Hives are a collective term for the allergic reaction called urticaria. Hives are characterized by a sudden outbreak of swollen, pale-red bumps called as welts on the skin. It usually lasts for 6 to 24 hours and does pose any health threat if the severity is normal. Hives typically occur as an allergic reaction to a substance, such as food, body products, etc., that you encounter or swallow. The non-sedating variant of antihistamines is mostly used for mild hives treatment. There are other conventional hives treatment as well, and if you are inclined to oriental medicine, ancient therapies, and home remedies, then you will not be disappointed either.

What are hives?

When our body comes into contact with an allergen, it releases a protein called histamine as a part of its defense mechanism. A significant amount of histamine leads to severe itching, swelling, and redness.

Hives rashes usually have defined edges, and they appear in varying shapes and sizes. Though wretched hives are considered harmless, and they tend to disappear within 24 hours. Also, hives are not a contagious disease.

What are hives symptoms?

Common hives symptoms are swelling of skin into pink or red welts or patches. If hives have occurred in reaction to some food, welts will occur either single in number or a group.

Welts can form a pattern with defined edges. The most common welt type is circular with a pale center and a red halo. Sometimes small welts join together to create a large area of raised skin.

If the allergy persists, another group of welts will appear at a different location after the first pattern disappears. In case of an extreme allergic reaction, angioedema can occur, which can cause severe swelling.

What causes hives?

Hives can occur for different reasons in different individuals.

Food allergy

The most common cause of hives encountered is food. Fruits such as citrus fruits, dairy products, peanuts, tomatoes, fresh berries, and shellfish are the few common allergens that are known to cause an allergic reaction in certain individuals.

Food additives, artificial colors such as Tartrazine and flavor enhancers such as MSG can also cause hives.

Drug allergy

Certain drugs can cause an acute allergic reaction in people, many people have known to be allergic to sulfa drugs or penicillin. Drugs following in the NSAIDS category such as aspirin and ibuprofen, anti-seizure medication can also cause hives.

Insect bite and animal contact

Insect bites and stings like bees and wasp stings can cause a severe allergic reaction. Sometimes people are allergic to certain animals like cats, dogs or horses and on coming in physical contact with them, an allergic reaction ensues.

Coming in contact with animal dander can also cause a reaction. Pollen can also trigger urticaria in some people who are allergic to it.

Chemicals and other causes

Coming in contact with a particular object like latex can also cause a reaction. Allergy shots, encountering certain chemicals can cause hives.

Infections, including colds and diseases caused by some bacteria or fungi, produce urticaria. Some illnesses, including a type of vasculitis, lupus, and thyroid disease have known to be associated with the occurrence of hives.

Extreme exercise and stress can also lead to an episode. Pressure on the skin, such as from sitting too long against an uneven surface; scratching the skin can also cause hives. Sun exposure, exposure to extreme change in temperature can cause physical hives (1).

Different types of hives

Hives in a broader way can be classified into following categories.

Acute Hives

This type of hives includes reaction which lasts less than six weeks. The most common causes are medicines, foods, latex, and infections.

Chronic hives

Chronic hives are also called recurrent hives. They tend to last longer than six weeks. The causes may be similar to acute urticaria, but may also include autoimmune conditions like lupus and malignancies (2).

Physical hives

Direct physical stimulation of the skin causes physical urticaria or hives. Exposure to sunlight, heat, cold air or water, pressure or vibration, sweating, and exercise can trigger a reaction.

Dermatographism is a type of physical urticaria which happens when the skin goes through stroking. It is an exaggerated wealing tendency.

Hereditary angioedema

Hereditary angioedema is rare and potentially life-threatening genetic condition. Minor trauma or stress can trigger an attack, but in most cases, swelling occurs without a known trigger.

Conventional hives treatment

For a mild or moderate case of hives, the most common hives treatment is a non-sedating variant of antihistamines (3). Antihistamines like Benadryl is most commonly used for hives. Drugs such as cetirizine or fexofenadine can also be used for the acute reaction. Antihistamines relieve symptoms like itching, redness, and swelling.

Corticosteroids like prednisone that suppresses the overly active immune reaction. Dapsone which is an antibiotic can also be prescribed as it relieves redness and swelling.

Omalizumab is an injectable medicine prescribed for patients diagnosed with chronic idiopathic urticaria. The doctor can also prescribe epinephrine auto-injector for people suffering from CIU.

Home remedies for hives treatment

1. Cold compress

Cold temperature helps shrink the blood vessels and block further release of histamine. This provides relief from swelling, inflammation, and itching. Also, a mere cold shower can provide you momentary relief from hives.

Also, make sure that you exercise caution while using body care products, such as soaps, cream, etc., which can worsen your itching and inflammation.

2. Baking Soda

Baking soda is another popular remedy for urticarial as it contains a significant amount of sodium bicarbonate. Take a teaspoon of baking soda and mix it with regular water.

Apply this mix on the affected area and wash it off after it dries completely. Baking soda has anti-inflammatory properties, which will help in reduction of itching and swelling associated with urticaria (4).

3. Apple Cider Vinegar

Apple cider vinegar is an excellent remedy for hives. Its antihistamine properties will help relieve inflammation quickly and regulate the body’s immune system response.

Mix two cups of apple cider vinegar in a tub full of water and stay in it for about 15 minutes. You can also apply an equal amount of apple cider vinegar with water and use this mixture on the affected area.

4. Oatmeal bath

Oatmeal works very well for hives. It has potent anti-irritating, anti-inflammatory and soothing properties that help provide relief from itching. But you do not have to eat oatmeal. Instead, go for an oatmeal bath.

Put one bowl of uncooked oats in a muslin or cheesecloth, tie it nicely to seal any chance of leakage. Put it in bath water and wait for a few minutes for letting oats to infuse in the water. Oats have natural salicylic acid content which can calm hives eruptions (5).

5. Turmeric

Turmeric is known for its active anti-inflammatory properties and helps stimulate the body’s natural anti-inflammatory corticosteroids. It can be applied in conjunction with honey for added benefits.

6. Witch hazel

Witch hazel is a skin-healing liquid that has potent antioxidant and astringent properties. They help reduce the redness and swelling seen in hives.

7. Primrose

Evening primrose oil has been proven to be effective in treating the itching and burning sensation in cases of urticaria due to its active ingredient gamma-linolenic acid.

8. Nettle

Nettle has been considered to be an alternative for hives treatment. It has antihistamine and has anti-inflammatory and astringent properties, which relieves swelling, inflammation, and itching. Care should be taken to do a patch test first as some people with chronic hives can be even allergic to nettle.

9. Mint

Mint is also a known remedy for hives. The thymol present in mint provides the cooling relief needed for urticaria. It has anti-inflammatory and antioxidant properties that help reduce the itching and burning sensations very quickly.

10. Acupuncture

By now you must have understood that the best hives treatment plan is to treat the imbalance inside your body. Acupuncture is one such Chinese medicine practice which can cure chronic hives for good.

Several acupuncture points exist, but it may vary case to case depending on symptoms and condition of the disease. Common acupuncture points for hives treatment are Large Intestine 11 (LI 11) and Spleen 10 (SP 10) (6).

11. Take supplements

You can go for supplements such as quercetin, evening primrose, vitamin B12, vitamin D, vitamin C and fish oil for getting relief from hives. Quercetin is a natural medicine for allergies and has anti-inflammatory properties.

Also, quercetin has antihistamine properties and can prevent immune cells from releasing histamines.

Final words on hives treatment

People who have had an allergic reaction must remember to avoid the allergens in future, to prevent the risk of another episode of hives. Extreme stress, exercise, wearing tight-fitting clothes, exposure to sunlight should be kept in check to avoid physical hives.

If at all you become the victim of hive disease then do not panic and follow different hives treatment options mentioned above. Chronic hives patients are recommended to refer a dermatologist or an allergy specialist for further investigation.