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Published on: 11/18/2024

How Can I Tell the Difference between Hives and Eczema by Looking at Pictures?

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.

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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.

(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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Dr. Kenji Taylor

Family Medicine, Primary Care Roots Community Health Center, Hippo Education, Kameda Medical Center

Kenji Taylor, MD

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