Do hives get worse with scratching

By Isabella Storyclaire

last updated September 16, 2024

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Hives (Urticaria)

What are hives?

Hives, or urticaria, are flat red welts that can appear anywhere on the skin and usually itch. Hives often occur as an allergic reaction to something eaten or something that has contacted the skin. Foods, medicines, and plants are common causes, but sun exposure, stress, infections, and autoimmune diseases have also been known to cause hives.

Symptoms include an itchy, stinging pink rash of slightly swollen skin. The rash may wax and wane in severity. Acute hives typically resolve within six weeks, but chronic hives (urticaria) can persist for months or years.

Hives often resolve on their own, especially in children. Otherwise, treatment for acute hives involves oral antihistamine medications to help relieve the itching and stinging. Chronic hives that do not improve with antihistamines may be treated additionally with corticosteroids, antibiotics, and other stronger medicines. A study found that 35% of people with chronic hives, are symptom free within one year, with another 29% having some reduction of symptoms.

You can safely treat this condition on your own as long as you does not develop trouble breathing. Any antihistamine (like Zyrtec, Clarinex, etc) works.

9 Ways to Ease the Itch of Chronic Hives

They're itchy, red, and raised and often appear at the worst possible times. About 20 percent of the population will get them at least once in their lives, according to the American College of Allergy, Asthma & Immunology. They're hives. And hives that last more than six weeks are considered chronic (persistent or recurring). For some people, these hives are a result of allergies, but for others there's no discernible cause. Chronic hives with no known cause are called chronic idiopathic urticaria (hives).

The itching associated with these hives, which stems from the release of natural chemicals called histamines by your bodys immune system, can dramatically affect your quality of life. This is among the main findings of a study published in August 2015 in the journal Annals of Allergy, Asthma & Immunology. Still, there's a lot you can do to ease the itch of chronic hives.

Hives and angioedema

Overview

Hives

Illustration of hives on different skin colors. Hives can cause swollen, itchy welts. Hives is also called urticaria.

Angioedema

Illustration of angioedema on different skin colors. Angioedema causes swelling in the deeper layers of skin, often of the face and lips. It often goes away within a day.

Hives also known as urticaria (ur-tih-KAR-e-uh) is a skin reaction that causes itchy welts that range in size from small spots to large blotches. Hives can be triggered by many situations and substances, including certain foods and medications.

Angioedema can arise with hives or alone. It causes swelling in the deeper layers of skin, often around the face and lips. Short-lived (acute) hives and angioedema are common. Most times, they are harmless, clear up within in a day and don't leave any lasting marks, even without treatment. Hives that last longer than six weeks are called chronic hives.

Hives and angioedema are usually treated with antihistamine medication. Angioedema can be life-threatening if swelling of the tongue or in the throat blocks the airway.

Symptoms

Hives

The welts associated with hives can be:

Skin-colored, reddish on white skin, or purplish on black and brown skin
Itchy, ranging from mild to intense
Round, oval or worm-shaped
As small as a pea or as large as a dinner plate

Most hives appear quickly and go away within 24 hours. This is known as acute hives. Chronic hives can last for months or years.

Angioedema

Angioedema is a reaction similar to hives that affects deeper layers of the skin. It can appear with hives or alone. Signs and symptoms include:

Welts that form in minutes to hours
Swelling, especially around the eyes, cheeks or lips
Mild pain and warmth in the affected areas

When to see a doctor

You can usually treat mild cases of hives or angioedema at home. See your health care provider if your symptoms continue for more than a few days.

If you think your hives or angioedema was caused by a known allergy to food or a medication, your symptoms may be an early sign of an anaphylactic reaction. Seek emergency care if you feel your tongue, lips, mouth or throat swelling or if you're having trouble breathing.

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Causes

For most people who experience acute hives and angioedema, the exact cause can't be identified. The conditions are sometimes caused by:

Foods. Many foods can trigger reactions in people with sensitivities. Shellfish, fish, peanuts, tree nuts, soy, eggs and milk are frequent offenders.
Medications. Many medications may cause hives or angioedema, including penicillins, aspirin, ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) and blood pressure medications.
Airborne allergens. Pollen and other allergens that you breathe in can trigger hives, sometimes accompanied by upper and lower respiratory tract symptoms.
Insect bites and infections. Other causes of acute hives and angioedema are insect bites and infections.

Risk factors

Hives and angioedema are common. You may be at increased risk of hives and angioedema if you:

Have had hives or angioedema before
Have had other allergic reactions
Have a family history of hives, angioedema or hereditary angioedema

Complications

Severe angioedema can be life-threatening if swelling of the tongue or in the throat blocks the airway.

Prevention

To lower your likelihood of experiencing hives or angioedema, take the following precautions:

Avoid known triggers. If you know what has triggered your hives, try to avoid that substance.
Bathe and change your clothes. If pollen or animal contact has triggered your hives in the past, take a bath or shower and change your clothes if you're exposed to pollen or animals.

Oct. 27, 2023

Healthdirect Free Australian health advice you can count on.

Key facts

Hives, also known as 'urticaria' or 'nettle rash', is a skin rash that can occur for a range of reasons, including allergies, medicines or infections.
A hive rash looks like red or skin-coloured raised bumps or welts on the skin, which are usually itchy.
A hives rash is caused when the body produces a substance called histamine, which is released by the body in response to a perceived threat.
Hives is diagnosed clinically, meaning that your doctor can diagnose the rash by talking to you and looking at your rash.
The rash usually resolves on its own, but if a hives rash continues or get worse, antihistamines can help relieve the symptoms.

What is hives?

Hives is also known as 'urticaria' or 'nettle rash'. This skin rash can have a range of triggers, most commonly an allergic reaction. Other triggers include medicines or infections. Sometimes the trigger is unknown.

What are the symptoms of hives?

The hives rash looks like raised bumps or welts on the skin that are usually itchy, but may also sting. These can be red or skin-coloured. The raised areas of skin are known as wheals.

Patches of hives often join together to form larger swollen patches or urticaria. The affected area of skin can vary in size from quite small to about as large as a dinner plate. The patches of hives often join together to look like larger swollen patches of urticaria.

The hives rash can last for a few minutes to hours, and usually disappears within 24 hours. In rare cases, the rash can last for weeks.

CHECK YOUR SYMPTOMS Use the Symptom Checker and find out if you need to seek medical help.

What causes hives?

A hives rash is caused when your body produces a substance called histamine. This is a protein released by the body in response to a perceived threat (trigger).

In most cases, it is not known what triggers this reaction. Sometimes, urticaria can occur in response to:

Other triggers may include:

cold air or water
heat or sunlight
vibration
scratching
sweating
certain foods and drinks, such as spicy food, alcohol or coffee

In children, hives can be caused by a viral infection. This is why they sometimes go together with a cold or diarrhoea.

Hives that lasts for days at a time are almost never due to an allergy, apart from some cases of medicine allergy.

Stress rarely causes hives, but stress can make the symptoms worse.

When should I see my doctor?

You should see you doctor if you have a rash that looks like hives.

Some people have hives that don't go away or recur on a frequent basis. This is known as chronic urticaria. See your doctor if you have hives that keep coming back.

If you have taken antihistamines for your hives but they do not control the symptoms, discuss alternative treatment options with your doctor.

If your baby gets hives repeatedly, it's important to see your doctor. This could indicate an allergy to something they are frequently fed, such as cow's milk.

Sometimes hives can last for a long time. If you have hives for more than 6 weeks, your doctor may refer you for more tests to check if an underlying infection or chronic immune disorder is causing the symptoms.

FIND A HEALTH SERVICE The Service Finder can help you find doctors, pharmacies, hospitals and other health services.

How are hives diagnosed?

Hives is diagnosed clinically. Your doctor can diagnose the rash by talking to you and looking at your rash.

How are hives treated?

Hives usually resolve on its own without treatment. However, if the hives rash continues or gets worse, it can be treated with antihistamines. You can buy antihistamines over the counter at pharmacies.

Ask your pharmacist for advice on which antihistamine to take, as some will cause drowsiness, and can be taken at bed time if your rash is itchy and keeping you awake at night. Other antihistamines are not likely to cause drowsiness, so you can take them before driving or going to work or school.

To search medicines by active ingredient or brand name, use the healthdirect Medicines search feature.

Can hives be prevented?

If your hives are caused by a specific trigger, such as a food or medicine, you should avoid your known triggers.

Since most people don't know what caused their hives, it can be difficult to prevent.

Resources and support

For more information about the causes and management of hives see the Australasian Society of Clinical Immunology and Allergy website.

The Royal Children's Hospital has a fact sheet on hives for parents to learn about care at home and more severe reactions.

You can also call healthdirect on 1800 022 222 at any time to speak to a registered nurse (known as NURSE-ON-CALL in Victoria) for more information and advice.