Red flags & when to go in person for Hives

Audience: adult

Hives, also known as urticaria, are raised, itchy bumps or welts on the skin that often appear suddenly. They can result from allergic reactions, infections, stress, or other triggers. Many cases of hives are mild and can be managed safely through telemedicine, where a healthcare provider can assess symptoms, suggest treatments, and offer advice. However, some signs indicate a more serious problem requiring in-person evaluation. These include difficulty breathing, swelling of the face or throat, or widespread rash with fever. Recognizing these red flags is important to ensure timely care. Telemedicine can help guide you on managing symptoms and deciding when to seek emergency or in-person care. This article explains when telemedicine is appropriate for hives and when you should go to a healthcare facility for further evaluation.

Red flags — go in person / ER

• Difficulty breathing, wheezing, or throat tightness — seek emergency care immediately.
• Swelling of face, lips, tongue, or throat (angioedema) — go to emergency services without delay.
• Hives with fever, widespread rash, dizziness, or fainting — seek urgent in-person evaluation.

What telemedicine can do

• Assessment of mild to moderate hives symptoms.
• Review of medical history and possible triggers.
• Guidance on over-the-counter antihistamines and symptom management.
• Monitoring symptom progression and advising on follow-up.

What telemedicine cannot do

• Severe allergic reactions with breathing difficulty or swelling.
• Hives accompanied by systemic symptoms like fever and fainting.
• Cases requiring immediate emergency interventions or advanced diagnostics.

What Are Hives?

Hives are raised, red or skin-colored bumps or welts on the skin 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 for days or weeks in some cases. They occur when the body releases histamine and other chemicals, often due to an allergic reaction or other triggers.

Common Causes of Hives

Hives can be caused by many factors, including:

Sometimes, the exact cause is not found.

When Telemedicine Can Help

Telemedicine is useful for evaluating mild to moderate hives. A healthcare provider can:

This approach can save time and reduce exposure to illnesses in healthcare settings.

Red Flags: When to Seek In-Person Care Immediately

Certain signs mean you should get urgent medical attention in person or call emergency services:

These symptoms may indicate a severe allergic reaction or other serious conditions.

Preparing for Your Telemedicine Visit

To make the most of your tele-visit:

Aftercare and Monitoring

After your telemedicine visit, follow your provider’s instructions carefully. Monitor your symptoms closely. If hives worsen, spread rapidly, or you develop any red flag signs, seek in-person care immediately. Keep track of any new triggers or reactions and report them during follow-up visits.

How to prepare for your tele-visit

• Prepare a clear description of your hives including onset, duration, and any triggers.
• List all current medications and any treatments tried for hives.
• Ensure good lighting and camera quality to show the rash if possible.
• Have your medical history and allergy information ready.
• Write down any questions or concerns you want to discuss.

After your tele-visit

• Follow the treatment plan and medication instructions provided.
• Monitor your symptoms daily and note any changes.
• Avoid known triggers as advised by your provider.
• Contact your healthcare provider if symptoms worsen or new red flags appear.
• Schedule follow-up appointments if recommended.

FAQs

Can hives be treated through telemedicine?

Yes, many cases of mild to moderate hives can be managed through telemedicine. A healthcare provider can assess your symptoms, suggest treatments like antihistamines, and provide advice on avoiding triggers.

When should I go to the emergency room for hives?

Seek emergency care if you have difficulty breathing, swelling of the face or throat, dizziness, fainting, or hives with fever and widespread rash. These may be signs of a severe allergic reaction requiring immediate treatment.

Are hives contagious?

No, hives are not contagious. They are usually caused by allergic reactions or other triggers and cannot be spread from person to person.

What triggers hives?

Common triggers include allergic reactions to foods, medications, insect stings, infections, stress, temperature changes, and pressure on the skin. Sometimes the cause is unknown.

How long do hives usually last?

Hives often come and go within a few hours to days. If they last more than six weeks, it is considered chronic urticaria and may require further evaluation.

Sources

1. Urticaria (Hives) — MedlinePlus | U.S. National Library of Medicine.
2. Hives (Urticaria) — Mayo Clinic.
3. Allergic Reactions — Centers for Disease Control and Prevention (CDC).
4. Urticaria and Angioedema — Merck Manuals Consumer Version.

This telemedicine guidance is for educational purposes only and is not a substitute for professional in-person medical care. If you experience any red flag symptoms or have concerns about your health, seek immediate medical attention.