How long until hives go away
How long can hives last?
Hives can appear and disappear quickly, with each hive only lasting around 23 hours. However, depending on the cause, they may reappear and continue affecting someone for days, weeks, or longer.
People can have acute hives, which occurs due to a specific trigger and resolves within
This article looks at how long hives last, factors that influence their duration, and treatment.
Each hive lasts only
Acute hives appear quickly and do not last long. Doctors classify hives as acute if the overall duration is less than 6 weeks.
However, around 25% of people go on to develop chronic hives. This is when hives regularly reappear over 6 weeks or more.
For many individuals, chronic hives eventually clear on their own, but this can take months. According to the American Academy of Dermatology Association (AAD), around half of people with chronic hives spontaneously recover within 1 year.
Acute hives often occur in response to an allergen or irritant. When the immune system perceives a substance as a threat, it releases histamine and other chemicals. This causes tiny blood vessels under someones skin to leak fluid, which accumulates and causes the bump.
Some
- food allergens, such as milk, eggs, tree nuts, peanuts, or shellfish
- contact allergens, such as latex or animal dander
- insect bites or stings
- medications
Any drug can cause hives, but some of the medications most commonly associated with this symptom include:
Acute hives can also occur in response to viral infections, parasitic infections, or during times of stress.
According to a 2018 review, doctors are unsure of the cause of acute hives in
Chronic hives may have the same cause as acute hives, but with symptoms lasting longer than 6 weeks. However, chronic hives are often not due to an allergen and instead have a physical cause.
There are two subcategories of chronic hives: inducible urticaria and chronic idiopathic urticaria.
Chronic idiopathic hives
Chronic idiopathic urticaria has no clear cause and is the most common form of chronic hives. Researchers are working to understand why this type of hives occurs, but a leading theory links it with autoimmunity.
Autoimmunity occurs when a persons immune system mistakenly attacks healthy tissue, and several autoimmune conditions are associated with chronic hives. The most common is thyroid disease, which is present in
This suggests that the hives may result from someones immune system not functioning as it should. Other conditions that can occur alongside chronic hives include type 1 diabetes, lupus, and rheumatoid arthritis.
Infections can also be associated with the onset of chronic hives. This includes bacterial, viral, and parasitic infections. Again, this may result from autoimmunity an infection may trigger a change in how the persons immune system works.
Inducible hives
Inducible or physical urticaria is less common than chronic idiopathic urticaria. With this subtype, it is possible to purposely induce the hives by a person exposing their skin to certain triggers, which could include:
- Scratching or pressure: The
most common type of inducible hives is known as dermatographia. This condition involves developing hives as a response to scratching or drawing on the skin. - Cold: Cold hives occur on someones skin or mouth after exposure to cold temperatures. Triggers include consuming iced drinks, touching cold water, or going outside in cold weather.
- Heat: Cholinergic hives occurs when an individuals body becomes hot or sweaty. Hot baths, exercise, and spicy food can be triggers.
- UV light: Solar hives occur in response to UV light from the sun and certain light bulbs, such as those in tanning beds.
- Water: Some people develop hives if their skin comes into contact with water. This is known as aquagenic urticaria and is very rare.
Doctors diagnose hives by performing a physical examination. There is no test to determine whether the persons hives are acute or chronic, so they will use the length of time they recur to do this.
The doctor may also ask an individual:
- when the rash began
- the shape, size, and distribution of the rash
- where on the body they first noticed the rash
- if they have had any insect bites
- if they live or work with common hive triggers, such as chemicals, animals, or latex gloves
- if they have bone or joint pain, fever, or abdominal pain
- if anyone in their family experiences hives
- if they take any medications or supplements
The doctor may use a skin prick test and serum-specific IgE test to check if the acute hives result from a specific substance, such as food, dust mites, or chemicals. Alternatively, they may refer someone to an allergy clinic for these tests.
However, in cases of chronic hives, allergy testing is rarely useful. A doctor may check for other underlying health conditions by performing additional tests, such as:
The most suitable treatment depends on whether the person has acute hives or chronic hives.
Acute hives
Doctors typically recommend second-generation antihistamines as the first-line treatment for acute hives, such as:
- loratadine (Claritin)
- desloratadine (Clarinex)
- fexofenadine (Allegra)
- cetirizine (Zyrtec)
- levocetirizine (Xyzal)
They may prescribe a standard dose or increase by up to 4 times if the individual does not respond.
If these medications do not improve symptoms, the doctor may recommend an additional antihistamine, such as cimetidine (Tagamet), famotidine (Pepcid), or ranitidine (Zantac). They may recommend a 310-day course of corticosteroids to help control the symptoms in severe cases.
The doctor may prescribe an epinephrine auto-injector if they think the individual is at risk of anaphylaxis, which is a severe allergic reaction that restricts breathing. This provides emergency medicine to treat anaphylaxis quickly.
The doctor will then reassess the individual in 26 weeks.
Chronic hives
Doctors may recommend a four-step treatment plan for chronic hives. This approach involves using an antihistamine daily, which may be up to 4 times the regular dosage depending on how the individual responds.If necessary, they may prescribe a second antihistamine or another medication, such as montelukast (Singulair). With persistent hives, they may suggest a high potency antihistamine, such as hydroxyzine or doxepin.
The final step is for a doctor to refer the individual to a specialist for immunomodulatory therapy. This may involve taking medications such as omalizumab (Xolair) or cyclosporine (Sandimmune).
Once symptoms are under control, a doctor may gradually reduce the dosage of these medications. If the hives have an identifiable cause, such as cold or heat exposure, adopting changes to avoid the triggers wherever possible is also important.
The AAD suggests the following methods for people to reduce irritation and itchiness in hives:
- applying topical anti-itch medications, such as calamine lotion
- wearing loose-fitting clothing
- moisturizing with fragrance-free lotion to prevent dry skin
- using cold compresses several times per day
However, it is important for individuals to try to determine whether the hives have a specific trigger, in addition to relieving symptoms. If someone has cold hives, for example, a cold compress may make them worse.
Therefore, it is a good idea for people to keep a symptom diary, recording when the hives occur and any factors that might have contributed. Symptom diaries are also useful to refer to at medical appointments. A person can take note of:
- the date and time the hives appear
- what they were doing just before they developed
- what they have had to eat or drink
If any common factors emerge when the hives occur, a person can try to temporarily avoid these to see if it helps. It is important for people to do this with the guidance of a doctor, allergist, or dietitian if someone has food-related hives.
Learn more about remedies and treatments for hives here.
Hives do not last long, taking only 23 hours to fade. However, more can appear, which makes the symptoms last longer. Acute hives can develop and resolve on their own within 6 weeks, while chronic hives can last much longer.
Doctors treat acute and chronic hives differently, so it is advisable for people to speak with a medical professional about this symptom, especially if the hives last longer than 6 weeks.
If hives or swelling occur in the mouth and airways, making it difficult to breathe, dial 911 or the number of the nearest emergency department immediately.
Why won't my hives go away?
Q.I've gotten hives from time to time when I've been overly stressed. But now I have a case that won't quit after six weeks. What's going on?
A. No one welcomes these red, itchy welts that crop up on our skin. Many things can lead to a temporary case of hives, including allergic reactions to food, medications, bug bites, pollen, latex, or animal dander. Like you, some people also develop them when they're stressed, or in response to ultraviolet light or excess skin pressure. Hives are more common in women than men, especially from our 30s to 50s.
Most cases of hives go away within several days to a couple of weeks. If they last six weeks or longer, you may have autoimmune hives. This happens when your immune system mistakenly targets healthy tissue in this case, triggering a skin reaction. Autoimmune hives are more common in people with other autoimmune conditions, such as lupus, thyroid disease, rheumatoid arthritis, or celiac disease. Anyone whose hives last longer than a few weeks should see a doctor.
Image: chokja/Getty Images
As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles.
No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
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.
Hives
Hives
What are hives?
Hives are raised, red, itchy areas on the skin (also called wheals or welts) that can result from an allergic reaction.The medical term for hives is urticaria.
How do they occur?
Clusters of hives may appear as a reaction to an allergen such as food, medicine, or an insect bite or sting. Hives may also occur as a reaction to infection or emotional stress. Histamine, a chemical your body makes, is released in response to the irritant that causes the hives to form. Histamine causes the redness, swelling, and itching. Often the cause of the hives cannot be determined.
What are the symptoms?
The raised, red, itchy areas may vary in size and shape. You may have one or many hives. The hives may appear on any part of the body. They are most common on the arms, legs, and trunk. You may have red blotches on your face. The rash may last for a few minutes or several days. Hives can be uncomfortable and they may recur.
In the case of a severe reaction--to a bee sting, for example--your face and throat may swell. Rarely, hives may cause problems with breathing, creating the danger of a severe asthma attack or a closing of the throat from swelling, which can be life-threatening.
How is it diagnosed?
Your healthcare provider will look at the hives and ask about your history of sensitivity to such things as:
- foods (especially eggs, shellfish, milk, nuts, berries, dyes or other additives)
- medicines (such as penicillin, aspirin, or sulfa drugs)
- plants (such as nettles) and pollens
- animals, such as an allergy to cats
- insect bites or stings
- exposure to heat, cold, or sunshine
To find the cause of your hives, the healthcare provider may suggest that you:
- Keep a detailed diary of everything you eat, drink, take as medicine, or are exposed to for 2 to 4 weeks.
- Avoid foods, one at a time, to which you may be allergic.
It is easiest to identify drugs, foods, or plants that may cause you to have hives because the response usually occurs within an hour. Identifying triggers such as emotional stress or multiple allergies may take more time. Identifying multiple allergies may require skin tests or other types of allergy tests.
How is it treated?
The treatment your healthcare provider recommends will depend on how serious your hives are. He or she may suggest that you do one or more of the following to relieve the itching and reduce the swelling:
- Soak in a lukewarm bath or use cool compresses.
- Avoid heat or rubbing, which releases more histamines.
- Take antihistamine medicine as directed by the label or your provider to reduce your allergic response.
If the rash is severe or not responding to the above treatments, your provider may prescribe an oral steroid medicine (for example, prednisone) to take for a few days.
Hives rarely cause emergencies. But sometimes they can cause throat swelling and trouble breathing. If your throat is swelling or you are having trouble breathing or are wheezing, call 911. Once you are getting medical care, you will be given a shot of epinephrine (adrenaline) to stop the reaction. When the emergency symptoms have been treated, you will probably be given steroid medicine--for example, prednisone--to take for the next several days to prevent the reaction from happening again.
Once the hives have gone and you are feeling better, you should see your healthcare provider to talk about whether you need tests to determine what caused the hives. If you are able to determine the cause, the best prevention is avoiding the cause, if that's possible. Whether you are able to learn the cause or not, if hives are a frequent problem, you may need to take antihistamines every day to prevent the hives.
How long will the effects of hives last?
The itching, swelling, and redness of hives can last hours to several weeks or months. In most cases the hives eventually go away without treatment, but taking drugs such as antihistamines or corticosteroids help the hives go away faster. The medicines also treat the itching and prevent new hives.
Chronic hives last a longer time. Most often (more than 50% of the time) it is not possible to determine their cause. Antihistamines are usually very helpful. The hives go away spontaneously after weeks or months but they may come back repeatedly.
How can I take care of myself?
- Call 911 right away for emergency medical care if you have an allergic reaction that affects your breathing, your throat feels tight, or your face begins to swell around the eyes, lips, or tongue.
- Take antihistamines or other medicines to help relieve your symptoms. Be sure to ask your healthcare provider or pharmacist about possible side effects or drug interactions.
- Avoid foods that seem to cause you to break out in hives.
- See your healthcare provider if you continue to have outbreaks of hives.
- If you have a known severe allergy, such as to bee stings or to a food such as peanuts, ask your provider about carrying EpiPen. EpiPen is a single-dose injection kit of epinephrine. You can use it to give yourself a shot if you have a severe allergic reaction. It will counteract or slow the allergic reaction until medical help arrives.
- Wear a medical ID bracelet or necklace that indicates your allergies and risk of a severe reaction. This can help ensure prompt and proper treatment during an emergency.
What can I do to help prevent hives from recurring?
If you know the cause of your hives, you should take steps to avoid the cause. You may need to take frequent, even daily, doses of antihistamine to prevent recurrences.
Developed by RelayHealth. Published by RelayHealth. This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional. 2018 RelayHealth and/or its affiliates. All Rights Reserved.
