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Here’s How to Break the Itchy Cycle of Hives

If you or your child has ever battled hives, you know they can be frustrating. Hives, also called urticaria, usually start with itching. It’s hard to resist scratching that itch, and when you do, your skin develops raised welts that look a lot like mosquito bites. If you have light skin, a red area will probably surround the welt. On darker skin, the welts might be slightly lighter or darker than your skin, or you might not notice a color change. The more you keep scratching, the more hives you develop.

William Culver, MD, an adult and pediatric allergist and immunologist at Banner Health Clinic in Loveland, CO, said, “Hives are relatively common. Up to 20 percent of people develop them at some point in their lives.”

A lot of people get acute hives—these can last for only a few hours or days before clearing up, though they might reappear again later. Some people have chronic hives (chronic urticaria), which develop two or three times a week for more than six weeks.

Most of the time, hives are only a problem that affects your skin. But rarely, they can cause sneezing, runny nose, watery eyes, wheezing, coughing, trouble breathing, gastrointestinal symptoms, low blood pressure and shock, which can be life threatening.

Here’s what could be causing your hives

There are a lot of different things that could trigger an outbreak of hives. You might develop hives within minutes, hours or days of being exposed to:

  • Insect bites
  • Antibiotics and some other medications
  • Vitamin and mineral supplements
  • Herbal remedies
  • Contact with an animal
  • Certain foods
  • Infections including colds, strep throat and mononucleosis
  • Exposure to cold or heat such as hot showers
  • Stress

“Hives are often called ‘allergic,’ but quite often, allergy does not play a role,” Dr. Culver said.

But a lot of times, when you develop hives, you can’t pinpoint what caused them. And despite what you may have heard, it’s rare to develop hives from contact with detergent, lotion or fabric. This can happen occasionally, but it’s usually easy to identify since the hives disappear when you stop using the product. If you’re prone to hives, introduce new products slowly to watch for a reaction.

“It’s important to try to identify what’s causing your hives, but it’s not always possible. Unfortunately, it’s frustrating when you don’t know what’s triggering your hives,” Dr. Culver said. If hives become chronic and you haven’t identified the trigger, it’s unlikely that you’ll figure out what’s causing them, and controlling them is your best option.

Here’s how you can treat your hives

Antihistamines are the best choice for treating hives. Talk to your doctor about the correct dose of antihistamine to prevent hives and  help get them under control. “Often, doses of antihistamines are too low,” Dr. Culver said. “Current guidelines suggest you might need up to four times the normal dose of antihistamines to control your symptoms.” If you don’t get relief with antihistamines, your doctor might prescribe a steroid. If antihistamines and steroids don’t get your hives under control, you can talk to your doctor about other treatment options.

When you know what causes your hives, you can try to avoid that trigger. If you can’t figure out what’s causing them, taking antihistamines regularly can prevent them or keep them from becoming so severe.

You can also take steps to minimize hives when outbreaks occur:

  • Avoid scratching so you don’t make hives worse. Sometimes, when hives are flaring, just stroking the skin can cause them to erupt.
  • Wear loose-fitting clothing since places where belts, straps or fabric touch the skin can be prone to hives during an outbreak.
  • Avoid aspirin and non-steroidal anti-inflammatory drugs such as Advil and Motrin, which could make hives worse.

Here’s when you should see a health care provider for your hives

If antihistamines aren’t getting your hives under control, if hives are recurring or interfering with your lifestyle, you should see a medical provider. If wheezing, shortness of breath, chest tightness or any symptoms beyond itching occur, you should seek immediate medical attention r go to the emergency room.

The bottom line

Hives can be itchy and annoying, but identifying what’s causing them can help keep them from erupting. If you can’t pinpoint what’s triggering your hives, medication can keep them at bay or keep them from being severe. If you or your child are struggling with hives, reach out to a Banner Health provider for help getting them under control.

These articles can help you learn more about common skin conditions:

Dermatology Allergy and Immunology Food Allergies