Hives and Food Allergies: Symptoms and Treatment

Hives and rash after subject's presentation to cold stimulus
Templeton8012/Wikimedia Commons

Hives (called "urticaria" in technical medical language) are a common food allergy symptom that can be triggered by reactions to a variety of foods.

Hives usually resemble bug bites — a raised, itchy, bumpy rash. They can appear in small clusters, or they can cover a large area of your body.

When you have hives for just a short time, doctors call it "acute urticaria." Meanwhile, hives lasting more than six weeks are considered "chronic urticaria."

Food allergies are not the only possible causes for hives. Other possible causes include medication or latex allergies, infections, exercise, and even heat and cold.

Sometimes, there's no obvious cause for your hives, even if they stick around for a long time. In that case, doctors call them "chronic idiopathic urticaria."

If you believe your hives are due to a food allergy, talk to your doctor before you drop that food from your diet, since your doctor may want to perform allergy testing first. However, once you know what's causing your hives, avoiding the trigger is the best way to prevent further outbreaks.

Treatment for Hives

Most hives are treated with antihistamines. You can use over-the-counter antihistamines like Benadryl (generic name: diphenhydramine) for short-term treatment of hives.

Newer antihistamines such as Xyzal (generic name: levocetirizine) and Clarinex (generic name: desloratadine), also can be used.

Those tend to cause less drowsiness than Benadryl (a real potential benefit), but you'll need your doctor to write a prescription for them.

In severe cases of hives, or when you just can't seem to get rid of them, your doctor may prescribe corticosteroids (such as cortisone or prednisone) for a short time to reduce inflammation.

If you get hives as part of an anaphylactic reaction to a food allergy, you may need to use epinephrine to stop the reaction.

When Should You Call Your Doctor?

It's safe for you to treat hives that appear only on a small part of your body by yourself with over-the-counter antihistamines. But when it comes to hives that cover a large area of your body, or hives that appear after you've started a new medicine or tried a new food, you should call your doctor.

Hives that don't respond to several doses of over-the-counter antihistamines, or hives that are causing you severe discomfort, also warrant a call to your doctor.

If your hives are accompanied by trouble breathing, changes in your heart rate, or other symptoms of anaphylaxis, call 911 or your local emergency number immediately, and take epinephrine if your allergist has prescribed it. These kind of reactions are rare, but represent a medical emergency when they occur.

Sources:

Adkinson, N. Franklin, et al. Middleton's Allergy: Principles & Practice. 6th Ed. St. Louis: Mosby, 2003.

American Academy of Asthma, Allergy & Immunology. "Tips to Remember: Allergic Skin Conditions." Internet Resource. 4 Feb. 2008.

DuBuske, Lawrence M. "Levocetirizine: The Latest Treatment Option for Allergic Rhinitis and Chronic Idiopathic Urticaria." Allergy and Asthma Proceedings. Nov./Dec. 2007 28(6): 724-34 (11). 5 Feb. 2008.

DuBuske, Lawrence M. "Desloratadine for Chronic Idiopathic Urticaria: A Review of Clinical Efficacy." American Journal of Clinical Dermatology. 2007. 8(5): 271-83. 4 Feb. 2008.

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