Hives (Adult)
Hives, often called urticaria, are pink or red bumps on the skin. These bumps are also known as wheals. The bumps can itch, burn, or sting. Hives can occur anywhere on the body. They vary in size and shape and can form in clusters. Individual hives can appear and go away quickly. Allergens are proteins that are harmless to many people but can cause an allergic reaction in sensitive people. These reactions often appear as hives. New hives may develop as old ones fade. Hives are common and usually harmless. They can't be spread from person to person. Sometimes hives are a sign of a serious allergy.
Hives may be caused by an allergic reaction. They may occur from:
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Certain foods, such as shellfish, nuts, tomatoes, or berries.
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Contact with something in the environment, such as pollens, animals, or mold.
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Certain medicines.
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Sun or cold air.
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Viral infections, such as a cold or the flu.
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Bacterial infection, such as strep throat.
If the hives continue to come and go over many weeks without any other symptoms (chronic hives), the cause may be hard to figure out.
There are 4 types of hives:
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Acute urticaria: hives that don’t last very long (less than 6 weeks).
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Chronic urticaria: hives that happen at least twice a week for more than 6 weeks.
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Chronic, spontaneous urticaria: chronic hives that don’t have an obvious cause. An older name for this condition is chronic idiopathic urticaria.
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Physical urticaria: also called inducible urticaria, these hives might pop up when you’re in the cold, heat, or sun. Some people react to vibrations or pressure, exercising, or sweating. Physical hives usually appear within an hour after exposure. This type of hives can also be chronic.
Home care
Follow these tips:
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Your doctor may prescribe medicines to ease swelling and itching. Follow all instructions when using these medicines. The hives will usually fade in a few days. But they can last for weeks or months.
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Try to find the cause of the hives and eliminate it. Discuss possible causes with your doctor. Your doctor may ask you to keep track of the food you eat and your lifestyle to help find the cause of the hives.
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Don’t scratch the hives. Scratching will delay healing. To reduce itching, apply cool, wet compresses to the skin.
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Dress in soft, loose cotton clothing.
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Don’t bathe in hot water. This can make the itching worse.
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Apply an ice pack or cool pack wrapped in a thin towel to your skin. This will help reduce redness and itching. But if your hives were caused by exposure to cold, then do not apply more cold to them.
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You may use over-the counter antihistamines to reduce itching. Some older antihistamines, such as diphenhydramine and chlorpheniramine, are inexpensive. But they need to be taken often and may make you sleepy. They are best used at bedtime. Don’t use diphenhydramine if you have glaucoma or have trouble urinating because of an enlarged prostate. Newer antihistamines, such as loratadine, cetirizine, levocetirizine, and fexofenadine, may be more expensive. But they tend to have fewer side effects. They can be taken less often.
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Another type of antihistamine is used to treat heartburn. This type includes nizatidine, famotidine, and cimetidine. These are sometimes used along with the above antihistamines if a single medicine is not working.
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If the hives are bad and other medicines don't work well, you may be given a steroid, such as prednisone, for a short time. Follow all instructions carefully when taking this medicine. Tell your doctor about any side effects.
Follow-up care
Follow up with your doctor if your symptoms don't get better in 2 days. Ask your doctor about allergy testing if you have had a bad reaction or have had several episodes of hives. Allergy testing may help figure out what you are allergic to. You may need blood tests, a urine test, or skin tests.
When to contact your doctor
Contact your doctor right away if:
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You have a fever of 100.4°F (38°C) or higher, or as advised.
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You have redness, swelling, or pain.
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Bad-smelling fluid is coming from the rash.
Call 911
Call 911 if:
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Swelling of the face, throat, or tongue.
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Trouble breathing or swallowing.
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Dizziness, weakness, or fainting.
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Coughing that won't stop.
Online Medical Reviewer:
Amy Finke RN BSN
Online Medical Reviewer:
Marianne Fraser MSN RN
Online Medical Reviewer:
Rajadurai Samnishanth Researcher
Date Last Reviewed:
6/1/2025
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