Urticaria (hives) 

Introduction 

Urticaria, also known as hives, welts or nettle rash, is a raised, itchy rash 

Anaphylaxis

Urticaria can be one of the first symptoms of a severe allergic reaction known as anaphylaxis.

Other symptoms of anaphylaxis include:

  • swollen eyes, lips, hands and feet
  • feeling lightheaded or faint
  • narrowing of the airways, which can cause wheezing and breathing difficulties
  • abdominal pain, nausea and vomiting 
  • collapse and unconsciousness

Anaphylaxis should always be treated as a medical emergency.

Dial 999 immediately and ask for an ambulance if you or someone else is experiencing anaphylaxis. Tell the operator about your (or their) symptoms.

Urticaria  also known as hives, welts or nettle rash  is a raised, itchy rash that appears on the skin.

The rash can be on just one part of the body or be spread across large areas.

The affected area may change in appearance within 24 hours, and the rash will usually settle within a few days. If it clears completely within six weeks, it's known as acute urticaria.

Sometimes the rash can persist or come and go for more than six weeks, often over many years, although this is less common. Doctors refer to this as chronic urticaria.

Read more about the symptoms of urticaria.

Who's affected by urticaria?

Urticaria is a common condition. It's estimated that around 1 in 6 people will have it at some point in their lives.

Children are often affected by the condition, as well as women between 30 and 60 years of age, and people with a history of allergies.

Long-term urticaria is much less common, affecting around 1 in 1,000 people in England. Women are twice as likely to develop chronic urticaria as men.

What causes urticaria?

Urticaria occurs when a trigger causes high levels of histamine and other chemical messengers to be released in the skin.

These substances cause the blood vessels in the affected area of skin to open up (often resulting in redness or pinkness) and become leaky. This extra fluid in the tissues causes swelling and itchiness.

Histamine is released for a wide range of reasons, including:

However, in over half of short-term urticaria cases, no obvious cause can be found.

There's also no obvious cause in many cases of long-term urticaria. However, most experts think that it's often caused by the immune system mistakenly attacking healthy tissue.

Certain triggers may also make the symptoms worse. These include:

  • drinking alcohol or caffeine
  • emotional stress
  • warm temperature

Read more about the causes of urticaria.

Diagnosing urticaria

Your GP will usually be able to diagnose urticaria by examining the rash on your skin.

They will want to find out what triggered your symptoms so you can avoid it in future. They may ask you a number of questions including:

  • when and where it began
  • what you had to eat just before it began and details of your usual diet
  • whether you started taking any new medication just before symptoms began
  • whether you live or work in an environment where you come into contact with possible triggers, such as pets, chemicals or latex gloves

If your GP suspects that it's caused by an allergic reaction, you may be referred to an allergy clinic for an allergy test.

If you've had urticaria most days for more than six weeks, it's unlikely to be the result of an allergy, so allergy tests aren't usually recommended.

However, your GP should ask about anything that makes your symptoms worse, such as medicines, as well as your alcohol and caffeine consumption and your stress levels.

You may also be referred for a number of tests, including a full blood count (FBC) and other tests, to find out whether there's an underlying cause of your symptoms.

Read more about diagnosing urticaria.

Treating urticaria

In many cases, treatment isn't needed for urticaria because the rash often gets better within a few days.

If the itchiness is causing you discomfort, a medication called antihistamine can help. Antihistamines are available over the counter at pharmacies. Speak to your pharmacist for advice.

A short course of steroid tablets (oral corticosteroids) may occasionally be needed for more severe cases of urticaria.

If you have persistent urticaria, you may be referred to a skin specialist (dermatologist). Treatment usually involves medication to relieve the symptoms, while identifying and avoiding potential triggers.

Read about treating urticaria.

Complications of urticaria

Around a quarter of people with acute urticaria and half of people with chronic urticaria will also develop swelling in a deeper layer of skin.

This is known as angioedema and it can cause severe swelling in different parts of the body, such as the eyes, lips and genitals.

Medication such as antihistamines and short courses of oral corticosteroids (tablets) can be used to relieve the swelling.

Steroid injections may be needed for more severe cases of angioedema. They're usually given in hospitals or specialist clinics by an allergy or immune system specialist.

Read about the complications of urticaria.




Page last reviewed: 21/03/2014

Next review due: 21/03/2016

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Comments

The 26 comments posted are personal views. Any information they give has not been checked and may not be accurate.

QueenieLady said on 24 August 2014

I have just has a major allergic reaction to a cream I put on my face, my whole forehead is covered with thousands of hives and is bright red and itches like hell on earth!!!

I went to my Doc who told me to take Piriton, which I am 6 times a day and also gave me Clobavate ointment.

2 days later and my forehead is no better, and all around my eyes are now swelling up and thus closing up, each day the swelling around my eyes gets worse and I am starting to get frightened.

I have put ice packs on my forehead that relieves the itching, burning and swelling but as soon as I take the ice pack off that all comes back again.

I have been taking Piriton for 4.5 days now (6 per day) with the steroid cream but nothing has improved and eyes are getting worse by the day.

This has stopped me from leaving the house so am now house bound until I get this sorted :(

I have another appointment with the Doc on Tuesday but am so worried about my eyes so I'm going to phone 111 at least to get some advice.

Will write back if I get it sorted and what was used.

Good luck everyone else as I literally feel you pain x

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conjam said on 14 August 2014

I'm mid forties with no heath issues I'm aware of other than slight asthma.
21 days ago I had to move a heavy load from A to B which was physically challenging espeacially on my palms and wrists. A day or so later I developed large blotches on my palms and wrists which were extremely sore.
I put this down to bruising from the heavy lifting but the blotches then turned unbearably itchy.
I therefore went to my G.P who said I'd had an allergic to something and prescribed antihistamines and cream for my hands.
Then the blotches spread to my fingers, feet, head and now to my face.
The blotches are extremely itchy and are raised espeacilly on my head and face.
I went back to my G.P who prescribed alternative antihistamines and cream.
The meds have provided no comfort at all and I beleive my condition is getting worse.
I've never been ill all my child/adult life and not knowingly been allergic to anything.
I again went back to my G.P and now I'm current taking the 3rd type of antihistamines (Fexofenadine Hydrchloride 180 mg tablets) and cream (Betnovate RD cream). I'm not sure how this thing I've got is going to pan out or what other remerdies are out there other than the prescribed meds, cool baths and cotton gloves....if anyone has other ideas of how to help overcome this problem please let me know

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SunflowaShaz said on 08 August 2014

I was on another site reading product reviews & many people mentioned that they suffered with Urticaria (so I Googled the condition as I had not heard of it before)

Their reviews say that they use the product for helping to relieve the itchiness. The product they were reviewing is called "Magicool Plus Itchy Skin Spray"

I don't work for this company and I personally don't suffer from this condition but I have used the original spray, to cool down in hot weather.

Just thought I'd mention it is it could be worth a try to help with the itching.

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sjthomson said on 17 June 2014

Hey All :)

My suffering started about a month and a half ago where i woke up one morning screaming in pain while going to the loo cause my hands where sore and swollen left it at that people and family thought it would be arthuritis ( rubbish at spelling sorry ) then went out to friends one day ate some paprika pringles my bottom lip started to swell to the point it was blue then i went to the doctors they said it was a allergic reaction then the next few day i was on antihistamines then thats when one morning at bang on 6am i woke to use the loo again lol and noticed my rash felt like i had rolled in nettles and so i phoned work cause had to attend the doctors about this he gave me yet another lot of antihistamines steriods and antibiotics it went for 2 weeks then came back then went to docs for the same answer and got same tablets then went and rash been back just ever so slightly not to notice but then now as im writing this im covered hands bad feet bad went to hospital saturday see if they would do test but just gave me storger tablets called fexofenadine 120mg and a swear i want to say they working but looking like docs later as i cant sleep for itching anyone else know of anything i can do help thanks all

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spam2002 said on 16 June 2014

I have had hives since 2006

I get chronic hives and chronic swelling from:
being run down, stress, exercise, drinking (no longer drink) and applying to much pressure to any part of my body.

This has made me miserable, I have tried every anti-histamine with no success, steroids works until I come off them then it is usually worse than before. The only thing that worked was cyclosporine but it is a very toxic drug so I could not be on this long term. The specialists I have seen are now at the stage where they don't know what to do. This is a cry for help, does anyone have any suggestions that I could bring to the table. Please!

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Pussycatlover3 said on 14 May 2014

I was interested in the comments below regarding gut bacteria.

I took repeat and large doses of antibiotics around 12 years ago for a chest infection and was attending the local hospital. I developed dizziness and urticaria both of which were very bad. I also had bowel problems and rectal bleeding and itching. I took a probiotic, Replete by Biocare, which relieved the bowel problems, rectal itching and bleeding on the first day. It was a six month dose taken over seven days. (I had previously had vaginal thrush for 14 years and used their probiotic vaginal pessaries.) Strangely, from then the dizziness and urticaria started to go and after a couple of months cleared up.

I have taken this product annually and after using antibiotics, after having a repeat of all these symptoms.

This last time, it has not worked so well. I had two antibiotics last year for a sinus infection (from which the chest infection originated). The cause of the symptoms is quite clearly thrush, which is normally kept under control by gut bacteria but this was killed off by the antibiotics and restored by the probiotics. I contacted Biocare who suggested another product which contains several oils (notably Oregano oil) and is in a dual capsule also containing probiotics. It seems to be working - after a week, I had no dizziness today and no urticaria. I fell over twice last week after serious disorientation while crossing the road. Hope this helps somebody.

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tried and tested said on 21 February 2014

I had urticaria for 6 year, often as bad as the picture on this page. I was treated and diagnosed by doctors and specialists on numerous occasions, but nothing they prescribed helped. It was only through my own determination to find a cure that I came upon several articles which lead to an almost hundred percent cure. First and foremost I insisted on being tested for " pylori" which came back positive. Within 4 days of treatment for this gut bacteria my urticaria vanished! I could actually feel the change in my whole body. During my own period of "trial and error" I found that I was highly allergic to aspirin and related products. Since being rid of urticaria I have tried taking a small dose of aspirin and I had an outbreak of urticaria, which luckily disappeared within 24hrs. Apart from small lumps behind my ears when using certain shampoos, I have been urticaria free for almost three year. Hope this helps.

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big dog said on 10 August 2013

I have suffered from itchy arms for about 12 years, it ussually occurs in the early hours of the morning and I realised a few years ago it could be linked to eating continental cheeses, the ones with the whihite coating on like brie. I think this coating is actually a type of mould and it present what they call aged cheeses. But it wasnt an alergic reaction, these occur almost immediatly after eating or taking something, my reaction happenend 4 or 5 hours later. A few days ago, I had another episode, but this time I had'nt eaten any cheese, after some research, I came accross an article on a condition called "diamine oxidase deficiency" what happens is the histamine in the food ( and the moulds on any cheeses or aged foods apparently contain lots of histamine) is released into the bloodstream, and because of the deficiency, it isn't metabolised quickly enough, when the histamine reaches a critical level, thats when the hives break out. I am going to try an anti-hitamine diet and see if that works.

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Bell2411 said on 05 March 2013

I have noticed my hive outbreaks are related to high stress levels, i had a traumatic experience at work recently and within an hour I was covered in hives from head to foot - this will be the second time I have experienced hives! The first time was after a car crash - again high stress levels! I find a cool bath or shower, plenty water and an anti-histamine helps to relax the itching untill its run its course! Chin up people :]

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hatty1 said on 24 January 2013

I was recently diagnosed with physical urticaria, triggered by various things including sudden changes of temperature. The urticaria also flares up my eczema which then needs steroid cream to calm it down. The allergy doctor I saw recommended an antihistamine everyday which does help, but she also said to avoid food containing vasoactive amines (easy to find a list online) These foods either have histamine in them or help to trigger the release of histamine in the body, so avoiding them helps to avoid symptoms.

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neoni said on 24 January 2013

Here i am again! ;(

Yesterday after an antihistamine and a good night's sleep my hives ...gone.
This evening- back again ;( ;( ;( worst than yesterday, it even affected my voice box (probably a fight between some flue virus and my immune system).
Another antihistamine washed down with water+ anti itch cream; after about 4 hours still no effect, still itchy as hell.

Going to the doctors.... enough self medication (either i am too impatient or i don't know what i am doing, but it is unbearable.... even between lines....got'a scratch :S )

My fellow sufferers i bid you get well!!

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neoni said on 23 January 2013

This is the second time in my live hives infested my body.
First time round was about 10-13 years ago and after a fright that lasted a couple of days went away same as it appeared. Although it itched it was manageable.

Now, today in a mater of a few minutes burning itchy feeling spread from the inguinal area to the back of the upper legs and spread over my whole body. I barely can keep from scratching.

After consulting numerous resources available on the internet I have come to conclusion that my hives were triggered by the very stressful day i had, hot bath employed to melt the stress away and spicy tai subsistence. Once again proven that road to hell is paved with good intentions.

The only purpose of my post is to share my itchy experience.

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sarz1986 said on 19 January 2013

I was prescribed with menthol cream to ease the itching etc for the urticaria virus that I was diagnosed with and was told to continue taking my piriton, The cream made things so much more worse, I ended up having an allergic reaction, my entire skin from top to toe went bright red and made my skin burn like mad, it gave me the shakes and everything. I was then put on steroids and stronger antihistimines as the piriton was doing nothing. I can only take these once a day, in the morning with breakfast, the steroids do not help treat the urticaria virus and only supresses this as when it comes to bed time, the entire rash returns with a vengence and I have sleepless nights due to this. I have to wait until I can take my medication as early as possible the following day as when I do take the medication it does remove all sight of the virus until they then wear off in the evening again. I really don't know what to do to help ease this, I started using diprobase as I know I dont have an allergy to this cream but it doesnt really do much, Does anybody reccomend anything? Should I go back to the doctor? will they even be able to do anything else for me? how long is this expected to last?

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skinrash said on 09 October 2012

I have been getting red itchy patches around my fingers,thumb on my right eyebrow, around my mouth. I cannot wear my wedding rings, I feel i get relief running my hands under warm water. this has been happening off and on for the last 2 years and drives me mad when it appears, I have been back and for the drs and they have no answers. All summer we have been eating white meat and fish, until last weekend I cooked a beef roast, within 2 hours I had itchy inner ears my throat was itchy, during the night I was awake with itchy fingers, this has taken five days for the redness and itchyness to settle down, I have visited my GP and she is writing to the hospital to see the allergist, she had never heard of anything like this before. Yesterday I made a lamb and vegetable stew with red split lentils, (I only eat the vegetable no meat,as an experiment) but I have had a worse reaction to the lamb than to the beef, so im guessing its the red meat I am allergic to, I have taken benadryl to ease the itchyness. I am keeping a diary of what i eat. I do not want to become reliant on antihistamines. I can sympathise with everyone who maybe suffering in the same way.

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giv said on 01 October 2012

I had Hives 2 weeks ago for no obvious reason. They seemed to be worse in the morning and then improve in the day only to come back with a vengeance in the evening where I would be covered in them from the waist down mostly. Went to the docs after 3 days and he recommended Cetrizine Hydrochloride which was very cheap to buy. I took 1 tablet and the next day I had the odd hive but after that they never came back.

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gingerwhinger said on 13 April 2012

Look up on You Tube a documentary about Asparteme it can cause Urticaria i should know Ive had it for 9 years. the specialist has perscribed 4 x the normal dose of Telfast in conjunction with Ranitidine 150mg which is usually taken for indigestion. normally works but i drank diet Pepsi on the week end and I'm paying for it now, i normally avoid asparteme like the plague, now you know why

Pob luc

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CoralHuby said on 01 March 2012

I have Addison's Disease and recently found out I have Chronic Idiosyncratic Urticaria (so now I'm living with 2 autoimmune conditions) and have no idea about any of this. I had several nasty infections down below which couldn't be traced to anything like thrush, etc. and was under constant attack of lesions everywhere on my body - and itchy is an understatement. I also developed exercise induced asthma and my hayfever got worse, all yr round.
My GP has been most unhelpful, I went to see a specialist at the hospital and waited a long time for a 'results' letter. In this letter it told me I had this and to trial different medication but nothing really in the way of support. I had taken the step myself whilst waiting frustrated and extremely uncomfortable to see a dietician who told me I was intolerent to pretty much everything! But, cutting out all the stuff I was eating before that wasn't agreeing with me, and with some new tablets (thanks to a second opinion from a different fantastic GP) seems to have done wonders (touch wood) I'm only 1 week in, so don't want to get ahead of myself but so far so good. I'm slowly going to introduce some foods back in to see if, with these tablets, my body can cope with them. On tablet is for the asthma and the other are very strong antihistamine. I also take steroids long-term for the Addisons so I'm currently rattling when I walk! I don't yet know if you have to take this tablets all the time, or for a certain period, and no one seems to hold anymore idea than I do, and I'm no doctor. I'm only 21 and was a little glum at the thought of this being the 2nd autoimmune condition of what seems like many you are prone to once you have one, but my message would be to people who think they may have this look at what you eat and don't let your doctor brush you off!!! You know your body better than anyone.

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alpha_beta_man said on 15 February 2012

I'm just having my second ever attack of hives - and it starts when I walk the dogs - but I've walked the dogs for many years without problem. It starts with a really itchy scalp - and then what look like insect bites appear on my body and face - just screaming to be scratched ! Absolutely no idea what is causing it - really weird. The last one went away in about 4 hours after a piriton tablet.

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tim1234 said on 14 January 2012

I have had several bouts of really bad chronic hives, the worst attack lasted for 6 months. The consultant told me it was an autoimmune problem caused by histamine released from my own antibodies to some threat. He suggested it was caused initially by a virus or maybe an injection. Since I had had several repeated dental injections recently I thought it was that. Since then I have been extremely careful to avoid all but the most essential injections, and to make sure I have no repeat injections within 6 months.
I have not had hives for 10 years now.

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neil6306 said on 25 November 2011

Absolutely gutted! Havent had my Urticaria since the late 80`s and now it has returned with a vengence. I`m a keen cyclist and although it does not stop me riding i cant do half as many miles as within an hour of stopping i blow up like a stuffed tomatoe. Got some useless anti-histamines which help a little with the itching but not a cure will have to go back to the Docs for some steriods if only for a few days relief! Sympathy to all you sufferers.

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la818 said on 04 November 2011

Chrissy, that is exactly what I have too. For the past 5 years, this has happened every day for about 6 months per year. Before this, there were other random spells of this, but it wasn't as frequent, only lasting a few months and not reoccurring every year. If I take antihistamines every day, most of the time it calms down, and eventually disappears, so after a while I stop. But then it starts again about a year later. Every day I will get the rash, and about 2 or 3 times a week my lip or eye will swell up too. I get the rash absolutely everywhere. It's totally unpredictable, I've had blood tests and kept diaries, and there's never a pattern. It is very frustrating and hard to live with, it sounds melodramatic, but to an extent it is ruining my life.

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Chrissy miss said on 02 August 2011

I am so thankful that you have all commented on this. When you have it you feel like the only person in the world that does. My rashes come up everyday, it has been controlled and even gone with medication (alot of it!) and cutting down the medication to nothing. Unfortunately it has returned and is controlled by medication but somethimes this will not work. I get it all on my legs, hips, tummy, back, shoulders, arms and face. On my face I get swollen lips and eyes. All my blood tests come back with nothing wrong. It is so frushtrating and makes me very upset. I have been suffering with this for nearly a year. I am going to see the doctor again today. If you get this the aqueous cream with menthol in really helps the itching, I have yet to try any holistic medicines as im not sure who to trust with this. Please let me know if anyone finds anything that helps make it better. Thank you.

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rochie1 said on 24 April 2011

I was diagnosed with acute urticaria about 6 year ago after I had a mole removed which became infected. I had a course of antibiotics and then it started.
I cannot get through the day without anti histamins. It has kept it at bay but for the last year Ia m experiencing extreme tierdness and the tablets are lasting for less hours. I have also found they make me hungry. If I take them through the day I am ravenous within about 2 hours, so I try to take before bed. The tierdness is terrible and I feel I should probably be visiting my doctor again.

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BRIGIGEE said on 13 February 2011

I started to get these weals in the beginning of the new year and after several visits to my doctor and various tests i was told that it was a Urticaria rash and at the time was unexplained. After thinking more i had suspected swine flu over Christmas and having done a little research found that this could have triggered the rash. Its now the middle of Feb and still suffer every day. The weals are on my head and body which is unbearable but find that loose clothing and bathing in... believe it or not.. oats. Put some oats on some tights / stocking, tie a knot and run a bath. This will soothe the itching espeacially before bed. It looks like this is chronic but hope it will go soon. If anyone has this i do sympathise but good luck.

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Tomargan said on 01 May 2010

i have attacks of urticaria, and take 2 antihistamine tablets a day to keep it at bay, less than that and i inflame within days, an attack can last for a number of weeks before dying down. i find calamine lotion in a daily bath of great benifit.. my answer seems to be to stay on the two antishistamine tablets daily.
m. edwards.

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Zoomph said on 13 December 2009

I have (according to this article) a type of chronic urticaria - I had an allergic reaction to a painkiller and didn't realise until a year later. I was able to play noughts and crosses on my arms because of the skin inflaming.
It's been three years, and the affects have subsided slightly, but if I forget one or two tablets then my skin starts to become more reactive (more itchiness, marks showing up more).
I recommend if your skin shows any of the systems you go to a doctor, because it becomes hard to sleep due to how itchy your skin becomes.

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