What Are the Symptoms and Treatment of Hives (Urticaria)?

This itchy skin condition can be acute or chornic

skin allergy
gokhan ilgaz/E+/Getty Images

Urticaria is the medical term for the skin condition largely known as hives. Hives are characterized by itchy welts on the skin that span in size from spots to blotches.

A hive, or wheal, is a symptom of urticaria. Most people don't develop just one hive when they have urticaria but many - hence the name hives.

How Common Is Urticaria?

Urticaria is a common condition that occurs in up to 20 percent of the population at one time or another.

It can affect any person of any race, at any age, in any season of the year, but it often shows up in the evening or in the morning just after waking. Itching is typically worse at night, which interferes with sleeping.

Quality of Life With Hives

Urticaria is one of those skin conditions that can range from mildly annoying to downright nerve-wracking. Just imagine trying to sleep when you itch like crazy. Urticaria interferes with many aspects of life.

In addition to sleep, it can affect one's image. That's because hives can appear on the face or other parts of the body that may be viewable to others. For the same reason and due to the discomfort that hives cause, urticaria can affect sexual relationships. The social life of a person suffering from hives can take a hit as well. After all, who wants to socialize when they're itching or covered in unsightly wheals?

That said, antihistamines typically provide much-needed relief for people suffering from hives since the condition is often triggered by an allergic reaction.

Corticosteroids and autoimmune drugs may also be used to treat hives if the condition is severe and antihistamines don't provide relief.

Types of Urticaria

Urticaria is classified as acute or chronic depending on how long the rash has been present. Acute hives last for less than six weeks, and chronic hives last for longer than six weeks.

The designation of six weeks as the divider is arbitrary.

Acute Urticaria

Acute urticaria is more common in children and young adults. The majority of acute urticaria episodes are called idiopathic, meaning we don't know the cause. If a cause can be found, it's likely to be an infection, food or drug allergy, or an insect sting. Acute hives usually resolve on their own.

Chronic Urticaria

Urticaria that occurs at least twice a week and has been present for more than six weeks is known as chronic urticaria. Unlike the acute type, chronic urticaria does not resolve quickly. In one study, 75 percent of people with chronic hives have symptoms for longer than one year; 50 percent have symptoms for longer than five years; and 20 percent have symptoms for decades. In 50 percent of the cases, the offending agent is not identified.

Chronic urticaria occurs more often in middle-aged women and rarely occurs in children. It can be caused by the same things that cause acute urticaria. Other possible causes include autoimmune diseases, chronic infections, and any one or combination of the physical urticarias. Physical urticarias are caused by a specific stimulus like stroking the skin or exposure to cold.


Amar, Sheila and Stephen Dreskin. “Urticaria.” Primary Care. 35(2008): 141-57.

Grattan, Clive and Anne Kobza Black. "Urticaria and Angioedema." Dermatology. 2nd. Ed. Jean Bolognia. New York: Mosby, 2008: 261-76.

Guldbakke, KK, and A Khachemoune. “Etiology, classification, and treatment of urticaria.” Cutis. 79(2007): 41-9.

Zuberbier, Torsten and Marcus Maurer. “Urticaria: current opinions about etiology, diagnosis and therapy.” Acta Derm Venereologica. 87(2007): 196-205.

Continue Reading