Urticaria Hives Evaluation And Treatment- Allergy/Immunology, Dermatology

Doctors: Allergist

What are hives (urticaria)?

Hives, also known as urticaria, welts, or nettle rash, are a raised, red, itchy skin rash which may be triggered due to an allergen.


Evaluation depends on the type of urticaria.

  • Acute urticaria: In the cases of acute urticaria, allergy testing would be helpful to find a specific allergen responsible for the trigger. Acute urticaria may be diagnosed by examining the rash on the skin.  Patient may be asked following questions:
    • Patient’s family history, medical history along with use of current medications
    • Patient’s work environment and living conditions
    • When and where the episode began?
    • Are there any incidents of an insect bite?
    • If acute urticarial is due to any allergen, blood tests and skin tests are done to identify specific allergen.
  • Chronic urticaria: If the urticaria continues for more than 6 weeks, allergy tests are not recommended as it is not due to any allergen. At this stage, some underlying health condition is causing chronic urticaria. The following tests can check for underlying health conditions:
    • Blood test (for anemia)
    • Stool sample to identify any presence of parasites
    • Erythrocyte sedimentation rate (ESR) test to identify problems related to the immune system
    • Thyroid function test
    • Liver function tests


Patient is advised to avoid known allergens/triggers. For acute urticaria, non-sedating antihistamines are prescribed for several weeks. Antihistamines help by blocking the effects of histamines and help to reduce rash and stop itching. An epinephrine auto-injector, for example, EpiPen, is prescribed in severe cases (swelling of the tongue or lips) in case of emergencies. If any medicine is causing the condition, doctor may prescribe an alternate medication.



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About the Author:

Dr. Anand Lakhkar is a physician scientist from India. He completed his basic medical education from India and his postgraduate training in pharmacology from the United States. He has a MS degree in pharmacology from New York Medical College, a MS degree in Cancer/Neuro Pharmacology from Georgetown University and a PhD in Pharmacology from New York Medical College where he was the recipient of the Graduate Faculty Council Award for academic and research excellence.  His research area of expertise is in pulmonary hypertension, traumatic brain injury and cardiovascular pharmacology.  He has multiple publications in international peer-reviewed journals and has presented his research at at prestigious conferences.