How can I tell the difference between hives and eczema by looking at pictures?

Reviewed by Yoshinori Abe, MD

Internal Medicine

Hives and eczema are two common skin conditions that can look alike but differ in key ways.

Hives (urticaria): Raised, red, intensely itchy welts or blotches that can appear anywhere on the body. They often come on suddenly and may fade within hours.
Eczema (atopic dermatitis): Dry, scaly, red patches that tend to appear in predictable areas, such as the insides of the elbows, behind the knees, or on the face and hands. It's typically chronic and recurring.

Key differences at a glance:

Feature	Hives	Eczema
Appearance	Raised welts	Scaly patches
Location	Anywhere on body	Specific, recurring areas
Duration	Often short-term	Chronic

Because hives and eczema can share symptoms with other skin issues—and their triggers vary widely—getting clarity early matters. A free, instant, online symptom check can help you understand what may be causing your rash and guide your next steps, whether that means at-home care or seeing a doctor. It takes just a few minutes and could save you hours of guessing.

Reviewed for medical accuracy: 07/14/2026

Important Next Steps

Learn if hives or eczema fit better Discover what your rash could indicate See how serious these skin changes are Find OTC relief for itchy rash Find a doctor for skin conditions Understand home remedies for hives or eczema Check if your rash needs care

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Explanation

Characteristics of Hives (Urticaria):

Appearance: Hives typically present as raised, red, or skin-colored welts on the skin. These welts can vary in size and shape and may appear suddenly. They often have a well-defined border and can change location quickly.
Itching: Hives are usually very itchy. The itching can be intense and may worsen with heat or pressure.
Duration: Hives can appear and disappear within hours or days. They may come and go, often resolving without treatment.
Triggers: Hives are often triggered by allergic reactions to foods, medications, insect stings, or environmental factors. They can also be caused by stress or physical stimuli like heat or cold.

Characteristics of Eczema (Atopic Dermatitis):

Appearance: Eczema usually appears as dry, red, and inflamed patches of skin. The affected areas may be scaly or crusty and can vary in color depending on skin tone. Unlike hives, eczema does not typically have raised welts.
Itching: Eczema is also itchy, but the itching may be more persistent and can lead to scratching, which can worsen the condition and cause the skin to become thickened or leathery over time.
Duration: Eczema tends to be a chronic condition, meaning it can last for weeks, months, or even years. Flare-ups may occur periodically, often triggered by irritants, allergens, or changes in temperature.
Location: Eczema commonly affects specific areas of the body, such as the inside of the elbows, behind the knees, and on the face or scalp, especially in children. If you're experiencing any of these symptoms and want personalized guidance, you can check your symptoms to better understand your condition.

(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.

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