Breaking out in an itchy rash? You could have urticaria

Urticaria, also known as wheal or hives, is a raised and itchy rash that appears on the skin.

Urticaria, also known as wheal or hives, is an allergic rash. It can appear anywhere on the body and join together to form larger affected areas, which trigger itching.

It may be mild and settle down without treatment if distance is maintained from the allergen.

However, if it recurs, the condition may be severe and can be accompanied by other symptoms such as wheezing, difficulty in breathing or even anaphylactic shock.

What is Urticaria?

It is a raised and itchy rash that appears on the skin. It may appear on a singular part of the body or spread across larger areas.

Wheal or hives is not life-threatening but it can cause discomfort throughout the day, even while sleeping.

Signs and symptoms

  • Batches of red or skin-coloured welts that appear on the face, body, hands or feet.
  • Welts that vary in size and shape.
  • Itching.

These symptoms are unpredictable and recurrence may take place within months or years.

There may be other symptoms that could show when you have urticaria. Consult a doctor immediately if you experience any abnormalities.

When to seek medical advice

You should see a doctor if:

  • The symptoms do not improve after two days.
  • The rash is spreading.
  • The rash is causing pain.
  • The rash is affecting the quality of daily life.
  • The rash is accompanied by other symptoms.
  • The rash does not respond to treatment.

You should seek immediate emergency medical care if you experience:

  • Dizziness.
  • Chest tightness or shortness of breath.
  • Dry tongue and throat swelling.

Causes and triggers

The welts that come with hives arise when certain cells release histamine and other chemicals into your bloodstream.

Hives is a common condition affecting people of all ages and tends to occur more often in women than men. You can control this condition by minimising its risk factors but it is best to consult a doctor for more details.

Acute urticaria, which is a condition marked by hives lasting less than six weeks, once affected about one-fifth of the world’s population.

Meanwhile, chronic urticaria or long-term urticaria is less common. Urticaria is common among children, women between the ages of 30 and 60 and those who have a history of allergies.

Women are twice as likely to suffer from urticaria than men.

What factors increase the risk of urticaria?

There are many factors that increase the risk of wheal:

  • Gender: Women are affected twice as often as men.
  • Age: Young people are at greater risk of falling sick from it.

The information provided herein is not a substitute for medical advice. Therefore, always consult with your doctor for more information.

How urticaria is diagnosed

The doctor will conduct a physical exam and ask a series of questions to understand the underlying cause of your signs and symptoms.

You may also be asked to keep a journal of your activities, any medications, herbal remedies or supplements you take, details of your diet, where urticaria appears and how long it takes a welt to fade.

The doctor may also do a blood test and skin test.


Urticaria will usually subside and disappear altogether without treatment in a few days.

In some cases, medications can be taken to reduce discomfort. In some severe cases, you may be prescribed a short course of high-dose corticosteroid tablets, which reduces the symptoms.

The most important aspect in preventing urticaria is to reduce any of the underlying factors that cause the symptoms.

Lifestyle changes and home remedies

You will be able to control this condition if you take the following measures:

  • Wear loose, light clothing.
  • Avoid scratching or using corrosive soaps.
  • Soothe the affected area with a bath, fan, cool cloth, lotion or anti-itch cream.
  • Keep a diary of specific details about the hives and their occurrence (eg what you were doing when it appeared; what you ate before it appeared, etc). This may help identify triggers.
  • Avoid certain types of foods and drinks that cause allergies.

Foods to avoid

Besides medications, people with urticaria should abstain from consuming foods that can aggravate the condition. These include:

  • Stimulants such as tobacco and coffee.
  • Spicy foods such as pepper, chilli.
  • Protein-rich foods such as seafood, chocolate, eggs, milk.
  • Foods high in sugar such as candy, cakes and sweetened porridge.
  • Salt.
  • Hot water, as it can cause skin to be more vulnerable.

Similar to dealing with other allergies, the best treatment of urticaria is to avoid allergens.

Pay attention to the seasons or locations as well as types of foods that can trigger an outbreak.

Although the symptoms can be cured with anti-allergy medication, avoid repeated contact with allergens as the condition would be worse, and will open you up to the possibility of a life-threatening risk called anaphylactic shock.

If you are concerned about any red flags with your health, consult a doctor for advice on the best treatment.

This article first appeared on Hello Doktor and was medically reviewed by Panel Perubatan Hello Doktor. The Hello Health Group does not provide medical advice, diagnosis or treatment.