Antihistamines are the main medication used in the management of hives. Histamine is the chemical in the skin that is responsible for causing the symptoms of hives and other allergies. It is released by allergy cells in response to allergy-causing stimuli. Antihistamines work by blocking this chemical, and they are available either over the counter or by prescription. Some of the older antihistamines cause drowsiness, so the newer or non-sedating antihistamines are preferred. They are very effective with few side effects, and most are long-lasting so they may be taken once a day for relief. 

If hives are severe or interfering significantly with daily activities, we will sometimes treat temporarily with oral steroids or other immune modulators to reduce the severity of symptoms. This is often a temporary measure and not a long-term solution.

If the cause of hives is known, the absolute best treatment is to avoid or eliminate the trigger. Some useful tips include:

  • Food: If foods are a known cause of your hives, don't eat particular foods that have been identified as a cause of symptoms.
  • Scratching: If rubbing or scratching is the cause, avoid harsh soaps and other factors that cause dry skin.
  • Pressure: Pressure hives can be partially relieved by wearing loose-fitting clothing and avoiding excess pressure on the skin from grocery bags.
  • Exercise: Cholinergic urticaria can be helped by avoiding stimuli that cause excessive sweating or stress.
  • Temperature: If cold has been identified as a cause, avoid cold exposure as much as possible. Do not swim in cold water, or if you must, be prepared by carrying an epi-pen with you. If cold weather cannot be avoided, wear warm protective clothing including a scarf around the nose and mouth and gloves on the hands.
  • Sun exposure: If sun is a cause, follow sun-protective measures year-round (we want you to be doing this anyway!).
  • Medications: If you think a medication may be the cause of your hives, let your physician know immediately.


Sometimes hives can last for months and are then known as chronic hives. With chronic hives, sometimes the cause cannot be identified, and they may be associated with underlying immune findings, thyroid disorders, other hormonal problems, or, in very rare cases, cancers. A thorough discussion and evaluation is important in these instances, and treatment is then aimed at alleviating symptoms.

Read more about hives in these related links: