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Urticaria (Hives): Causes, Symptoms & Treatment in Australia

What is Urticaria?

Urticaria, commonly known as hives, is a condition that causes raised, itchy welts on the skin. These welts can appear suddenly, change shape, and often come and go within hours.

In clinical practice, urticaria is something we see quite often. It can be short-lived (acute) or persist for weeks to months (chronic urticaria), and the experience can vary significantly between individuals.

While it can be uncomfortable and sometimes distressing, most cases are not dangerous — although identifying triggers and patterns can be important.

At Dermo Direct, dermatologists can assess suspected urticaria online and help guide appropriate management.

Urticaria (Hives)

What Do Hives Look Like?

Common features include:

  • Raised, red or skin-coloured welts (wheals)
  • Intense itching
  • Lesions that change size or location
  • Individual spots that usually fade within 24 hours

Some people also experience angioedema, which is deeper swelling (often around the eyes, lips, or hands).

Types of Urticaria

Acute Urticaria

  • Lasts less than 6 weeks
  • Often linked to a clear trigger (e.g. infection, food, medication)

Chronic Urticaria

  • Persists for more than 6 weeks
  • Often no clear external trigger is identified
  • May be related to immune system activity

What Causes Urticaria?

Urticaria occurs when histamine and other chemicals are released in the skin, leading to swelling and itching. Common triggers include:

  • Viral infections (very common)
  • Foods (e.g. nuts, shellfish — varies by individual)
  • Medications
  • Heat, cold, pressure, or exercise
  • Stress

In chronic urticaria, a specific trigger is often not identified, which can be frustrating.

Risk Factors

You may be more likely to experience urticaria if you:

  • Have a history of allergies
  • Have autoimmune conditions
  • Are experiencing infections or illness
  • Are under significant stress

How is Urticaria Diagnosed?

Diagnosis is usually based on:

  • The appearance of the rash
  • How long the welts last
  • Your medical history and potential triggers

In many cases, extensive testing is not required, particularly for acute urticaria.

With Dermo Direct, you can upload photos and describe your symptoms, helping dermatologists determine whether this is likely urticaria or another condition.

Treatment for Urticaria in Australia

Treatment focuses on relieving symptoms and reducing flare-ups.

1. Antihistamines

These are the mainstay of treatment.

  • Non-drowsy antihistamines are commonly used
  • Doses may be adjusted under medical guidance
  • Often effective in controlling symptoms

2. Avoiding Triggers (Where Possible)

If a trigger is identified, avoiding it can help reduce recurrence.

That said, in many cases — particularly chronic urticaria — a clear trigger isn’t found.

3. Short-Term Medications

In some situations, short courses of additional medications may be considered to help settle more severe flare-ups.

4. Specialist Treatments

For persistent or severe chronic urticaria, referral to a specialist may be recommended. This can include:

  • Further investigation
  • Advanced therapies under specialist supervision

Access to these treatments depends on individual circumstances and clinical assessment.

When to Seek Urgent Medical Attention

Most cases of urticaria are not dangerous, but you should seek urgent care if you experience:

  • Swelling of the lips, tongue, or throat
  • Difficulty breathing
  • Dizziness or collapse

These may indicate a more serious allergic reaction (anaphylaxis) and require immediate medical attention.

How Long Does Urticaria Last?

  • Individual hivesUsually resolve within 24 hours
  • Acute urticariaDays to weeks
  • Chronic urticariaCan persist for months or longer

While chronic urticaria can be persistent, many people experience gradual improvement over time.

Living with Urticaria

Urticaria can be unpredictable, especially when triggers aren’t clear. We often see patients feel frustrated by:

  • Sudden flare-ups
  • Lack of obvious cause
  • Ongoing itch or discomfort

With the right management approach, symptoms can often be controlled effectively.

Frequently asked questions

1. Is urticaria contagious?

No, it is not contagious.

2. Is it always caused by allergies?

Not always — many cases, especially chronic urticaria, are not linked to a specific allergy

3. Do I need allergy testing?

Not in all cases. Testing is usually guided by your clinical history.

4. Can stress cause hives?

Stress can be a contributing factor for some people.

Start Your Online Skin Consultation

If you’re experiencing recurrent or persistent hives, getting the right advice can help you manage symptoms more effectively.

You can start your online consultation with Dermo Direct today.

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Your dermatologists

Dr. Brendan Stagg

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Dr Arabella Wallett

Dr. Arabella Wallett

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Dr. Dev Tilakaratne

Dr. Dev Tilakaratne

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