference is that angioedema occurs deeper within the skin and often causes swelling around the eyes and mouth. It can also affect your hands, feet, and genital area. In rare cases, both angioedema and hives can be dangerous if they cause throat swelling, which could hinder breathing. If you notice your throat swelling, difficulty breathing, or dizziness, seek immediate medical attention [source: Mayo Clinic].
By now, aside from the itchiness, you’re probably curious about what actually causes hives and how to get rid of them if you experience them. Keep reading for more information.
What Causes Hives
Hives are generally triggered when your body releases histamine in response to an allergen or other irritants.
Here are some common causes of hives:
- Food -- Food is one of the primary triggers for hives. Certain foods are more likely to provoke an allergic reaction. In fact, 90% of hives are linked to milk, soy, eggs, nuts, shellfish, or wheat. Other frequent triggers include chocolate and food additives like sulfites and salicylates. If a particular food causes your hives, eliminating it from your diet may help.
- Medications -- Much like food, medications can be a common cause of hives, with some drugs being more likely to induce allergic reactions than others. Common triggers include painkillers such as ibuprofen, aspirin, and codeine, as well as certain antibiotics and blood pressure medications. If you develop hives after taking a medication, consult your doctor before deciding on the next steps.
- External factors -- Hives caused by external factors like exercise, sunlight, temperature fluctuations, or cold are called physical urticarias. These hives typically appear within an hour of exposure to the trigger.
- Other underlying conditions -- If you suffer from other allergies, infections, or pre-existing health conditions, hives may develop as a result of those issues [sources: Mayo Clinic, American Academy of Dermatology, American Academy of Allergy, Asthma & Immunology, WebMD].
While there are many potential causes of hives, there are also a variety of treatments available. Keep reading to discover which treatments work best for different types of hives.
If you've had hives before, you likely want to prevent future flare-ups. The first step is to identify what caused them. Keeping a log of your outbreaks, especially if you suspect food might be the culprit, can be helpful. Once you think you've identified the trigger, try eliminating it and see if that helps [source: Mayo Clinic].
Managing Hives
One option for dealing with your hives is to simply do nothing. If the itching is mild and not particularly bothersome, you can wait it out and see if the hives resolve on their own.
However, if your hives are more severe and causing significant discomfort, you should consult your primary care doctor or dermatologist about using antihistamines. There are several over-the-counter options as well as prescription medications available.
Common over-the-counter antihistamines include diphenhydramine and chlorpheniramine. Additionally, loratadine and cetirizine, once available only by prescription, can now be found over the counter. Prescription-only antihistamines include fexofenadine, hydroxyzine, desloratadine, and levocetirizine [source: Mayo Clinic]. Keep in mind that some antihistamines may cause drowsiness, so be sure to consult your doctor about possible side effects.
How do antihistamines work? Think of histamines as concertgoers trying to get into a sold-out show, and the receptor sites on your body as the concert venue. Antihistamines fill up those receptor sites, blocking the histamines from getting in. While the antihistamines enjoy the show, the histamines are left outside, unable to cause the allergic reaction that leads to hives [source: WebMD].
In rare cases, your doctor may recommend that you carry an EpiPen, a portable device for injecting epinephrine in emergencies. If you experience severe hives or internal hives that cause swelling so intense it obstructs breathing, an EpiPen could be life-saving [source: Saini].
Are there alternative ways to treat hives beyond over-the-counter and prescription medications? Keep reading to explore natural remedies for hives.
If your hives don’t respond to regular antihistamines, your doctor might suggest trying heartburn medication. Your body has a second type of histamine receptor site, not only in your skin but also in your stomach. If a standard antihistamine isn’t effective, a heartburn medication might help by blocking this additional receptor site [source: Saini].
Natural Treatments for Hives
Some people prefer natural remedies for hives instead of relying on over-the-counter or prescription medications. But what natural treatments are available for hives?
Soaking in a cool bath can help relieve the itching. Adding baking soda or oatmeal may enhance the bath's effectiveness. You can use regular uncooked oatmeal or oatmeal specifically made for baths (known as "colloidal" oatmeal). If a bath isn't an option, a cool, damp compress may work just as well [source: Mayo Clinic].
Acupuncture is a widely used alternative treatment for hives, with some individuals finding it quite effective [source: Saini]. While the effectiveness of acupuncture is debated, one theory is that it interacts with the nervous system, influencing the body's signaling mechanisms to encourage healing [source: Institute for Traditional Medicine].
If baths aren't providing relief and acupuncture seems intimidating, you might consider trying herbs, supplements, or essential oils. Some herbalists recommend quercetin, a natural antihistamine found in leafy greens, for hives [source: American Chronicle]. Vitamin C has been associated with lower histamine levels, which may help prevent hives [source: How Stuff Works]. Chamomile, lavender, or sandalwood oils are also known to help soothe hives [source: American Chronicle]. Additionally, the calming effects of these oils can benefit relaxation, especially when dealing with the stress of constant itching.
If you're already under the care of a doctor, be sure to consult them before starting any natural treatments to ensure they won't interfere with your ongoing treatment plan.
Now that you understand how to treat regular hives, you may be curious about managing chronic hives. Keep reading for more information.
Raising your body temperature can trigger hives. Whether you're exercising, spending time in the sun, or taking a hot shower, the heat can stimulate histamine production, causing itching. Increased blood flow to the skin also worsens the problem [source: Saini]. To help manage hives, avoid overheating by wearing loose clothing and keeping your environment cool [source: WebMD].
Chronic Hives
Chronic hives can be extremely challenging for those who experience them. Unlike acute hives, chronic hives persist for over six weeks, sometimes lasting for months or even years. Even if the hives eventually subside, they can resurface later. In fact, about 40% of individuals with chronic hives will experience another episode at some point in their lives [source: American Academy of Allergy, Asthma & Immunology]. What makes it even more confusing is that in over 80% of cases, the exact cause of chronic hives remains unidentified [source: Cleveland Clinic].
Despite the mystery surrounding chronic hives, there are tests that can help identify their cause. Just like with acute hives, your doctor may recommend blood tests and allergy screenings. In some cases, additional tests may be required to rule out other underlying conditions, such as thyroid problems, which could be contributing to your hives [source: Mayo Clinic].
If your doctor can't pinpoint the cause of your chronic hives, treatment will focus more on symptom management rather than finding a specific cure [source: Saini]. Initially, oral antihistamines commonly used for acute hives will likely be tried. If they don't provide relief, your doctor might suggest corticosteroids, tricyclic antidepressants, or a combination of antihistamines and H2 blockers. Newer treatments being explored for chronic hives include cyclosporine, omalizumab (an asthma drug), and leukotriene receptor antagonists [source: Mayo Clinic].
Whether you're dealing with chronic or acute hives, you don't have to face them alone. If you're struggling with hives, consult a doctor who can help you identify the triggers and provide appropriate treatments that will work for you.
Here are five key facts about hives:
- The size and duration of hives can vary significantly.
- Hives can grow large enough to match the size of a plate.
- Smaller hives can merge to form larger clusters.
- Hives may resolve within 24 hours to a few days, or they could last for months or even years.
- In some instances, new hives emerge as older ones begin to fade or disappear [source: American Academy of Dermatology].
