Urticaria is a common skin condition that affects nearly one in five people at some point in their lives. It is characterized by intensely itchy, raised patches on the skin called weals or hives. These can vary in shape—ranging from small, round spots to larger ring-shaped lesions—and may merge to form larger areas of irritation. The welts often become more noticeable after scratching and can appear on virtually any part of the body.

The reaction occurs when histamine and other inflammatory chemicals are released into the bloodstream by mast cells, a type of immune cell. This release triggers fluid to leak from tiny blood vessels in the skin, creating the visible swelling and redness associated with hives. Although most welts fade within 24 hours, the overall condition can last days, weeks, or even longer depending on the underlying cause.

Urticaria is frequently accompanied by angio-oedema, a deeper form of swelling beneath the skin. Unlike the superficial itchiness of hives, angio-oedema tends to be more painful and often affects softer, more delicate areas of the body—such as the lips, eyelids, tongue, or inside the mouth. While the swelling usually disappears more slowly than hives, it can sometimes pose greater discomfort.

In cases where angio-oedema develops without the presence of weals, the cause may be an inherited condition known as hereditary angio-oedema. This form is unrelated to urticaria, does not respond to standard antihistamine treatment, and typically requires specialized testing and medical evaluation for proper diagnosis.

Types of Urticaria

Urticaria can be divided into several categories based on how long it lasts and what triggers it:

1. Acute Urticaria
This is the most common form, often linked to a clear cause such as an allergic reaction, infection, or environmental trigger. Episodes usually resolve within six weeks.

2. Chronic Urticaria
When symptoms persist for more than six weeks, the condition is classified as chronic. The triggers are often difficult to identify, and the hives may come and go unpredictably. In many cases, the cause remains unknown despite medical testing.

3. Physical Urticaria
This type is brought on by external physical triggers. These may include scratching or friction, exposure to cold, pressure on the skin from clothing or objects, sunlight, or an increase in body temperature from exercise or heat. People with physical urticaria tend to experience symptoms quickly after contact with the triggering factor.

Common Causes and Triggering Factors

The most frequent causes of urticaria include allergic responses, viral or bacterial infections, and emotional stress. Individuals with existing allergies are at higher risk of developing hives. The reaction may also occur after taking certain medications or after contact with unexpected allergens such as specific foods, pollen, or environmental substances. Additionally, when the body is fighting an illness or when another health condition is present, the immune system can become more reactive, making hives easier to trigger.

Treatment Options and Management

In many cases, treatment isn’t necessary because individual welts tend to fade within a day. However, if the condition persists or becomes uncomfortable, doctors may prescribe antihistamines to reduce itching and swelling. For more severe or stubborn symptoms, steroid tablets or soothing topical treatments like menthol cream may be recommended.

Managing urticaria often involves identifying and avoiding triggers when possible, maintaining skin hydration, and reducing stress—since emotional or physical strain can worsen flare-ups. With proper care and awareness, most people can keep symptoms under control and prevent frequent outbreaks.