Hives (Urticaria & Angioedema)

  • Medical Author:
    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.

  • Medical Editor: Melissa Conrad Stöppler, MD
    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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What are hives (urticaria) and angioedema? What do hives look like?

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 centimeters 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 are 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. An individual hive usually lasts 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 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. Continue Reading

Reviewed on 2/22/2016
References
REFERENCES:

Bernstein, Jonathan A., et al. "The Diagnosis and Management of Acute and Chronic Urticaria: 2014 Update." J Allergy Clin Immunol 133.5 May 2014: 1270-1277.

Criado, Paulo Ricardo. "Chronic Urticaria in Adults: State-of-the-Art in the New Millennium." An Bras Dermatol 90.1 (2015): 74-89.

Fine, Lauren M., and Jonathan A. Bernstein. "Urticaria Guidelines: Consensus and Controversies in the European and American Guidelines." Curr Allergy Asthma Rep 15 (2015): 30.

Frigas, Evangelo, and Miguel A. Park. "Acute Urticaria and Angioedema." Am J Clin Dermatol 10.4 (2009): 239-250.

Langley, Emily W., and Joseph Gigante. "Anaphylaxis, Urticaria, and Angioedema." Pediatrics in Review 34 (2013): 247-258.

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