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Acute hives may clear up in a few weeks. Chronic hives are defined as a case lasting more than six weeks or as a recurring problem over months or years.

We can help determine the cause of your hives and formulate a customized treatment plan to alleviate the symptoms. If you are experiencing the following symptoms you should seek treatment:

  • Varying sizes of welts which come and go
  • Itchy patches of red or discolored skin
  • Sleeplessness caused by welt pain or itching
  • Repeated outbreaks of welts over months or years
  • Painful swelling of throat, lips, eyelids

As a stand-alone problem, hives are not a medical emergency. However, if these occur as part of a bigger issue such as a serious allergic reaction, especially in a child, you should seek emergency care. For instance, seek help if itchy hives are accompanied by dizziness, breathing trouble, and/or lip, eyelid or tongue swelling.

Possible Causes

A welt occurs when a histamine is released into certain cells. Determining a cause is helpful, but it is not always possible. Outbreaks could be caused by:

  • Pain medications
  • Insect bites
  • Parasites
  • Infection
  • Alcohol or food
  • Allergic reaction

With chronic cases, it may be easier to identify triggers rather than causes. In some cases, avoiding the triggers may prevent or slow outbreaks:

  • Heat or cold
  • Sunlight
  • Exercise
  • Stress
  • Pressure from tight clothing

If you are dealing with the pain and itch of hives, there are treatments available. Your dermatologist will need an accurate list of your recent/current medications, herbal supplements, and vitamins. It is also important to inform your doctor about all of your current conditions. In the short term, you may get a prescription for itching and pain. In the long run, addressing hives may require a lifestyle approach to eliminating the symptoms and/or cause.

Common Treatments

Your dermatologist will eliminate direct causes such as medications and bug bites. Beyond that, there are some blood and skin tests that may find an underlying cause. In many cases, the treatment will be aimed at helping you with the symptoms. The dermatologist at may prescribe medications based on your current hives, your hives history and other factors. Prescriptions may include:

  • Anti-inflammatory medications such as oral corticosteroids
  • Histamine H-2 blockers (pill or injection)
  • Asthma drugs with antihistamines (long-term prescription)
  • Immune-suppressing drugs
  • Man-made antibodies (monthly injection)

How to Get Relief

For those with chronic hives, it helps to keep a diary. Your dermatologist may be able to use this information to determine underlying causes. Here are some questions your dermatologist may ask. You can be ready by making brief notes ahead of your visit:

  • How frequently do you get welts?
  • What are the locations of welts on your body?
  • How many days between welt appearance and fade?
  • What are your symptoms? Itching, discoloration, painful swelling, etc.
  • Are your symptoms causing you to lose sleep?
  • Have you noticed triggers (exercise, heat, cold, stress, etc.)?
  • What medications, supplements, etc. are you taking?
  • What is your diet? Do you often try new foods/drinks?
  • Describe any recent travel (beach, woods, foreign country, etc.).
  • Describe your normal routine (work, exercise, etc.).

Pediatric Skin Care

Babies, children, and teens often suffer from hives. These youngsters deserve the best of care to relieve their symptoms. It is also critical to protect their young skin from creams and treatments that could cause damage. MetroDerm’s pediatric dermatologists specialize in making your little ones feel better. Finding answers now may relieve current and future suffering from this chronic condition.


Make an appointment to speak with one of our trusted Skin Care Providers to discuss options for controlling your hives. Finding effective ways to control your hives can help greatly improve your quality of life.