Hives – Causes and Risk Factors

Hives (or urticaria) is a common dermatological clinical manifestation. Although it starts with a red, patchy and itchy area of skin, it develops into a raised mounted area with well-defined borders. Hives can be caused by a variety of causes. The most found clinical forms of hives are caused due to allergies (to a food item or a drug). Non-allergic forms of hives are also frequently found. Symptoms related to hives may last for several years in the dormant form. Hence, clinical manifestation of hives can occur after a long period of time. The main drugs of choice are typical anti-histamines. Although corticosteroids and anti-depressants are also prescribed in addition to these.

Symptoms of Hives

Urticaria (or hives) are caused by the leakage of plasma fluid by the dermal capillaries beneath the first layer of tissue of the outer skin. This leakage is caused by the inflammatory reaction caused in the capillaries. Due to this, accumulation of the plasma occurs in a designated area of uplifted skin. This continues till the plasma fluid starts to get reabsorbed from the surrounding cells.

What are the signs which showcase a case of Hives?

1. The area in which the fluid has been accumulated appears to be raised. This raised bump is demarcated with a clear cut boundary.

2. The rash developed due to hives is usually itchy. This itchy sensation is coupled with a burning sensation and a hypersensitive reaction to pain.

3. On pressing the rash, the rash would decolorize from red to white. This is known as the blanching of the rash.

4. Usually, the entire body is affected by hives. The shape of the elevated area can change forms over time.

5. If resolved, the rash returns to normal.

6. No secondary clinical manifestations like fever, joint pain and nausea are associated with hives.

Also Read: Home Remedies to Treat Hives

What are the different types of Hives?

The main two types of hives include :

  • Acute hives
  • Chronic hives

The acute condition of hives lasts for a period of about 6 weeks while the chronic condition of hives has a manifestation of more than 6 weeks.

1. Acute Hives

Acute hives are usually manifested in young children and teenagers. The cause of acute hives is usually not known. The lesions/rash formed as a result of hives are resolved within a few hours. The condition is self-healing in almost all cases. The most probable cause of acute hives is insect bites or food allergy.

2. Chronic Hives

This condition usually requires medical treatment. The treatment involves an arduous period of more than 1 year in almost 75% of patients having hives.

Around 25% of patients have a chronic effect for almost up to 5 years.

Other forms of hives include:

1. Cholinergic hives.

This usually caused due to excessive perspiration. Small bumps with bright red flares are observed in this condition. Working out for long periods of time is a causative trigger.

2. Cold urticaria.

In contrast to cholinergic hives, cold hives are usually caused by a trigger of cold temperatures. The bumps are slightly cream coloured. Extreme cases of cold hives are manifested by classical fainting.


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Janet Fudge

Janet Fudge writes on general health topics for She holds a post-graduate diploma in Public Health with a major in epidemiology. During the outbreak of COVID-19, Janet actively volunteered in vaccination drives throughout the state of Iowa. She lives in Iowa with her husband and two children.