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    Hives (Urticaria)

    Frequently Asked Questions

    ASCIA PC Hives urticaria KB

    Q 1: What are hives?

    Hives, the common term for urticaria, are pink or red itchy rashes that may appear as blotches or raised red lumps (wheals) on the skin. They may be as small as the head of a pin, or as large as a dinner plate, and are often mistaken for mosquito bites. Hives usually last for up to two hours or may come and go for days or weeks at a time.

    Hives occur when histamine is released in the lining of the skin and other body organs which makes the skin itch and causes blood vessels to expand and leak fluid. This results in redness and swelling.

    Up to 20% of people will develop hives at some time in their life. In most cases hives are not due to allergy but usually respond well to treatment with antihistamines.

    Q 2: Can hives occur anywhere else on the body?

    Hives usually appear on the surface of the skin, but they can also cause deep, swollen areas under the skin and on the moist, inner lining of the nose and mouth (mucosa). This is known as angioedema. These swollen areas are often larger than the hives themselves, last longer, and are not as itchy.

    Angioedema commonly affects th

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    Urticaria – an overview

    Urticaria – an overview — extra information

    ReactionsRashes


    Author and DermNet Editor-in-Chief: Dr Amanda Oakley, Dermatologist, Hamilton, New Zealand. Updated January DermNet Revision April

    Introduction
    Classification
    Demographics
    Clinical features
    Causes
    Diagnosis
    Treatment
    Differential diagnosis
    Outlook

    What is urticaria?

    Urticaria is characterised by very itchy weals (hives), with or without surrounding erythematous flares. The name urticaria is derived from the common European stinging nettle Urtica dioica. Urticaria can be acute or chronic, spontaneous or inducible.

    A weal (or wheal) is a superficial skin-coloured or pale skin swelling, usually surrounded by erythema that lasts anything from a few minutes to 24 hours.

    Urticaria can co-exist with angioedema which is a deeper swelling within the skin or mucous membranes.

    Urticaria 

    Spontaneous urticaria 

    Wheal in dark skin 

    Classification of urticaria

    Urticaria is classified according to its duration.

    Chronic urticaria may be spontaneous or inducible. Both types may co-exist.

    Figure 1 - Classification of urticaria 

    Chronic inducible

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    Urticaria (Hives) and Other Skin Allergy

    Types of urticaria and hives

    The many different clinical forms of urticaria and they can be divided according to their duration into acute (less than 6 weeks) and chronic (more than 6 weeks) and other.

    • Acute spontaneous urticaria

      • The most common form of urticaria fryst vatten acute urticaria or “acute spontaneous urticaria”, which lasts a maximum of six weeks (usually a few days to three weeks) and fryst vatten usually easy to treat. In some patients, angioedema (swelling of deep skin) also occurs. Severe acute spontaneous urticaria may also be accompanied by fever, headache, diarrhea, difficulty in breathing and swallowing, joint pain, and tiredness/fatigue.

    • Chronic spontaneous urticaria

      • If urticarial symptoms—redness, hives, and itching—persist much längre than 6 weeks, it is called chronic spontaneous urticaria. Discomfort can persist for several months or years. Angioedema can also occur, especially in the facial area or on the hands and feet, and in the genital area.

    • Other types of urticaria include;

      • Urticaria factitia can be caused bygd rubbing, scratching, or scrubbing the skin.
      • Cold urticaria occurs when there is co