Urticaria– causes & treatment of “hives”

Urticaria– causes & treatment of “hives”

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Urticaria- what causes hives and how is it treated?

what is urticaria?

What is Urticaria?

  • Urticaria (commonly known as “hives”) is a common itchy rash- around 20% of people get it at some point in life.
  • It usually leads to raised pink itchy skin lesions, which can look a bit like mozzie bites.
  • These spots can vary in size, from quite small to much larger “welts”- and they can fluctuate quickly- appearing, disappearing and reappearing over minutes hours or days.
  • Urticaria is NOT a crusty or blistering rash, and it should always go pale (blanche) when pressure is applied to the lesions.
  • An antihistamine may relieve the symptoms.
  • If it goes on for more than 6 weeks, it’s considered to be Chronic Urticaria.


a child with hives, also known as urticaria

What causes Urticaria?

Urticaria (hives) happen when a substance called histamine is released from cells in your skin, leading to swelling and irritation. It’s not known exactly why this happens, but the following may be triggers for urticaria:

  • Viral illness- this is a very common trigger in children
  • Certain foods
  • A side effect of a medicine
  • Insect stings or bites
  • Exposure to certain plants or animals
  • Less commonly it can be caused by physical triggers like cold weather, sunlight, rubbing or pressure on the skin, exercise,

What conditions can be treated by our online doctors?

Occasionally, urticaria is part of a more serious allergic reaction – this possibility should be considered if any of the following occur:

  • It’s always within 2 hours of a meal
  • Tightness of breathing
  • Nausea, vomiting and/or tummy pain
  • Light-headedness
  • Swelling of the throat and/or tongue

If there is breathing difficulty, tongue and mouth swelling, or abdominal pains with the rash it could mean it’s Anaphylaxis, which is a life-threatening allergic reaction- immediate medical attention should be sought.

What is the treatment for urticaria?

  • If you know the trigger, avoid it.
  • Antihistamines may ease the rash and the itch- these are available over the counter from your pharmacist.
  • Avoid anything that makes the rash more prominent – like stress, alcohol, getting too hot or hot spicy food.
  • It seems anti-inflammatories (NSAIDs such as Ibuprofen (Nurofen) and Diclofenac (Voltaren) and Aspirin can make urticaria worse in some people- so these should be avoided. Paracetamol (Panadol) is still OK.
  • Sometimes oral steroid medication (cortisone) is prescribed- but it’s often not very helpful, and there are many possible side effects of this treatment.
  • People who have chronic urticaria may need to see an allergy specialist or dermatologist for further advice- sometimes they may try medications which act on the immune system.
A close up picture of a person who as hives, also known as urticaria. But what causes urticaria?
what conditions can our doctors treat online?

Are there any tests for urticaria?

  • Tests are not usually needed- as they usually don’t offer any helpful information.
  • However, if urticaria goes on for more than 6 weeks, or if a person has other unexplained symptoms apart from the rash (eg fevers, pain or feeling generally unwell), blood tests may be advised.
  • If there are symptoms suggestive of Anaphylaxis, further allergy testing will usually be recommended.

If you have any questions or concerns about urticaria, speak to your doctor.

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About the Author:

Aifric Boylan
Dr Aifric Boylan is an experienced GP based in Melbourne. She completed medical school at Trinity College Dublin, Ireland, and undertook specialist training as a General Practitioner. She has 10 years experience working in General Practice and currently works as a full time family doctor in Melbourne, with a special interest in women’s health and paediatrics. She is a medical writer, covering common health issues in General Practice, as well as publications and opinion pieces in the medical press.

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