An overview of urticaria

Hives, also known as urticaria, are itchy, raised welts that are found on the skin. They are usually red, pink, or flesh-coloured, and sometimes they sting or hurt. In most cases, hives are caused by an allergic reaction to a medication or food or a reaction to an irritant in the environment. 1

They can appear anywhere on the body, including the face, lips, tongue, throat, or ears. Hives vary in size (from a pencil eraser to a dinner plate), and may join together to form larger areas known as plaques. They can last for hours, or up to one day before fading. 2

In some people hives are caused by physical triggers, including cold (such as cold air, water or ice), heat, sunlight, vibration, rubbing or scratching of the skin and delayed pressure, such as after carrying heavy bags. 3

Most hives are acute and self-limited, resolving on their own within 24 to 48 hours. Others may take days or weeks before they fully resolve. During this time, it is not uncommon for the hives to disappear and reappear. Urticaria may sometimes be accompanied by a deep-seated swelling of tissue known as angioedema, most commonly affecting the face, lips, tongue, throat, or eyelids. 4

Doctors usually classify hives into 3 categories 5

  1. Acute urticaria is a case of hives that lasts less than 6 weeks. The most common causes are foods, medications, latex, or infections, but insect bites and internal disease can be responsible too. The most common foods that trigger hives are nuts, fish, tomatoes, and fresh berries. Medications that can cause hives include aspirin, other nonsteroidal anti-inflammatory medications such as ibuprofen, high-blood-pressure medications (ACE inhibitors), and painkillers such as codeine.
  2. Chronic urticaria lasts more than 6 weeks. The cause of this type of reaction tends to be much more difficult to identify than the cause of the acute kind. For this reason, it is often not found. In fact, the cause of chronic urticaria remains unknown in more than 80% of cases.
  3. Physical urticaria is a case of hives caused by direct physical stimulation of the skin from exposure to cold, heat, sun, vibration, pressure, sweating, exercise, and other sources. These hives usually occur at the site of the stimulation and rarely appear elsewhere. Most of outbreaks in this class appear within 1 hour after exposure.

In many cases, mild hives won’t need treatment and will go away on their own. 6

There are other home remedies that can be adopted to help manage hives such as: 7

  • A cold compress. A person can apply a cool, damp cloth to the affected area. This can provide relief from itchiness and help reduce inflammation. A cold compress can be used as often as necessary.
  • Bathing in an anti-itch solution. Oatmeal and baking soda baths can soothe skin and reduce irritation. Adding witch hazel to a bath is another effective home remedy.
  • Applying aloe vera. The healing properties of aloe vera may soothe and reduce hives. It is advisable, however, to do a skin test before applying aloe vera to the entire area that is affected.
  • Avoiding irritants. This includes perfumes, fragranced soaps or moisturisers, and staying out of the sun. A person should also stay cool and wear loose, comfortable clothing.

Speak to your healthcare professional if they are suitable for you or for more information.

If the hives feel itchy, your doctor may recommend an antihistamine medicine to block the release of histamine in the bloodstream and prevent breakouts.6

For chronic hives, your doctor may suggest a non-sedating (non-drowsy) prescription or over-the-counter antihistamine to be taken every day. Not everyone responds to the same medicines, though, so it’s important to work with the doctor to find the right one for you.6

If a non-drowsy antihistamine doesn’t work, your doctor may suggest a stronger antihistamine, another medicine, or a combination of medicines. In rare cases, a doctor may prescribe a steroid pill or liquid to treat chronic hives.6

If your symptoms are recurrent and unexplained, ask your doctor for a referral to either  dermatologist, who can run tests to identify possible triggers, or an allergist, who can check whether an allergen (allergic trigger) is to blame.

Go to for more information about allergies and how to treat them.

DISCLAIMER: This editorial has been commissioned and brought to you by iNova Pharmaceuticals. Content in this editorial is for general information only and is not intended to provide medical or other professional advice. For more information on your medical condition and treatment options, speak to your healthcare professional.

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  1. Healthline Hives. [online] March 2019 [cited November 2022]; Available from URL:
  2. Hives and Your Skin. [online] March 2022 [cited November 2022]; Available from URL:
  3. Australasian Society of Clinical Immunology and Allergy. Hives (Urticaria). [online] March 2021 [cited November 2022]; Available from URL:
  4. An Overview of Urticaria (Hives). [online] June 2022 [cited November 2022]; Available from URL:
  5. Cleveland Clinic. Urticaria (Hives) and Angioedema. [online] November 2022 [cited November 2022]; Available from URL:
  6. Hives (Urticaria). [online] February 2021 [cited November 2022]; Available from URL:
  7. Medical News Today. How to treat hives. [online] November 2021 [cited November 2022]; Available from URL: