RELATED: What Are Hives? Symptoms, Causes, Diagnosis, Treatment, and Prevention In most cases, the rash will go away on its own, with each individual welt healing within 24 hours. But sometimes, hives could last for months or even years (in which case they are chronic hives) and could be a sign that something else is going on, such as an underlying autoimmune disorder. (4) Here’s what you need to know about identifying and diagnosing hives. (3) The red or pink welts may be raised and swollen and may be accompanied by itchiness, pain, or stinging (though not always) and should go away within 24 hours. (2) Red bumps on the skin can be a sign of a number of skin issues, so how can you tell if it’s hives? Sourab Choudhury, DO, a dermatologist and the chief medical officer at the Dermatology Specialists, a private practice in New York City, says to look for welts that come and go, as that’s “highly indicative of hives,” he says. If you’re not having difficulty breathing, it still may be a good idea to seek professional medical help, though you don’t need to visit the emergency room if the rash isn’t accompanied by life-threatening symptoms. These are a few indications that it’s time to see a doctor:
If the rash does not go away and lasts longer than six weeks, which could indicate you’re dealing with chronic hivesIf the welts are causing discomfortIf an individual welt lasts longer than 24 hours and is accompanied by pain
Dr. Choudhury says if any of these symptoms occur, it’s appropriate to see a doctor for a formal diagnosis. You should schedule an appointment with your primary care doctor first. At that appointment, they may refer you to a dermatologist or an allergist. (5) “Both dermatologists and allergists are experts in treating hives,” Choudhury says. In a large percentage of hives cases, however, the reason for the outbreak is not clear, so you and your doctor will need to work together to figure out the cause. (6) When you visit your doctor, they will likely start with a physical exam and will take a look at the welts on your skin. There’s little doubt about how to manage acute hives. “Providers prescribe patients with antihistamines, and it usually goes away,” Choudhury says. When it comes to chronic hives, however, your doctor may recommend additional blood tests and skin tests to determine if there’s an underlying issue. (5) A blood test, for instance, could pick up on a blood protein that’s associated with hereditary angioedema. This disorder is associated with severe swelling, in the absence of hives, and is important to rule out. (7,8) If you visit an allergist, they may call for skin tests, blood tests, or urine tests to try to figure out what’s going on. An additional skin-prick test or blood test may be necessary once the allergist has identified a food that might be triggering the outbreak. (3) A dermatologist will likely diagnose hives simply by looking at your skin, though it’s possible that they may do a skin biopsy, too, during which the affected skin is examined under a microscope. (2) They may also ask: (5)
What are your symptoms, and when did they begin? Have you done anything or taken any medication that has made the symptoms better or worse?How large are the hives? Where on the body have they appeared?How long does it take for a welt to go away?Are the hives painful or accompanied by swelling?What other medications and supplements do you currently take? Did you recently start taking any of these? (Often, a common medication like ibuprofen (Advil) or aspirin can be a trigger for hives in certain individuals.)Have you recently: Had an infection (viral or bacterial)? Experienced any difficulty breathing, feelings of nausea, or lightheadedness? Tried a new food? Returned from a trip to a new place?Do you know if anyone else in your family has experienced hives?
You’ll also want to be prepared to ask your doctor questions at your appointment to help you better understand what’s going on. Plan to ask: (5)
What’s causing my symptoms?What tests will you need to do?How long will the hives last?What are the treatment options? And what side effects do each of these treatments come with?Is it necessary that I take prescription medication? Is there an over-the-counter version I can use instead?Will this treatment interfere with my existing health issues?
Dr. Palep says to also ask how long it will take for treatment to start working, whether the areas of the skin affected by the hives will scar, and how to relieve itchiness, pain, or burning.
