What is urticaria (hives)?
Urticaria, commonly called hives, is a skin condition characterised by raised, itchy welts (wheals) that can appear anywhere on the body. Hives occur when the immune system releases histamine and other chemicals into the skin, causing swelling and irritation.
Hives can affect individuals of all ages. Most cases are short-lived (acute), but some develop chronic urticaria, lasting more than six weeks. Although not contagious, hives can cause significant discomfort and disrupt sleep or daily activities.
What causes urticaria?
Urticaria is caused by immune system activation, often in response to a trigger.
Key contributing factors:
- Allergic reactions to foods (nuts, shellfish, eggs)
- Medication reactions (antibiotics, NSAIDs)
- Infections (viral, bacterial)
- Physical triggers (pressure, heat, cold, sunlight, exercise)
- Stress or emotional factors
- Chronic autoimmune dysfunction in persistent cases
Common triggers:
- Certain foods or additives
- Recent infections
- Environmental allergens (pollen, dust)
- Hormonal changes or stress
What are the common symptoms of urticaria?
You may notice:
- Raised, red or skin-coloured welts that blanch on pressure
- Intense itching, sometimes burning or stinging
- Swelling of lips, eyelids, or face (angioedema)
- Welts that move or change shape over hours
- Occasional fever or fatigue if linked to infection
Hives can appear suddenly and resolve within hours, or persist for weeks in chronic cases.
How is urticaria diagnosed?
A GP will usually diagnose hives based on clinical history and examination:
- Pattern, timing, and duration of welts
- Possible triggers (foods, medications, infections)
- Presence of swelling in deeper tissues (angioedema)
Online consultations are suitable for initial assessment and management advice. In-person review may be needed if:
- Diagnosis is uncertain
- Severe swelling affects the face or airways
- Symptoms persist despite antihistamines
How long does urticaria last?
- Acute hives: Usually resolve within hours to days, always less than six weeks
- Chronic hives: Persist for more than six weeks, sometimes months or years
Duration is influenced by trigger exposure, underlying health conditions, and response to treatment.
Is urticaria contagious?
No. Hives are not infectious.
How to feel better and recover quickly
Self-Care at Home
- Avoid known triggers
- Wear loose clothing and avoid overheating
- Cool compresses to soothe itching
- Avoid scratching to prevent skin damage
Treatment from a GP
- Non-sedating antihistamines
- Higher-dose antihistamines for persistent symptoms
- Short courses of oral steroids in severe cases
- Treatment for any underlying infection if identified
When referral is needed
- Chronic urticaria lasting over six weeks
- Severe angioedema
- Suspected autoimmune or systemic cause
When to seek urgent medical help
Seek emergency care if:
- Breathing difficulties develop
- Swelling of tongue or throat occurs
- Fainting, dizziness, or collapse
Seek same-day GP care if:
- Facial or lip swelling worsens
- Rapidly spreading hives
- Severe itching or sleep disruption
How Dr.Online UK can help
We offer:
- Same-day online GP appointments
- Assessment, diagnosis, and trigger identification
- Private prescriptions for antihistamines or other therapies
- Referral to allergy specialists if required
