Hives Treatment Specialist Q&A

Hives, also known as urticaria, are welts or bumps that appear on the skin. They can be pale, pink, or red, are slightly raised, and very itchy. They often appear suddenly and can move from one place to another and grow or shrink quickly. They usually only last from six to twelve hours, but some can last much longer. Hives sometimes appear whitish at the center, and if there are many in the same place, they appear to grow together.

There are two different categories of hives:

1. Acute urticaria or ordinary hives – these are more common, and come and go more quickly. These are frequently caused by allergic reactions or exposure to irritants.

2. Chronic idiopathic urticaria – these last for six to eight weeks or longer and often require medical treatment. These can also be a result of allergies, but also sometimes are caused by heat, cold, sunlight, pressure, or exercise. Some people get hives from having their skin scratched or clothing rubbing against their skin.

Hives can appear when white blood cells of the immune system release histamine, which is a chemical that defends against unfamiliar substances that could be harmful. Histamine is useful to fight harmful pathogens like viruses, bacteria, and toxins, by causing the heart rate to increase, blood vessels to dilate, muscles to contract, and making blood vessels more permeable, meaning other cells and substances can pass into them. One effect histamine causes is for fluid to leak out of blood vessels and pool, causing swelling of the skin, which is the hive.

The cause of most hives is an allergy, which means the immune system recognizes a particular allergen as a threat (even if it isn’t) and then causes a histamine reaction. People can get hives if they have allergies to certain foods, medications like aspirin or ibuprofen, codeine, or morphine, saliva, and dander from animals, bites or stings from insects, or chemicals like soap or cosmetics.

If you notice hives on your skin after starting a new medication, exposure to new foods, or when something has changed like a new pet, new detergent, or new cleaning products in your home, you may want to see a doctor to determine whether you are having an allergic response and need to make a change. Since the skin of pregnant women is stretched and extra sensitive, some pregnant women have outbreaks of hives called pruritic urticarial papules and plaques of pregnancy (PUPP), which can be extremely itchy. If your hives make it difficult to sleep, you should see a doctor.

Hives are also associated with a condition called angioedema, which is swelling in deeper layers of your skin. If you have severe angioedema in your lips, mouth, tongue, or throat, this can cause a life-threatening blockage of your airway called anaphylaxis, which requires emergency care. If you have hives along with other symptoms like stomach pain or nausea, swelling of the face, mouth, and throat, dizziness, or trouble breathing, you need help immediately.

Our immunology specialists at Piniella Asthma + Allergy in Coral Gables and Palmetto Bay, FL are highly trained in diagnosing and treating allergic reactions, including hives, in children and adults.

Because most hives are related to allergic reactions and immune responses, you will see the most benefit from seeing an allergist/immunologist. They will assess your symptoms as well as take a full medical history and ask about your diet, environment, and then proceed with allergy testing and treatment. Dr. Carlos Piniella and his team at Piniella Asthma + Allergy are board-certified in Allergy and Immunology and can help determine the cause of your hives and recommend treatment to reduce your distress. Call us for an appointment or book online. We serve patients from Coral Gables FL, Palmetto Bay FL, Westchester FL, Brownsville FL, Kendall FL, Pinecrest FL, Richmond West FL, and Goulds FL.