Your doctor will examine any welts or areas of swelling and take a careful medical history to identify possible causes of your signs and symptoms. In some cases, you may be asked to undergo a skin-prick allergy test or other tests.
If your symptoms are mild, you may not need treatment. Hives and angioedema often clear up on their own. But treatment can offer relief for intense itching, serious discomfort or symptoms that persist.
Treatments for hives and angioedema may include prescription drugs, including:
- Anti-itch drugs. The standard treatment for hives and angioedema are antihistamines that don't make you drowsy. These medications reduce itching, swelling and other allergy symptoms. They're available over-the-counter or by prescription.
- Anti-inflammatory drugs. For severe hives or angioedema, doctors may sometimes prescribe an oral corticosteroid drug — such as prednisone — to reduce swelling, redness and itching.
- Drugs that suppress the immune system. If antihistamines and corticosteroids are ineffective, your doctor might prescribe a drug capable of calming an overactive immune system.
For a severe attack of hives or angioedema, you may need a trip to the emergency room and an emergency injection of epinephrine — a type of adrenaline. If you have had a serious attack or your attacks recur, despite treatment, your doctor may have you carry a pen-like device that will allow you to self-inject epinephrine in emergencies.
Lifestyle and home remedies
If you're experiencing mild hives or angioedema, these tips may help relieve your symptoms:
- Avoid triggers. These can include foods, medications, pollen, pet dander, latex and insect stings. If you think a medication caused your rash, stop using it and contact your primary care provider.
- Use an over-the-counter anti-itch drug. A nonprescription oral antihistamine, such as loratadine (Claritin), cetirizine (Zyrtec Allergy) or diphenhydramine (Benadryl Allergy, others), may help relieve itching. Consider whether you might prefer a type that doesn't cause drowsiness. Ask your pharmacist about options.
- Apply cold washcloth. Covering the affected area with a cold washcloth can help soothe the skin and prevent scratching.
- Take a comfortably cool bath. Find relief from itching in a cool shower or bath. Some people may also benefit from bathing in cool water sprinkled with baking soda or oatmeal powder (Aveeno, others), but this isn't a solution for long-term control of chronic itching.
- Wear loose, smooth-textured cotton clothing. Avoid wearing clothing that's rough, tight, scratchy or made from wool. This will help you avoid skin irritation.
- Avoid the sun. When outdoors, seek shade to help relieve discomfort.
Preparing for your appointment
You're likely to start by seeing your primary care doctor. In some cases when you call to set up an appointment, you may be referred immediately to a skin disease specialist (dermatologist) or to an allergy specialist.
What you can do
Here are some tips to help you get ready for your appointment.
- List your signs and symptoms, when they occurred, and how long they lasted.
- List any medications you're taking, including vitamins, herbs and supplements. Even better, take the original bottles and a list of the doses and directions.
- List questions to ask your doctor.
For hives and angioedema, questions you may want to ask include:
- What is likely causing my symptoms?
- Do I need any tests to confirm the diagnosis?
- What are other possible causes for my symptoms?
- Is my condition likely temporary or chronic?
- What is the best course of action?
- What are the alternatives to the primary approach that you're suggesting?
- Do I need prescription medication, or can I use over-the-counter medications to treat the condition?
- What results can I expect?
- Can I wait to see if the condition goes away on its own?
What to expect from your doctor
Your doctor is likely to ask you a number of questions, such as:
- When did you first begin experiencing symptoms?
- What did your skin reaction look like when it first appeared?
- Have your symptoms changed over time?
- Have you noticed anything that makes your symptoms worse or better?
- Do your skin lesions mainly itch, or do they burn or sting?
- Do your skin lesions go away completely without leaving a bruise or a mark?
- Do you have any known allergies?
- Have you ever had a similar skin reaction before?
- Have you tried a new food for the first time, changed laundry products or adopted a new pet?
- What prescriptions, over-the-counter medications and supplements are you taking?
- Have you started taking any new medications or started a new course of a medication you've taken before?
- Has your overall health changed recently? Have you had any fevers or lost weight?
- Has anyone else in your family ever had this kind of skin reaction? Do other family members have any known allergies?
- What at-home treatments have you used?