What are hives?  

Urticaria, commonly known as hives, is actually the name for a diverse group of diseases with many subtypes. While the symptoms of hives—raised patches of skin surrounded by a red area of skin (wheals) and/or swelling of the skin (angioedema)—may be easily identified, further classifying the disease can be challenging.1


Hives fall into two main categories: acute and chronic.   

  • Acute hives (<6 weeks) 
  • Lifetime prevalence: 8 to 20 percent of adults globally2,3  
  • Chronic hives (>6 weeks) 
  • Lifetime prevalence: 0.1 to 1.8 percent of adults globally2,3 

Acute hives resolve quickly—most often in a couple of hours to a day.

What causes hives? 

There are many causes of hives, including extreme temperatures, sun, exercise, viral infections, and stress, along with medications, latex, animal saliva, and insect venom. Occasionally, hives can point to a more serious, rare condition known as mastocytosis, a disorder that is characterized by an increased number of mast cells in the gastrointestinal tract, skin, bone marrow, spleen, liver, and lymph nodes.4

 Allergy-related acute hives can be difficult to identify and manage as up to 80 percent of people with allergies are sensitized to more than one allergen.5  Furthermore, identifying the obvious allergen is not always enough. Allergic responses can develop to previously tolerated substances, and sensitization to seasonal and perennial allergens often add up to trigger symptoms. 

 The following types of allergens may trigger an immune-mediated response: 

  • Contact or inhaled allergens (e.g., latex, animal saliva, dust, pollen, mold, dander) 
  • Ingested allergens (e.g., peanuts, tree nuts, shellfish, fish, wheat, eggs, milk, soy) 
  • Insect venom (e.g., Hymenoptera venom)

Learn about these allergens, including common symptoms, management, and relief. 

Allergen Fact Sheets

Symptoms of Hives

The hallmark symptoms of hives may include the following:1  

  • Itchy, red skin plaques that can occur alone or in groups on any part of the skin. 
  • Wheals (i.e., raised patches of skin surrounded by a red area) that vary in size, change shape, and appear and fade repeatedly as the reaction runs its course. 
  • Swelling under the skin (angioedema), present on the lips and/or eyelids and inside the throat. Angioedema can be life-threatening if swelling causes the throat or tongue to block the airway. 

 The following types of allergens may trigger an immune-mediated response: 

  • Contact or inhaled allergens (e.g., latex, animal saliva, dust, pollen, mold, dander) 
  • Ingested allergens (e.g., peanuts, tree nuts, shellfish, fish, wheat, eggs, milk, soy) 
  • Insect venom (e.g., Hymenoptera venom)

Hives Treatment 

If your symptoms are mild, you may not need treatment. Hives and angioedema often clear up on their own. But treatment can offer relief for intense itching, serious discomfort, and/or symptoms that persist.If the cause of hives can be identified, the best treatment is to avoid the trigger or eliminate it.7 

Antihistamines—available either over the counter or by prescription—are a frequently recommended treatment for hives.7  They work by blocking the effect of histamine, a chemical released in the blood stream, which among other substances can be responsible for some of the allergy symptoms.  

  These tips may also help relieve your symptoms:6 

  • Apply a cold washcloth.  Covering the affected area with a cold washcloth can help soothe the skin and prevent you from scratching. 
  • Take a comfortably cool bath.  Find relief from itching in a cool shower or bath. Some people may also benefit from bathing in cool water sprinkled with baking soda or oatmeal powder, but this isn't a solution for long-term control of chronic itching. 
  • Wear loose, smooth-textured cotton clothing.  Avoid wearing clothing that's rough, tight, scratchy, or made from wool. This will help you avoid skin irritation. 
  • Avoid the sun.  When outdoors, seek shade to help relieve discomfort. 


Is it an allergy or something else? 

Understanding the instigating factor behind hives is one piece of the puzzle. Discovering whether it is acute or chronic and if it happens alone or in association with other conditions, such as allergies, are also important pieces. These clues can be obtained through a physical exam, detailed medical history, and possibly even the results of specific IgE blood testing. With the right information in place, a healthcare provider can put together a comprehensive management plan to address your symptoms. 

 A blood test—together with an allergy-focused medical history—may help identify underlying allergen triggers. 

Tools for Understanding Allergies


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  1. Zuberbier T, Aberer W, Asero R, et al. The EAACI/GA(2) LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update. Allergy. 2014;69(7):868-887.  
  2. Sanchez-Borges M, Asero R, Ansotegui IJ, et al. Diagnosis and treatment of urticaria and angioedema: a worldwide perspective. World Allergy Organ J. 2012;5(11):125-147.   
  3. Gaig P, Olona M, Muñoz Lejarazu D, et al. Epidemiology of urticaria in Spain. J Invest Allergol Clin Immunol. 2004;14(3):214-220.   
  4. Valent P, et al. Standards and standardization in mastocytosis: consensus statements on diagnostics, treatment recommendations and response criteria. Eur J Clin Invest. 2007;37. 435-53.  
  5. Ciprandi G, Alesina R, Ariano R, et al. Characteristics of patients with allergic polysensitization: the POLISMAIL study. Eur Ann Allergy Clin Immunol. 2008;40(3):77-83.   
  6. Mayo Clinic, “Hives and angioedema,” https://www.mayoclinic.org/diseases-conditions/hives-and-angioedema/diagnosis-treatment/drc-20354914 (accessed August 27, 2021).  
  7. American College of Allergy, Asthma, & Immunology, “Hives,” https://acaai.org/allergies/allergic-conditions/skin-allergy/hives/ (accessed August 27, 2021).