Treatment

The best approach to treatment depends on the cause and whether the issue is acute or chronic.

Acute urticaria

If symptoms are mild and occur after exposure to an allergen or irritant, home remedies can usually soothe the itchiness until the rash disappears.

Options that a doctor may recommend include:

• non-sedating antihistamines, such as cetirizine (Zyrtec) or fexofenadine (Allegra)
• short-term use of topical steroids
• antiseptic creams to prevent a secondary infection
• soothing creams to reduce itchiness

If there are signs of allergy, and the person has swelling in their lips, face, or tongue, the doctor may prescribe an epinephrine auto-injector to carry for use in emergencies.

Chronic urticaria

A person with chronic urticaria may need to take antihistamines regularly until their symptoms resolve.

Omalizumab (Xolair) is an injectable drug that blocks immunoglobulin E, a substance that plays a role in allergic responses. It can reduce symptoms of chronic spontaneous urticaria, a type of hives with an unknown origin.

Meanwhile, a 2016 review concluded that acupuncture might help relieve chronic urticaria, though there is not enough evidence to confirm that this is a safe, effective treatment.

Chronic hives can lead to severe discomfort, distress, and possibly depression. Stress, too, can aggravate hives. And having hives can worsen stress. Anyone who feels that hives is affecting their quality of life or mental well-being should speak with a doctor.

If tests reveal an underlying disease, such as lupus, the doctor will recommend treatment for this.