Red flags & when to go in person for Hives (Urticaria)

Audience: adult

Hives, also called urticaria, are red, itchy bumps or welts on the skin that often appear suddenly. They can be caused by allergies, infections, stress, or other triggers. Most hives go away on their own or with simple treatments like antihistamines. However, sometimes hives can signal a more serious problem that needs urgent care. This guide helps you understand when hives can be safely managed through telemedicine and when you should seek in-person medical attention. It also explains warning signs to watch for, how to prepare for a telemedicine visit, and what to expect afterward. Remember, this information is educational and not a substitute for professional diagnosis or treatment. If you experience severe symptoms or feel unsure, it is important to get medical help promptly.

Red flags — go in person / ER

• Difficulty breathing, wheezing, or tightness in the throat — seek emergency care immediately.
• Swelling of the face, lips, tongue, or throat (angioedema) — go to the emergency room right away.
• Dizziness, fainting, or rapid heartbeat — these may signal a severe allergic reaction requiring urgent attention.

What telemedicine can do

• Assessment of mild to moderate hives without severe symptoms.
• Guidance on over-the-counter antihistamines and symptom management.
• Advice on avoiding known triggers and when to seek in-person care.

What telemedicine cannot do

• Severe allergic reactions with breathing difficulty or swelling.
• Hives accompanied by signs of infection like high fever or severe pain.
• Unstable vital signs or symptoms suggesting anaphylaxis or other emergencies.

What Are Hives (Urticaria)?

Hives are raised, red or skin-colored bumps or welts that often itch. They can vary in size and shape and may appear anywhere on the body. Hives usually come and go within hours but can last days or longer. They happen when the body releases histamine and other chemicals in response to triggers like allergens, infections, or stress.

Common Causes and Triggers

Hives can be triggered by many things, including:

Identifying and avoiding triggers can help reduce outbreaks.

When to Use Telemedicine for Hives

Telemedicine can often help you manage mild to moderate hives. A healthcare provider can:

Telemedicine is useful when symptoms are stable and there are no signs of severe allergic reactions.

Red Flags: When to Seek In-Person Care Immediately

Seek emergency care if you experience:

These signs may indicate a serious allergic reaction or other urgent condition.

Preparing for Your Telemedicine Visit

Before your tele-visit:

This information helps your provider assess your condition accurately.

Aftercare and Monitoring

After your telemedicine visit, follow your provider's advice carefully. This may include:

Keep a symptom diary if hives recur frequently to help identify patterns.

How to prepare for your tele-visit

• Note the time of onset and progression of hives.
• List any recent exposures to foods, medications, or environmental triggers.
• Prepare a list of current medications and known allergies.
• Take clear photos of the affected skin areas.
• Be ready to describe any other symptoms such as swelling, difficulty breathing, or dizziness.

After your tele-visit

• Follow the treatment plan or medication instructions provided by your healthcare provider.
• Avoid known triggers identified during your telemedicine visit.
• Monitor your symptoms daily and note any changes or new symptoms.
• Seek in-person care promptly if red flag symptoms develop or worsen.
• Schedule follow-up appointments if recommended by your provider.

FAQs

Can hives go away on their own?

Yes, many cases of hives resolve without treatment within a few hours to days. Avoiding triggers and using antihistamines can help reduce symptoms.

Are hives contagious?

No, hives are not contagious. They are a reaction of your immune system and cannot be spread to others.

When should I worry about hives?

You should seek immediate medical care if you have difficulty breathing, swelling of the face or throat, dizziness, or other severe symptoms. Otherwise, persistent or frequent hives should be evaluated by a healthcare provider.

Can stress cause hives?

Yes, stress can trigger or worsen hives in some people by affecting the immune system and releasing chemicals that cause skin reactions.

What treatments are available for hives?

Mild hives often improve with over-the-counter antihistamines. Severe or chronic cases may require prescription medications or further evaluation.

Sources

1. Urticaria (Hives) — MedlinePlus, U.S. National Library of Medicine / National Institutes of Health.
2. Hives (Urticaria) — Mayo Clinic.
3. Urticaria and Angioedema — National Institute of Allergy and Infectious Diseases (NIAID).
4. Allergic Reactions: Hives and Angioedema — Centers for Disease Control and Prevention (CDC).

This telemedicine guidance is for educational purposes only and is not a substitute for in-person medical care. If you experience severe symptoms or are unsure about your condition, seek immediate medical attention.