Stress, infection, autoimmune disease, and even food poisoning can lead to hives.
The cause and severity of hives can vary from one person to the next.
Urticaria can affect people of any age, gender, and race.
© Verywell, 2018
Allergic Reaction
Allergy is a common cause ofurticaria.
Other symptoms include swelling (edema) and trouble breathing, which can become life-threatening in severe cases.
Seek immediate medical attention if you experience hives with symptoms that include:
Anaphylaxis is life-threatening.
Reproduced with permission from © DermNet and © Te Whatu Ora Waikatowww.dermnetnz.org2023.
Call 911 at the first sign of anaphylaxis.
Do not wait to see if symptoms get better.
Most of these allergy-induced hives will resolve on their own when the allergy trigger (allergen) is removed.
These types are more likely to be a chronic condition that recurs.
This photo contains content that some people may find graphic or disturbing.
Reproduced with permission from A DermNet and A Te Whatu Ora Waikatowww.dermnetnz.org2023.
Stress
Stressis commonly associated with the development or worsening of chronic hives.
It’s not entirely clear why there is a relationship between mental health and urticaria.
In some cases, it may be a physical exposure like stress-related perspiration that leads to a heat rash.
What causes facial hives?
Like urticaria, angioedema has both allergic and non-allergic triggers.
Exercise
Physical activity can cause urticaria to appear in some people.
The cause remains unknown, although it’s common for another co-occurring food allergy to be present.
Symptoms typically occur within 30 minutes of starting to exercise.
In some cases, this can lead to a potentially life-threatening exercise-induced anaphylaxis.
Infections and Diseases
There are certain infections and diseases for which urticaria is common.
The hives tend to develop within a week of infection and usually resolve in a week or two withouttreatment.
Why do hives seem worse at night?
Cortisol levels drop at night, reducing inflammation but increasing the itch.
Changes in body temperature and water in the skin may also contribute.
Diagnosis
With urticaria, diagnosis is focused on identifying the cause.
In some cases, over-the-counter medications like Claritin (loratadine) can help to treat symptoms.
Prescription drugs or additional therapies may be needed.
Summary
Hives are a common allergy response to foods, medication, or environmental exposure.
Treatment will vary depending on the cause.
Allergy Asthma Immunol Res.
2017;9(3):212-219.
Ben-Shoshan M, Kanani A, Kalicinsky C, Watson W.Urticaria.Allergy Asthma Clin Immunol.
2024 Dec 9;20(Suppl 3):64. doi:10.1186/s13223-024-00931-6
Johns Hopkins Medicine.Food allergies.
2024 Mar 7;390(10):889-899. doi:10.1056/NEJMoa2312382
American College of Allergy, Asthma & Immunology.Drug Allergies.
Schaefer, P.Acute and Chronic Urticaria: Evaluation and Treatment.Am Fam Physician.2017; 95(11):717-724.
2020 Sep;29(3):141-148.
2022 Mar;128(3):330-331. doi:10.1016/j.anai.2021.11.009.
Konstantinou GN, Konstantinou GN.Psychiatric comorbidities in children and adolescents with chronic urticaria.World J Pediatr.
2018;15(6).
doi:29844295
Tarbox JA, Bansal A, Peiris AN.Angioedema.JAMA.
2022 Mar 11;14(3):e23062.
doi:10.7759/cureus.23062
Shin M, Lee S.Prevalence and Causes of Childhood Urticaria.
Allergy Asthma Immunol Res.
2017;9(3):189-190.
2018 Feb;32(2):276-281. doi:10.1111/jdv.14548
DermNet.Urticaria an overview.
2016;17(3):425. doi:10.3390/ijms17030425
Harvard Health Publishing.Hives (Urticaria).
