Our skin is subject to so many random bumps and breakouts that some days it seems like the only good solution is to have a dermatologist on speed dial. (Turns out this is sort of possible.) That’s because some of these reactions, like hives, can be tricky both to identify and to treat properly. Enter this guide to hives, which breaks down how to identify them correctly, figure out whether they’re chronic and how to keep them from driving you crazy.
Hives are basically your skin’s version of a temper tantrum. “Hives are itchy, red or white splotches on the skin that arise quickly but last less than 24 hours,” says Jennifer Herrmann, MD, FAAD, dermatologist at MFC Dermatology in Beverly Hills, CA. “They may be just a few millimeters in diameter or much larger, and can even change in shape over their lifetime.” What makes them unique is their short lifespan—think minutes to hours. New hives may develop, but each individual hive should fade relatively quickly.
Certain factors—like foods, infections, medications, internal diseases and even changes in temperature—can lead to a breakout of hives. Even so, there’s no one identifiable trigger about 60 percent of the time. People who tend to be allergic in general and those who suffer from eczema and psoriasis are especially prone to hives, but they’re not the only ones affected by them. “One in five people get an episode of hives sometime during their lifetime,” explains Dr. Herrmann.
Chronic hives are hives that show up on a frequent basis. “When patients suffer recurrent courses of hives for more than six weeks, we classify them as having chronic hives,” says Dr. Herrmann. Still, those courses of hives are still over quickly. Other types of rashes, like eczema and psoriasis, erupt quickly—like hives—but they also last longer than 24 hours. That time frame serves as a general dividing line between hives and other types of skin reactions.
Hives are an immune reaction (hence the connection with other allergies) in which histamines are released. That’s why over-the-counter antihistamines are your best bet for immediate relief. “They dampen down the itchy reaction and help melt hives away,” explains Dr. Herrmann. Plus, certain menthol-based lotions may help soothe any lingering itchiness. If that’s not enough—or your hives are chronic—there are injectable medications that may help in these more serious cases.
Desperate times call for desperate measures—and if you have any swelling of the lips and throat, you need to see a doctor ASAP. The same goes if you have what seems like a flare-up of hives that lasts longer than a week, says Dr. Herrmann. It could be angioedema, a serious, hive-like reaction that could be life-threatening.