Hives are raised, swollen areas of the skin (wheals) that are typically itchy and may vary in size and shape.

They often appear as:

• Pink or red welts
• Smooth, raised patches
• Lesions that may merge together
• Areas that change location over hours

Individual hives usually resolve within 24 hours, although new ones may continue to appear.

Hives occur when certain cells in the skin release histamine and other inflammatory mediators, leading to swelling and itching.

Common triggers include:

• Allergic reactions to foods, medications, or environmental exposures
• Infections
• Physical triggers such as pressure, heat, or cold
• Stress

In many cases, especially with chronic hives, a specific trigger may not be identified.

Acute Urticaria

Acute hives typically last less than six weeks and are often related to a specific trigger.

They may occur in response to:

• Food or medication exposure
• Viral or bacterial infections

Chronic Urticaria

Chronic hives persist for more than six weeks and may occur daily or intermittently.

They are often:

• Idiopathic (no clear cause identified)
• Related to underlying immune activity

Physical Urticaria

Certain forms of hives are triggered by physical stimuli.

Examples include:

• Dermatographism (hives from scratching or pressure)
• Cold-induced urticaria
• Heat or exercise-induced urticaria

Clinical Evaluation

Diagnosis is based on the appearance and behavior of the lesions, along with a detailed history.

Important considerations include:

• Duration and frequency of outbreaks
• Associated symptoms
• Potential triggers or exposures
• Response to prior treatments

Additional Testing

In some cases, further evaluation may be recommended, particularly for chronic or atypical hives.

Testing is tailored based on clinical findings.

Antihistamines

Antihistamines are the first-line treatment for hives.

They help:

• Reduce itching
• Decrease the formation of new hives

Dosing may be adjusted based on severity and response.

Additional Medications

For more persistent or severe cases, additional therapies may be considered.

These may include:

• Other anti-inflammatory medications
• Targeted therapies for chronic urticaria

Treatment is selected based on individual needs.

Short-Term Therapies

In acute or severe cases, short courses of additional medications may be used to quickly control symptoms.

Trigger Avoidance

When a trigger is identified, avoiding that exposure is an important part of management. Patients are guided on practical ways to minimize risk.

Treatment focuses on controlling symptoms and preventing recurrence.

For acute hives, therapy is often short-term and resolves once the trigger is removed. For chronic urticaria, a longer-term management plan may be developed, with adjustments based on response.

Many patients experience improvement within days of starting antihistamine therapy.

Chronic cases may take longer to stabilize, requiring ongoing management and adjustment of treatment.

Evaluation is appropriate for patients who:

• Experience recurrent or persistent hives
• Have significant itching or discomfort
• Do not respond to over-the-counter treatments
• Suspect a trigger but are uncertain

Accurate assessment helps guide effective treatment.

At Treiber Dermatology, urticaria is managed with a focus on symptom control, trigger identification, and long-term stability.

Treatment plans are designed to be adaptable, allowing patients to manage flares while maintaining daily comfort.

Patients throughout New York and Connecticut choose Treiber Dermatology for urticaria treatment because of the practice’s expertise in managing complex inflammatory skin conditions.

Care is known for being:

• Thorough and diagnostic-driven
• Practical and easy to follow
• Tailored to individual patterns
• Supportive and responsive

The emphasis is on delivering relief and long-term control.