To diagnose hives or angioedema, your doctor will likely look at any hives or areas of swelling and ask about your medical history.
You may also need blood tests or an allergy skin test.
If your symptoms are mild, you may not need treatment. Urticaria and angioedema often go away without intervention. But treatment can offer relief for severe itching, severe discomfort, or symptoms that persist.
Treatments for hives and angioedema may include prescription medications:
- Anti-itch medications. The standard treatment for urticaria and angioedema is non-drowsy antihistamines. These medications reduce itching, swelling, and other allergy symptoms. They are available in over-the-counter and prescription formulations.
- Drugs that suppress the immune system. If antihistamines are ineffective, your doctor might prescribe a medication that can calm an overactive immune system.
- Medications for hereditary angioedema. If you have the type of angioedema that runs in families, you can take medications to relieve symptoms and keep the levels of certain proteins in your blood at levels that don't cause symptoms.
- Anti-inflammatory drugs. For severe hives or angioedema, doctors may prescribe short-term treatment with an oral corticosteroid medication (such as prednisone) to reduce swelling, inflammation, and itching.
In the event of a severe attack of hives or angioedema, you may need to go to the emergency room for an emergency injection of epinephrine (a type of adrenaline). If you've already had a severe seizure or if you have recurring seizures despite treatment, your doctor may recommend that you carry a pen-like device to self-inject epinephrine in an emergency.
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Lifestyle and home remedies
If you have mild hives or angioedema, these tips may help relieve your symptoms:
- Avoid triggers. These can include food, medicine, pollen, pet dander, latex, and insect bites. If you think a medication caused your rash, stop using it and contact your primary healthcare provider. Some studies suggest that stress or fatigue can trigger hives.
- Use an over-the-counter anti-itch medication. An over-the-counter oral antihistamine, such as loratadine (Alavert, Claritin, or others), cetirizine (Zyrtec Allergy, or others), or diphenhydramine (Benadryl Allergy, or others), may help relieve itching. Consider whether you prefer a non-drowsy type. Ask your pharmacist about the options.
- Apply cold. Covering the affected area with a cool cloth or rubbing an ice cube on it for a few minutes can help soothe the skin and prevent scratching.
- Take a cool and comfortable bath. Find relief from itching in a cool shower or bath. Some people may also benefit from bathing in cool water sprinkled with baking soda or oatmeal powder (Aveeno or others), but this is not a solution for long-term control of chronic itching.
- Wear loose-fitting, soft-textured cotton clothing. Avoid wearing clothing that is rough, tight, itchy, or made of wool.
- Protect your skin from the sun. Apply sunscreen liberally a half hour before going outdoors. When you're outdoors, seek shade to help ease discomfort.
Preparation for consultation
You'll likely start by seeing your primary care doctor. In some cases, when you call to schedule an appointment, you may be immediately referred to a specialist in skin conditions (dermatologist) or an allergy specialist.
What can you do
Here are some tips to help you prepare for your doctor's appointment.
- Write down your signs and symptoms, when they occurred, and how long they lasted.
- Write down any medications you are taking, including vitamins, herbal medicines, and supplements. Even better, bring the original bottles and a list of dosages and instructions.
- Prepare a list of questions to ask the doctor.
For hives and angioedema, here are some questions you can ask:
- What could be causing the symptoms?
- Do I need any tests to confirm the diagnosis?
- What are other possible causes of the symptoms?
- Is my condition likely to be temporary or chronic?
- What are the best measures to take?
- What are the alternatives to the main approach that you indicate?
- Do I need prescription drugs or can I use over-the-counter drugs to treat the condition?
- What results can I expect?
- Can I wait to see if the condition goes away on its own?
What to expect from the doctor
Your doctor is likely to ask you questions such as:
- When did you start having symptoms?
- What did the skin reaction look like when it first appeared?
- Have the symptoms changed over time?
- Have you noticed anything that makes your symptoms worse or better?
- Are your skin lesions primarily itchy, burning, or stinging?
- Do the skin lesions completely disappear without leaving bruises or marks?
- Do you have any known allergies?
- Have you ever had a similar skin reaction before?
- Have you tried a new food for the first time, changed laundry products, or adopted a new pet?
- What prescription or over-the-counter medications and supplements are you taking?
- Have you started taking new medications or started any new treatment with medications you have taken before?
- Has your general state of health changed recently? Have you had a fever or have you lost weight?
- Do you have a family member who has ever had this type of skin reaction? Do you have a family member with any known allergies?
- The most important thing is to visit your doctor and clear up any doubts.