Urticaria (Hives)
Urticaria, commonly known as hives, is a skin condition marked by red, raised, itchy welts that can appear suddenly anywhere on the body. These welts may last for a few hours or persist for days. Hives can result from allergic reactions, infections, medications, stress, or even temperature changes.
At The Medical Group of New Jersey, our dermatologists work to identify triggers, relieve itching, and prevent recurrent episodes through evidence-based and compassionate care.
Symptom Onset & Initial Evaluation
Hives can appear suddenly and vary in frequency and severity. Common symptoms include:
- Itchy, raised welts that may change shape or location
- Swelling of the eyelids, lips, or throat (angioedema) in some cases
- Episodes triggered by allergens, medications, pressure, heat, or stress
- Recurrent or chronic outbreaks lasting more than six weeks
During your visit, your dermatologist will review your symptoms, exposures, and medication history. A physical exam and discussion of possible triggers help distinguish between acute hives (short-term) and chronic urticaria (lasting longer than six weeks).
Diagnosis
Diagnosis is typically clinical, based on history and symptom pattern. Additional testing may be performed to uncover underlying causes:
- Allergy testing: To identify environmental, food, or medication triggers
- Blood work: To check for autoimmune or thyroid-related causes in chronic cases
- Skin testing or challenge testing: If physical triggers (e.g., pressure, cold, heat) are suspected
Treatment & Ongoing Management
Treatment focuses on relieving symptoms, preventing recurrences, and addressing underlying triggers. Options may include:
- Antihistamines: First-line therapy to reduce itching and redness
- Short courses of corticosteroids: For severe or persistent flares
- Biologic therapy (omalizumab): For chronic or treatment-resistant hives
- Trigger avoidance and prevention: Identifying allergens, adjusting medications, managing stress, and avoiding tight clothing or extreme temperatures
Your dermatologist may collaborate with an allergist or immunologist when hives are chronic or associated with systemic allergic reactions.
Follow-Up & Outlook
Most cases of acute hives resolve within days, while chronic urticaria can often be well controlled with ongoing care. With proper management and lifestyle adjustments, most patients experience significant improvement and lasting relief from itching and swelling.