Hives (Urticaria) Quiz
Check your symptoms and
find possible causes with AI for free
Worried about your symptoms?
Start the Hives (Urticaria) test with our free AI Symptom Checker.
This will help us personalize your assessment.
By starting the symptom checker, you agree to the Privacy Policy and Terms of Use
Red rash
Rashes
Itchy
There is a sore on the side
Redness of the skin
Red skin rash all over the body
Feeling stressed
Not seeing your symptoms? No worries!
What is Hives (Urticaria)?
An itchy, allergic rash with red bumps, also known as "hives". The causes are broad, ranging from foods and medications to viral infections and bee stings. In most cases, the rash disappears within 24 hours, however medical attention is needed if there is facial swelling or breathlessness.
Treatment of Hives (Urticaria)
Treatment usually involves antihistamines to stop the allergic reaction. Severe cases (e.g. swollen lips and eyes or breathlessness) may require emergency medical care. It is important to identify and avoid the cause of the allergy in the future.
Reviewed By:
Unnati Patel, MD, MSc (Family Medicine)
Dr.Patel serves as Center Medical Director and a Primary Care Physician at Oak Street Health in Arizona. She graduated from the Zhejiang University School of Medicine prior to working in clinical research focused on preventive medicine at the University of Illinois and the University of Nevada. Dr. Patel earned her MSc in Global Health from Georgetown University, during which she worked with the WHO in Sierra Leone and Save the Children in Washington, D.C. She went on to complete her Family Medicine residency in Chicago at Norwegian American Hospital before completing a fellowship in Leadership in Value-based Care in conjunction with the Northwestern University Kellogg School of Management, where she earned her MBA. Dr. Patel’s interests include health tech and teaching medical students and she currently serves as Clinical Associate Professor at the University of Arizona School of Medicine.
Yukiko Ueda, MD (Dermatology)
Dr. Ueda graduated from the Niigata University School of Medicine and trained at the University of Tokyo Medical School. She is currently a clinical assistant professor at the Department of Dermatology, Jichi Medical University, and holds several posts in the dermatology departments at Kyoto Prefectural University of Medicine, Komagome Hospital, University of Tokyo, and the Medical Center of Japan Red Cross Society.
Content updated on Dec 8, 2024
Following the Medical Content Editorial Policy
Was this page helpful?
Tell your friends about us.
We would love to help them too.
Think you might have
Hives (Urticaria)?
Try a symptom check testHow Ubie Can Help You
With a free 3-min Hives (Urticaria) quiz, powered by Ubie's AI and doctors, find possible causes of your symptoms.
This questionnaire is customized to your situation and symptoms, including the following personal information:
Biological Sex - helps us provide relevant suggestions for male vs. female conditions.
Age - adjusts our guidance based on any age-related health factors.
History - considers past illnesses, surgeries, family history, and lifestyle choices.
Your symptoms
Our AI
Your report
Your personal report will tell you
✔ When to see a doctor
✔︎ What causes your symptoms
✔︎ Treatment information etc.
Diseases Related to Hives (Urticaria)
FAQs
Q.
Is This an Allergic Reaction? Why Your Body Reacts & Medically Approved Next Steps
A.
An allergic reaction is your immune system overreacting to a trigger like foods, medicines, insect stings, latex, pets, or pollen, causing hives, swelling, itching, breathing trouble, or digestive upset; severe symptoms can be anaphylaxis and require epinephrine and immediate emergency care. There are several factors to consider to tell allergy from intolerance or infection. For medically approved next steps, see below for how to remove triggers, use antihistamines and cold compresses safely, monitor symptoms, the red flags that mean seek emergency care now, and when to get testing, an epinephrine auto-injector, or an allergist referral.
References:
* An, S. M., Lee, Y. W., Shim, J. C., Kim, J. Y., & Kim, Y. J. (2021). Allergic Reactions and Anaphylaxis: A Review. *The Journal of emergency medicine*, *61*(4), e125–e137.
* Akdis, C. A., Jutel, M., Klimek, L., Agache, I., Angier, E., Canelo-Aybar, C., ... & Akdis, M. (2021). Immune mechanisms of allergic diseases. *Nature Reviews Immunology*, *21*(4), 209–224.
* Shaker, M. S., Greenhawt, M., Khan, D. A., Lang, D. M., LeBovidge, J., Lifschitz, C., ... & Shaker, M. (2020). Anaphylaxis—A 2020 practice parameter update, systematic review, and Grading of Recommendations Assessment, Development and Evaluation (GRADE) analysis. *Annals of Allergy, Asthma & Immunology*, *125*(2), 163–182.
* Akdis, C. A., Akdis, M., & Akdis, M. (2020). Allergic diseases: current status, challenges, and future directions. *Allergy*, *75*(5), 1025–1043.
* Rosenstreich, D. L., & Busse, W. W. (2017). Understanding allergic reactions: mechanisms, diagnosis, and treatment. *Annals of Allergy, Asthma & Immunology*, *119*(1), 1–7.
Q.
Always Inflamed? Why Your Body Overreacts to Histamine + Medically Approved Next Steps
A.
There are several factors to consider. Many “always inflamed” symptoms actually come from histamine being released too often or cleared too slowly, most commonly due to allergies or chronic hives, sometimes histamine intolerance or hormone and stress effects, and rarely mast cell disorders; see below for how each cause differs and why that matters. Medically approved next steps include getting a proper diagnosis, using second generation antihistamines when appropriate, tracking and reducing triggers, a short-term low histamine diet with professional guidance, stress and sleep support, and urgent care for breathing trouble or throat swelling. For complete guidance, decision points, and red flags that can change your next steps, see below.
References:
* San Mauro Martin I, et al. Histamine and histamine intolerance. Clin Transl Allergy. 2019 Feb 1;9:14. doi: 10.1186/s13601-019-0261-2. PMID: 30678589; PMCID: PMC6354676.
* Schnedl WJ, Enko D. Histamine Intolerance: The Current State of the Art. Biomolecules. 2021 Apr 29;11(5):622. doi: 10.3390/biom11050622. PMID: 33917892; PMCID: PMC8143336.
* Akin C. Mast Cell Activation Syndrome: A Review. Clin Rev Allergy Immunol. 2021 Oct;61(2):167-177. doi: 10.1007/s12016-021-08871-3. PMID: 34200707.
* O'Mahony L, et al. Histamine Signaling in Allergic Inflammation. Front Immunol. 2019 Jul 9;10:1537. doi: 10.3389/fimmu.2019.01537. PMID: 31339396; PMCID: PMC6632420.
* Zirk M, et al. Treatment of Histamine Intolerance: A Systematic Review. Nutrients. 2022 Jul 28;14(15):3092. doi: 10.3390/nu14153092. PMID: 35930006; PMCID: PMC9370005.
Q.
Always Reacting? Why Your Body Is Overreacting to Histamine + Medical Next Steps
A.
Feeling like you’re always reacting can stem from excess histamine or reduced breakdown, with common causes including allergies, chronic spontaneous hives, mast cell activation, histamine intolerance, and some autoimmune conditions. There are several factors to consider; see below to understand more. Next steps typically include tracking triggers, getting a medical evaluation and targeted tests, using evidence-based treatments such as non sedating antihistamines and short, supervised low histamine diet trials, managing stress, and seeking urgent care for breathing trouble or throat swelling, with important nuances that could change your plan explained below.
References:
* Mušič, H., & Korošec, M. (2021). Histamine Intolerance: A Comprehensive Review of Molecular Mechanisms, Clinical Manifestations, and Therapeutic Strategies. *Diagnostics (Basel)*, *11*(8), 1359.
* Afrin, L. B., Weinstock, L. B., & Ackerley, C. C. (2020). Mast Cell Activation Syndrome: A Review. *Diagnostics (Basel)*, *10*(10), 800.
* Korošec, M., Mušič, H., Novak, L. M., Konić, B., & Korošec, B. (2024). The Role of Diamine Oxidase in the Pathogenesis of Histamine Intolerance: A Narrative Review. *International Journal of Molecular Sciences*, *25*(1), 475.
* Vente, D. F. M., Wieringa, J. M., van der Vlugt-Koesveld, D. J., Theunissen, D. E. M., van der Gaag, M. D. E. T., van der Sluis, J. M. S. W., ... & Visser, E. M. (2024). The Interplay Between Histamine, Histamine-Secreting Bacteria, and the Gut Microbiome in Health and Disease. *International Journal of Molecular Sciences*, *25*(5), 2699.
* Schink, F. G., van der Vlugt, J. G. M., Meijssen, S. R. W., Peeters, A. M. L. E., van der Sluis, J. M. S. W., Brandt, H. A., & Visser, E. M. (2022). Dietary Management of Histamine Intolerance: A Systematic Review. *Nutrients*, *14*(7), 1443.
Q.
Still Itching? Why Your Body Resists Cetirizine and Medically Approved Next Steps
A.
Persistent itch on cetirizine often reflects too low a dose, a non histamine driver, or chronic spontaneous urticaria; evidence-based options include supervised dose escalation, switching or adding a second antihistamine, adding H2 or leukotriene blockers, short steroid bursts for severe flares, moving to omalizumab in refractory cases, and evaluating for underlying conditions. There are several factors to consider, including trigger avoidance and urgent red flags like lip or throat swelling that require emergency care. See below for the complete guidance that can impact which next step you take with your clinician.
References:
* Kolkhir, P., Maurer, M., & Weller, K. (2021). Mechanisms of Antihistamine Resistance in Chronic Urticaria. *Frontiers in Immunology*, 12, 650058. doi: 10.3389/fimmu.2021.650058
* Zuberbier, T., Abdul Latiff, A. H., Abuzakouk, M., Aquilina, S., Asero, R., Baron, J. M., ... & Maurer, M. (2022). The EAACI/GA²LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticaria 2021 update. *Allergy*, 77(3), 734-766. doi: 10.1111/all.15090
* Kim, A., & Kwatra, S. G. (2023). Update on the Classification and Treatment of Chronic Pruritus. *Dermatologic Clinics*, 41(1), 1-13. doi: 10.1016/j.det.2022.07.001
* Sussman, G., & Chauhan, A. (2021). Omalizumab: an update on its use in chronic spontaneous urticaria. *Therapeutic Advances in Chronic Disease*, 12, 20406223211025528. doi: 10.1177/20406223211025528
* Abasolo, A., & Maurer, M. (2023). Emerging Therapies for Chronic Urticaria. *Drugs*, 83(1), 1-16. doi: 10.1007/s40265-022-01804-w
Q.
Constant Itch? Why Cetirizine Calms Your Histamine Storm & Medical Next Steps
A.
Cetirizine calms histamine driven itch and hives by blocking H1 receptors, providing once daily, less drowsy relief and serving as a first line option for allergies and urticaria; there are several factors to consider, and the complete guidance is explained below. It does not cure the cause or replace emergency care, so seek urgent help for swelling of the lips, tongue, or throat, trouble breathing, chest tightness, or fainting, and speak with a clinician if symptoms persist beyond six weeks, itch occurs without rash, or cetirizine is not helping; key details on alternative causes, trigger control, dosing cautions in pregnancy, kidney disease, and children, and when to escalate care are outlined below.
References:
* Simons FE. Cetirizine: a second-generation H1-antihistamine for the treatment of allergic diseases. J Allergy Clin Immunol. 2011 May;127(5 Suppl):S1-37. doi: 10.1016/j.jaci.2011.02.007. PMID: 21536294.
* Kostecki J, Hadas E, Reich A. Itch: A Histamine-Dependent or -Independent Phenomenon? Clin Rev Allergy Immunol. 2019 Jun;56(3):364-375. doi: 10.1007/s12016-018-8724-4. PMID: 30267156.
* Ständer S, Weisshaar E, Mettang T, et al. European guideline for the management of chronic pruritus. J Eur Acad Dermatol Venereol. 2018 Jul;32(7):1066-1083. doi: 10.1111/jdv.14794. PMID: 29676571.
* Ma Z, Ma H, Zhang C, et al. Efficacy and safety of cetirizine for treatment of chronic urticaria: a systematic review. J Eur Acad Dermatol Venereol. 2021 Jun;35(6):1273-1282. doi: 10.1111/jdv.17066. PMID: 33580517.
* Tey HL, Yosipovitch G. Chronic Pruritus: A Review of Differential Diagnosis and Treatment. Am J Clin Dermatol. 2019 Feb;20(1):103-118. doi: 10.1007/s40257-018-0389-7. PMID: 30478799.
Q.
Benadryl: What Women 30-45 Must Know Now & Vital Next Steps
A.
Benadryl can help with short term allergies, hives, motion sickness, and occasional insomnia, but women 30 to 45 have several factors to consider, including sedation that impairs driving and focus, anticholinergic effects on memory and bladder, medication and alcohol interactions, and special pregnancy or breastfeeding considerations. It is not for severe allergic reactions, and for daily allergies non drowsy second generation antihistamines are usually safer, while smart next steps include using the lowest effective dose, avoiding regular use for sleep, and talking to a clinician if symptoms persist or you take other medicines. See the complete guidance below for red flag symptoms that need urgent care and step by step actions to protect brain health, sleep quality, and long term safety.
References:
* Ruyssen-Witrand A, et al. Antihistamines in pregnancy: a systematic review and meta-analysis. *Drug Saf*. 2014;37(8):575-87. doi: 10.1007/s40264-014-0177-y. PMID: 24719001.
* Salahudeen MS, et al. Anticholinergic Medications and Cognitive Impairment: A Narrative Review. *J Clin Psychopharmacol*. 2020 Sep/Oct;40(5):502-511. doi: 10.1097/JCP.0000000000001258. PMID: 32909947.
* Saravanan V, et al. Diphenhydramine and its use as a hypnotic: A narrative review. *Sleep Med Rev*. 2021 Oct;59:101509. doi: 10.1016/j.smrv.2021.101509. Epub 2021 Jul 29. PMID: 34509156.
* Church MK, et al. Pharmacological and clinical aspects of antihistamines. *Handb Exp Pharmacol*. 2017;245:129-150. doi: 10.1007/164_2017_153. PMID: 28314959.
* Vena G, et al. Update on antihistamines. *Clin Cosmet Investig Dermatol*. 2018 May 30;11:235-241. doi: 10.2147/CCID.S154696. eCollection 2018. PMID: 29872322.
Q.
If hives are suspected, should I see a primary care doctor or a specialist?
A.
If hives are suspected, it is generally advisable to start by seeing a primary care doctor. They can evaluate your symptoms, provide initial treatment, and determine if a referral to a specialist, such as an allergist or dermatologist, is necessary based on the severity and persistence of the condition.
References:
Kayiran MA, Akdeniz N. Diagnosis and treatment of urticaria in primary care. North Clin Istanb. 2019 Feb 14;6(1):93-99. doi: 10.14744/nci.2018.75010. PMID: 31180381; PMCID: PMC6526977.
Ryan D, Tanno LK, Angier E, Clark E, Price D, Zuberbier T, Maurer M. Clinical review: The suggested management pathway for urticaria in primary care. Clin Transl Allergy. 2022 Oct 5;12(10):e12195. doi: 10.1002/clt2.12195. PMID: 36225262; PMCID: PMC9533216.
Kolkhir P, Giménez-Arnau AM, Kulthanan K, Peter J, Metz M, Maurer M. Urticaria. Nat Rev Dis Primers. 2022 Sep 15;8(1):61. doi: 10.1038/s41572-022-00389-z. PMID: 36109590.
Q.
Is it possible to get an eyelid rash caused by hives around the eyes?
A.
Yes, it is possible to develop an eyelid rash caused by hives (urticaria) around the eyes. Hives can lead to localized swelling and redness, which may manifest as a rash on the eyelids. Understanding the causes and characteristics of this condition is important for effective management.
References:
Hine AM, Waldman RA, Grzybowski A, Grant-Kels JM. Allergic disorders of the eyelid. Clin Dermatol. 2023 Jul-Aug;41(4):476-480. doi: 10.1016/j.clindermatol.2023.08.002. Epub 2023 Sep 15. PMID: 37574152.
Guin JD. Eyelid dermatitis: experience in 203 cases. J Am Acad Dermatol. 2002 Nov;47(5):755-65. doi: 10.1067/mjd.2002.122736. PMID: 12399770.
Moreira J, Gonçalves R, Coelho P, Maio T. Eyelid Dermatitis Caused by Allergic Contact to Acrylates in Artificial Nails. Dermatol Reports. 2017 May 29;9(1):7198. doi: 10.4081/dr.2017.7198. PMID: 28603598; PMCID: PMC5452630.
Q.
How can I tell the difference between hives and eczema by looking at pictures?
A.
Hives and eczema are two distinct skin conditions that can appear similar but have different characteristics. Hives are typically raised blotches of red skin that are very itchy and occur all over the body. Eczema, on the other hand, is generally scaly red patches of skin at stereotypical places on the body.
References:
Schettini N, Corazza M, Schenetti C, Pacetti L, Borghi A. Urticaria: A Narrative Overview of Differential Diagnosis. Biomedicines. 2023 Apr 4;11(4):1096. doi: 10.3390/biomedicines11041096. PMID: 37189714; PMCID: PMC10136346.
Sohn A, Frankel A, Patel RV, Goldenberg G. Eczema. Mt Sinai J Med. 2011 Sep-Oct;78(5):730-9. doi: 10.1002/msj.20289. PMID: 21913202.
Frazier W, Bhardwaj N. Atopic Dermatitis: Diagnosis and Treatment. Am Fam Physician. 2020 May 15;101(10):590-598. PMID: 32412211.
Ubie is supervised by 50+ medical experts worldwide
Our symptom checker AI is continuously refined with input from experienced physicians, empowering them to make more accurate diagnoses.
Ubie is recognized by healthcare and tech leaders
“World’s Best Digital
Health Companies”
Newsweek 2024
“Best With AI”
Google Play Best of 2023
“Best in Class”
Digital Health Awards 2023 (Quarterfinalist)
Which is the best Symptom Checker?
Ubie’s symptom checker demonstrated a Top-10 hit accuracy of 71.6%, surpassing the performance of several leading symptom checkers in the market, which averaged around 60% accuracy in similar assessments.
Link to full study:
https://www.medrxiv.org/content/10.1101/2024.08.29.24312810v1References
Saini SS, Kaplan AP. Chronic Spontaneous Urticaria: The Devil's Itch. J Allergy Clin Immunol Pract. 2018 Jul-Aug;6(4):1097-1106. doi: 10.1016/j.jaip.2018.04.013. PMID: 30033911; PMCID: PMC6061968.
https://www.jaci-inpractice.org/article/S2213-2198(18)30290-3/fulltextRadonjic-Hoesli S, Hofmeier KS, Micaletto S, Schmid-Grendelmeier P, Bircher A, Simon D. Urticaria and Angioedema: an Update on Classification and Pathogenesis. Clin Rev Allergy Immunol. 2018 Feb;54(1):88-101. doi: 10.1007/s12016-017-8628-1. PMID: 28748365.
https://link.springer.com/article/10.1007/s12016-017-8628-1Maurer M, Fluhr JW, Khan DA. How to Approach Chronic Inducible Urticaria. J Allergy Clin Immunol Pract. 2018 Jul-Aug;6(4):1119-1130. doi: 10.1016/j.jaip.2018.03.007. PMID: 30033913.
https://www.jaci-inpractice.org/article/S2213-2198(18)30265-4/fulltextAntia C, Baquerizo K, Korman A, Bernstein JA, Alikhan A. Urticaria: A comprehensive review: Epidemiology, diagnosis, and work-up. J Am Acad Dermatol. 2018 Oct;79(4):599-614. doi: 10.1016/j.jaad.2018.01.020. PMID: 30241623.
https://www.jaad.org/article/S0190-9622(18)30139-7/fulltextSaini S, Shams M, Bernstein JA, Maurer M. Urticaria and Angioedema Across the Ages. J Allergy Clin Immunol Pract. 2020 Jun;8(6):1866-1874. doi: 10.1016/j.jaip.2020.03.030. Epub 2020 Apr 13. PMID: 32298850.
https://www.jaci-inpractice.org/article/S2213-2198(20)30329-9/fulltext