Hives
(Urticaria & Angioedema)

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Medical Author:

Gary W. Cole, MD, FAAD

Gary W. Cole, MD, FAAD

Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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• Hives (medically known as urticaria) are red, itchy, raised areas of skin that appear in varying shapes and sizes.
• Hives are very common and most often their cause is elusive.
• Hives can change size rapidly and to move around, disappearing in one place and reappearing in other places, often in a matter of hours.
• Ordinary hives flare up suddenly.
• Physical hives are hives produced by direct physical stimulation of the skin.
• Treatment of hives is directed at symptom relief while the condition goes away on its own.
• Antihistamines are the most common treatment for hives.
• Hives typically are not associated with long-term or serious complications.

Hives (medically known as urticaria) appear on the skin as wheals that are red, very itchy, smoothly elevated areas of skin often with a blanched center. They appear in varying shapes and sizes, from a few millimeters to several inches in diameter anywhere on the body.

It is estimated that 20% of all people will develop urticaria at some point in their lives. Hives are more common in women than in men. One hallmark of hives is their tendency to change size rapidly and to move around, disappearing in one place and reappearing in other places, often in a matter of hours. Individual hives usually last no longer than 24 hours. An outbreak that looks impressive, even alarming, first thing in the morning can be completely gone by noon, only to be back in full force later in the day. Very few, if any other skin diseases occur and then resolve so rapidly. Therefore, even if you have no evidence of hives to show the doctor when you get to the office for examination, the diagnosis can be established based upon the accurate accounting of your symptoms and signs. Because hives fluctuate so much and so fast, it is helpful to bring along a photograph of what the outbreak looked like at its worst.

Swelling deeper in the skin that may accompany hives is called angioedema. This swelling of the hands and feet, as well as the lips or eyelids, can be as dramatic as it is brief.

What does urticaria (hives) look like?