Urticaria / Hives
Urticaria presents as raised, itchy welts (hives) on the skin. It can be acute (lasting less than 6 weeks) or chronic. Prof. Dr. Usha Gupta authored the chapter on urticaria in the IADVL undergraduate textbook.
Signs and symptoms
Urticaria / Hives commonly presents with the following signs. Not every patient shows all of them — an in-person examination by a dermatologist is what confirms the diagnosis.
Hives (Wheals)
Raised, itchy, red or skin-coloured welts that appear suddenly and may change shape or location within hours. Individual lesions typically resolve within 24 hours.
Affected area: skin (any area)
Itching (Pruritus)
Persistent urge to scratch the skin, which may be localised to a specific area or generalised across the body. Itching can range from mild to severe and may worsen at night.
Affected area: skin (any area)
Swelling (Oedema)
Puffiness or enlargement of skin and underlying tissue, often warm to touch and associated with inflammation or allergic reactions.
Affected area: skin (any area), eyelids, lips
Treatment approach
Management includes identifying triggers, antihistamines (second-generation for fewer side effects), and systemic treatment for chronic cases. We follow a systematic approach to identify the underlying cause — which can range from food allergies to autoimmune conditions.
Common questions
Why can't the cause of my hives be found?
In a large share of long-standing urticaria no external trigger is ever identified, and this is a recognised finding rather than a failure of investigation. Extensive allergy testing in these patients usually produces false leads and a great deal of expense without changing what is prescribed. Treatment is directed at controlling the hives reliably and then reducing medication slowly once control has held, which is a more achievable goal than hunting an allergen that in most cases is not there.