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What Is the Difference between Urticaria and Hives?

Urticaria is the medical term for what's commonly known as hives, which are red, itchy welts on the skin. While they're essentially the same condition, "urticaria" often refers to a chronic or recurrent issue, whereas "hives" might imply a one-time reaction. Intrigued by what triggers them and how they differ in severity? Join us as we uncover the nuances.
Drue Tibbits
Drue Tibbits

There is no difference between urticaria and hives. Urticaria is a skin condition that causes intense itching and rapid development of raised, smooth patches of skin. It is commonly called hives, and is often the sign of an allergic reaction. This condition occurs most often on the face and trunk. Occasionally, the affected area extends to the throat and causes difficulty in breathing. In these severe cases, emergency injections of epinephrine or corticosteroids may be required.

Urticaria is characterized by an outbreak of red and white welts of varying size that appear suddenly either in small areas or all over the body. The welts often appear and disappear, lasting anywhere from a few minutes to a day or two. Sometimes, the outbreak can last for weeks. Acute urticaria lasts less than six weeks, while the chronic form lasts longer. Additional symptoms such as intense itching, fever, and nausea can accompany the hives.

Small cluster of hives.
Small cluster of hives.

This condition can be caused by an allergy to certain foods, particularly shellfish, strawberries, or tomatoes. Urticaria can also be a reaction to drugs, food dyes, or animal skin. Contact with certain plants, insect bites, and insect stings can also result in an outbreak. Cold weather, sunlight, and exercise have been known to cause urticaria and hives too. A predisposition to hives tends to run in families.

Anti-itch cream can be applied to alleviate the symptoms of hives.
Anti-itch cream can be applied to alleviate the symptoms of hives.

A diagnosis of urticaria is based on the observance of the symptoms. If a patient suffers repeated outbreaks of hives, his or her physician may need to perform allergy tests to pinpoint the cause. Allergy testing can be extensive and take time as suspected triggers are tested individually before they can be discounted. Eliminating many suspect foods and then reintroducing them one at a time sometimes helps to identify the cause.

The itching and welts of urticaria and hives are treated with antihistamines. When taken several times a day at a prescribed dosage, the correct type of antihistamine will help control swelling by preventing the released histamine from triggering the hives. Drowsiness and dry mouth are common side effects of antihistamines, so the type and dosage may need to be adjusted periodically to minimize discomfort. Serious urticaria outbreaks are sometimes treated with corticosteroids to reduce inflammation.

Prevention of urticaria and hives is accomplished by avoiding contact with the triggering substance or allergen. Sometimes, the triggering substances or allergens cannot be identified. Hives that develop from unknown causes are called idiopathic. Idiopathic urticaria can result in chronic episodes of itching and welts and may require regular treatment with antihistamines or a combination of antihistamines and corticosteroids.

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Discussion Comments


@fBoyle-- I've heard of people with severe urticaria using immunosuppressant drugs.

Hives and urticaria are the same thing. But when hives occurs very often for long periods and when the doctor has trouble identifying the cause, it can be referred to as urticaria or chronic urticaria. Technically though, there is no difference between the two conditions.

I used to get hives often but then discovered that the cause was a food allergy (nuts). I eliminated all nuts from my diet and have not had hives since.

But apparently, allergy test results may not come back positive even though someone continues to have hives. My doctor told me that when this happens, they will give alternative medicines to relieve symptoms like immunosuppressants or even psychoactive (sedative type) drugs. If a drug is working for you, that's great.


@MikeMason-- Has your doctor given you anything other than antihistamines?

My doctor gave me an immunosuppressant drug to help treat my urticaria. I've never heard of hives being treated this way.


I've been diagnosed with chronic urticaria. I've had hives almost every single day for the past three months. Antihistamines work for a short while but don't relieve my symptoms completely. My doctor is still trying to figure out the cause. Right now, it doesn't appear to be due to anything specific. I think my body is not responding to histamines properly.

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    • Small cluster of hives.
      By: Rob Byron
      Small cluster of hives.
    • Anti-itch cream can be applied to alleviate the symptoms of hives.
      By: picsfive
      Anti-itch cream can be applied to alleviate the symptoms of hives.