Reviewed by The Wellness Team. Last reviewed October 2026.
Raised, itchy weals that appear from nowhere and vanish within hours are one of the most common reasons people look for skin advice. Hives affect around one in five of us at some point, and while they look alarming, most cases settle with simple treatment.
This guide explains what hives are, what triggers them, what actually calms them, and when a rash needs urgent care.
What hives are
Hives, known medically as urticaria, are raised patches of skin, called weals, that can be red or skin coloured and are usually intensely itchy. They come from a sudden release of histamine and other chemicals from cells in the skin, which makes small blood vessels leak fluid into the surrounding tissue.
Two features make hives recognisable. Each individual weal comes and goes within 24 hours, often much faster, and the rash moves around the body. A patch on your arm at breakfast can be gone by lunch and replaced by a new one on your back by dinner. If a single spot stays put for days, that is a different sort of rash and worth having checked.
Some people also get deeper swelling, called angioedema, most often around the eyes and lips. This can look dramatic but usually settles the same way.
Common triggers
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In many cases no single trigger is ever found, and that is normal. When a cause can be identified, the usual suspects are:
- A recent infection, often a simple cold or sore throat, especially in children
- Foods such as nuts, shellfish, eggs and some fruits, usually causing hives within minutes to two hours
- Medicines, particularly ibuprofen and other anti-inflammatories, aspirin, some antibiotics and occasionally blood pressure tablets called ACE inhibitors
- Physical triggers: pressure from tight clothing or a bag strap, heat, cold, sunlight, water and exercise
- Stress, which does not cause hives directly but is a well recognised aggravator
Acute and chronic hives
Acute hives last less than six weeks and most cases clear within days to a couple of weeks. Chronic hives carry on, or keep coming back, beyond six weeks. Chronic urticaria affects around one in a hundred people, is rarely an allergy, and is usually driven by the immune system rather than anything you are eating or touching. It is uncomfortable but very treatable, and it burns itself out in time.
Treatment that works
The first line treatment is a non-drowsy antihistamine taken every day, not just when the rash appears. Cetirizine, loratadine and fexofenadine are the ones doctors reach for first, and guidelines support increasing the dose up to fourfold under medical supervision when standard doses do not control the rash. Old-fashioned sedating antihistamines are best kept for short-term night use when the itch is stopping sleep.
Alongside antihistamines:
- Keep the skin cool; a cool shower or cold compress eases the itch
- Avoid very hot baths, tight clothing and anything you have noticed sets the rash off
- Go easy on alcohol and anti-inflammatory painkillers such as ibuprofen, which can aggravate hives
- Take a photo of the rash when it flares; individual weals disappear, so a photo genuinely helps a doctor
Steroid tablets are sometimes used for a few days for a severe flare, but they are not a long-term answer. Chronic hives that do not respond to antihistamines have further options a specialist can offer.
When hives are an emergency
Call 999 straight away if hives come with swelling of the tongue or throat, difficulty breathing, a tight chest, dizziness or collapse. Those are signs of anaphylaxis, which is a medical emergency.
What a GP can do
A doctor can usually confirm hives from the pattern you describe and a photo. The useful things a consultation adds are a check for triggers in your medicines and recent illnesses, a proper antihistamine plan, and blood tests where the rash has become chronic. Current guidance suggests a full blood count, inflammatory markers and thyroid tests for chronic urticaria, since an underactive thyroid is a recognised association.
A video consultation is £150, a telephone consultation is £59 and an in-person consultation is £220, and any prescription can usually be sent to your preferred pharmacy the same day.
To talk to a doctor, message WhatsApp, call 020 3951 3429 or email team@thewellnesslondon.com.
Questions people ask
How long do hives last?
Each individual weal lasts less than 24 hours, even though the rash as a whole can keep moving around for days. Acute hives usually settle within a few days to a couple of weeks. Hives that keep coming back beyond six weeks are called chronic and are worth a proper assessment.
Are hives contagious?
No. Hives are a reaction inside your own skin and cannot be passed to anyone else.
Can stress cause hives?
Stress is a recognised aggravator rather than a root cause. Many people notice flares during pressured periods, and physical stress responses such as heat and sweating can also trigger the rash. Managing stress helps, but antihistamines are the mainstay.
When should I see a doctor about hives?
See a doctor if the rash keeps coming back, lasts more than a couple of weeks, is not controlled by over-the-counter antihistamines, or interferes with sleep and daily life. Swelling of the face, lips or eyes also deserves medical review. Tongue or throat swelling, breathing difficulty or dizziness mean call 999.
Can I get hives treatment online?
Yes. Hives are well suited to a video or telephone consultation because the pattern and a photo usually tell the story. A doctor can confirm the diagnosis, prescribe a full-strength antihistamine plan and arrange blood tests if the rash has become chronic, usually the same day.