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Hives, Urticaria and Angioedema

Urticaria, or more commonly known as hives, appear on the skin as red, itchy lesions, that occur for a variety of reasons. These appear because the skin becomes leaky, as a result of small blood vessels causing redness from a wheal and flare reaction. Hives usually appear within 24 hours, however, new ones may appear over the older ones.

A minor reaction, hives vary widely in size and shape. They can occur anywhere on the body and are typically itchy, but will not cause any change to the skin when they clear.


Angioedema, a significant swelling, can also occur. Even though this reaction is comparable to urticaria, angioedema happens at a deeper level within the skin and does appear red. This swelling is not itchy and is not painful. It can appear anywhere on the body but commonly occurs on the face.

Acute and Chronic

Like other allergic reactions, hives can be classified as both acute or chronic, depending on the duration of the reaction. Acute is present for less than six weeks, where certain foods, medications, and infections are the most common causes. Chronic can last more than six weeks, but the causes are more difficult to detect compared to acute. Thyroid problems, infections, and cancers may be some of the root causes.

Treatment for Hives

The most common treatment for hives is antihistamines.

Other treatments include:

  • Benadryl- drowsiness can occur as this medication is normally taken before bedtime.
  • Allegra- less likely to cause drowsiness, and are available over-the-counter.
  • Vistaril- another over-the-counter use, but causes drowsiness.
  • Zyrtec- a less sedated option.

When should I visit a Doctor?

Most cases only occur for a short time, but if it becomes difficult to sleep, you should schedule a consultation with an allergy expert like Dr. Lighvani.

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