What You Need to Know About Hives

Hives occur when something prompts cells to release histamine, a chemical found in the skin. The histamine causes nearby blood vessels to dilate. Fluid leaks out of the dilated vessels and collects under the skin in a raised, flushed, itchy bump called a wheal or hive. Some wheals look like mosquito bites. Wheals often come in groups and may be as small as pencil erasers or as large as 2 to 3 inches across.

Some people know that certain foods or drugs give them hives. For most others, the causes may not be obvious.

"Acute" hives, or hives that are a reaction to a stimulus such as a drug, can last for hours or days. Chronic hives, often of unknown cause, can last for weeks or months.

Some foods that occasionally cause hives are peanuts and other nuts; eggs; beans; chocolate; strawberries and other berries; tomatoes; seasonings, such as mustard, ketchup, mayonnaise and spices; fresh fruits, especially citrus fruits, mango and papaya; corn; freshwater fish; shellfish; milk; wheat, and cheese.

Drugs that can cause hives include penicillin, sulfa drugs and codeine.

Extensive hive breakouts can be very serious, especially when hives form on the lips and in the throat, interfering with breathing and swallowing. Shock—in which severe swelling, dizziness and even loss of consciousness occur—can accompany widespread hives.

Self-care for hives

  • Take an oral antihistamine; be aware of drowsiness.

  • Rub ice directly over the hives or take a cool shower for temporary relief from itching.

  • Try a topical anti-itch cream.

  • Soak in a lukewarm or cool bath with one cup of baking soda or an oatmeal product.

  • If hives develop after a bee sting or an insect bite, see a health care provider. You may need a prescription kit to counteract the reaction. A kit contains an injectable dose of epinephrine.

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