Rash That Comes And Goes

Some of the bumps are small circles and others are larger, uneven shapes. Most are close together in groups, but some are further apart. The bumps are a lighter brown than the surrounding skin and look puffy, like blisters.

Urticaria (hives)

Urticaria (hives) is a raised, itchy rash that appears on the skin. Children are often affected by the condition, as well as women aged 30 to 60, and people with a history of allergies. Hives rashes usually improve within a few minutes to a few days.

Types of urticaria

Urticaria may appear on one part of the body or be spread across large areas.

It can lead to a red, raised, itchy rash. The rash can be in one place or spread through the body. The raised areas on the skin are sometimes called hives or weals.

Urticaria rash can be in one place or spread through the body

The raised areas can range from a few millimetres to the size of a hand.

Doctors may call urticaria either:

• acute urticaria – if the rash clears completely within six weeks (most cases last 24 to 48 hours)
• chronic urticaria – in rarer cases, where the rash persists or comes and goes for more than six weeks, often over many years

A much rarer type of urticaria, known as urticarial vasculitis, can cause blood vessels inside the skin to become inflamed.

In these cases, the raised areas or weals last longer than 24 hours, are more painful, and can leave a bruise.

When to seek medical advice

Urticaria on its own is not a serious condition. However, urticaria can occur in a severe allergic reaction called anaphylaxis.

If you have symptoms of anaphylaxis this is a medical emergency.

Call 999 immediately and ask for an ambulance if you, or someone else is experiencing anaphylaxis.

If you have urticaria, without the symptoms of anaphylaxis, visit your GP if your symptoms don’t go away within 48 hours.

You should also contact your GP if your symptoms are:

• severe
• causing distress
• disrupting daily activities
• occurring alongside other symptoms

Causes of urticaria

Urticaria occurs when a trigger causes high levels of histamine and other chemical messengers to be released in the skin. This extra fluid in the tissues causes swelling and itchiness.

Histamine is released for many reasons, including:

• an allergic reaction, such as a food allergy or a reaction to an insect bite or sting
• cold or heat exposure
• infection, such as a cold
• certain medications – check the patient information leaflet with your medication to see if urticaria is a usual side effect, or if you need advice speak to your pharmacist or GP

In many cases of urticaria, no obvious cause can be found.

Some cases of long-term urticaria may be caused by the immune system mistakenly attacking healthy tissue. This can be difficult to treat and your GP may refer you to a specialist for tests and treatment.

Certain triggers may also make the symptoms worse. These include:

• drinking alcohol or caffeine
• emotional stress
• warm temperature

Diagnosing urticaria

Your GP will usually be able to diagnose urticaria by examining the rash. They may also ask questions to find out what triggered your symptoms. They may do some blood tests and may prescribe medication.

If your GP thinks that it’s caused by an allergic reaction and the cause is difficult to identify, you may be referred to hospital for allergy testing.

If you’ve had urticaria most days for more than six weeks, or the treatment is not working, it’s likely you will be referred to the hospital for further tests.

Finding out what is causing your rash may help you to avoid something you are reacting to, or help by treating the underlying cause.

Treating urticaria

Most cases of urticaria don’t need treatment. This is because the symptoms are usually mild and often get better within a few days.

If the itchiness is causing you discomfort, antihistamines can help. Antihistamines are available over the counter at pharmacies.

Your pharmacist can give you advice about the best treatment to treat the rash.

Your GP may consider a short course of steroid tablets (oral corticosteroids) for more severe cases of urticaria. This treatment is not used routinely.

If you have persistent urticaria, you may be referred to a skin specialist (dermatologist).

Complications of urticaria

Around a quarter of people with acute urticaria and half of people with chronic urticaria also develop angioedema, which is a deeper swelling of tissues.

Chronic urticaria can also be upsetting and negatively impact a person’s mood and quality of life.

Angioedema

Angioedema is swelling in the deeper layers of a person’s skin. It’s often severe and is caused by a build-up of fluid. The symptoms of angioedema can affect any part of the body, but usually affect the:

Medication such as antihistamines and short courses of oral corticosteroids (tablets) can be used to relieve the swelling.

Anaphylaxis (severe allergic reaction)

Urticaria can be one of the first symptoms of a severe allergic reaction known as anaphylaxis.

Other symptoms of anaphylaxis include:

• swollen eyes, lips, hands and feet
• feeling lightheaded or faint
• narrowing of the airways, which can cause wheezing and difficulty breathing
• abdominal pain, nausea and vomiting
• collapsing and becoming unconsciousness

Anaphylaxis should always be treated as a medical emergency.

More useful links

• How to use your health services
• Hives

The information on this page has been adapted from original content from the NHS website.

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Health conditions A to Z

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Hives

Hives rashes usually get better within a few days. You can often treat hives yourself.

Check if it’s hives

The main symptom of hives is an itchy rash.

• be raised bumps or patches in many shapes and sizes
• appear anywhere on the body
• be on 1 area or spread across the body
• feel itchy, sting or burn
• look pink or red when affecting someone with white skin; the colour of the rash can be harder to see on brown and black skin

• 1: White skin with hives rash (thumbnail). 1
• 2: White skin with hives rash (thumbnail). 2
• 3: Hives rash on light brown skin (thumbnail). 3
• 4: Hives rash on light brown skin (thumbnail). 4
• 5: Hives rash on light brown skin (thumbnail). 5
• 6: Dark brown skin with hives rash (thumbnail). 6

DR P. MARAZZI/SCIENCE PHOTO LIBRARY https://www.sciencephoto.com/media/694159/view

Long description, image 1

Hives rash on the leg and hand of a child with white skin.

The skin on most of their thigh is pink, raised and bumpy. At the side of their thigh, close to their hand, are deep creases in the skin.

Their hand is pink with some red patches between their thumb and finger and on their fingertips.

Elizabeth Nunn / Alamy Stock Photo https://www.alamy.com/stock-photo-an-urticarial-rash-caused-by-an-allergic-reaction-to-penicillin-111762116.html?pv=1&stamp=2&imageid=261CE1C1-DA64-4EAE-8D55-1794DA842BD3&p=278658&n=0&orientation=0&pn=1&searchtype=0&IsFromSearch=1&srch=foo%3dbar%26st%3d0%26pn%3d1%26ps%3d100%26sortby%3d2%26resultview%3dsortbyPopular%26npgs%3d0%26qt%3dGDR5M4%26qt_raw%3dGDR5M4%26lic%3d3%26mr%3d0%26pr%3d0%26ot%3d0%26creative%3d%26ag%3d0%26hc%3d0%26pc%3d%26blackwhite%3d%26cutout%3d%26tbar%3d1%26et%3d0x000000000000000000000%26vp%3d0%26loc%3d0%26imgt%3d0%26dtfr%3d%26dtto%3d%26size%3d0xFF%26archive%3d1%26groupid%3d%26pseudoid%3d%26a%3d%26cdid%3d%26cdsrt%3d%26name%3d%26qn%3d%26apalib%3d%26apalic%3d%26lightbox%3d%26gname%3d%26gtype%3d%26xstx%3d0%26simid%3d%26saveQry%3d%26editorial%3d1%26nu%3d%26t%3d%26edoptin%3d%26customgeoip%3d%26cap%3d1%26cbstore%3d1%26vd%3d0%26lb%3d%26fi%3d2%26edrf%3d0%26ispremium%3d1%26flip%3d0%26pl%3d

Long description, image 2

Hives rash on the leg, arm and hand of a person with white skin.

Small, slightly raised pink spots cover their leg. Some are close together and some are further apart.

The same spotty rash spreads along the side of their arm and across the top of their hand. The knuckles and fingertips are red.

Loisjoy Thurstun / Alamy Stock Photo https://www.alamy.com/close-up-of-toddler-with-urticaria-caused-by-sensitivity-to-plum-skins-image8981367.html?pv=1&stamp=2&imageid=51FCF349-CE6C-46DB-B51B-CBCAE97EA94D&p=373224&n=0&orientation=0&pn=1&searchtype=0&IsFromSearch=1&srch=foo%3Dbar%26st%3D0%26sortby%3D2%26qt%3DAP98R8%26qt_raw%3DAP98R8%26qn%3D%26lic%3D3%26edrf%3D0%26mr%3D0%26pr%3D0%26aoa%3D1%26creative%3D%26videos%3D%26nu%3D%26ccc%3D%26bespoke%3D%26apalib%3D%26ag%3D0%26hc%3D0%26et%3D0x000000000000000000000%26vp%3D0%26loc%3D0%26ot%3D0%26imgt%3D0%26dtfr%3D%26dtto%3D%26size%3D0xFF%26blackwhite%3D%26cutout%3D%26archive%3D1%26name%3D%26groupid%3D%26pseudoid%3D%26userid%3D%26id%3D%26a%3D%26xstx%3D0%26cbstore%3D1%26resultview%3DsortbyPopular%26lightbox%3D%26gname%3D%26gtype%3D%26apalic%3D%26tbar%3D1%26pc%3D%26simid%3D%26cap%3D1%26customgeoip%3D%26vd%3D0%26cid%3D%26pe%3D%26so%3D%26lb%3D%26pl%3D0%26plno%3D%26fi%3D0%26langcode%3Den%26upl%3D0%26cufr%3D%26cuto%3D%26howler%3D%26cvrem%3D0%26cvtype%3D0%26cvloc%3D0%26cl%3D0%26upfr%3D%26upto%3D%26primcat%3D%26seccat%3D%26cvcategory%3D*%26restriction%3D%26random%3D%26ispremium%3D1%26flip%3D0%26contributorqt%3D%26plgalleryno%3D%26plpublic%3D0%26viewaspublic%3D0%26isplcurate%3D0%26imageurl%3D%26saveQry%3D%26editorial%3D1%26t%3D0%26edoptin%3D

Long description, image 3

Hives rash on the knee of a person with light brown skin. The skin is slightly darker brown around where the rash is.

There are many skin-coloured bumps on and around the knee which vary in size from around 2mm to 1cm. The larger bumps look puffy like blisters. Some bumps are very close together in groups.

Long description, image 4

Hives rash on the cheek, chin and neck of a person with light brown skin.

There are about 50 raised bumps in different shapes and sizes.

Some of the bumps are small circles and others are larger, uneven shapes. Most are close together in groups, but some are further apart. The bumps are a lighter brown than the surrounding skin and look puffy, like blisters.

Arlee. P: https://www.shutterstock.com/image-photo/child-symptoms-itchy-urticaria-body-arm-1101565460

Long description, image 5

Hives rash on the thigh and hip of a child with light brown skin.

There are about 20 patches of pink skin in different shapes and sizes. The patches are mainly flat and vary in size from around 1cm to 8cm.

Some patches are close to or join others, while some are further apart.

Some patches are dark pink. Others are lighter pink with a darker pink border around the patch.

There’s a long, dark pink patch spreading from their groin to their hip.

Long description, image 6

Hives rash on the thigh of a person with dark brown skin.

There are many raised patches of skin in different shapes and sizes very close to each other. They range from around 5mm to 5cm.

The skin near the left knee also has raised lines, like scars. The skin on the inside of the thigh is smooth.

The rash is the same colour as the person’s skin.

If you’re not sure it’s hives

A pharmacist can help with hives

A pharmacist can give you advice about antihistamine treatment to help a hives rash.

Tell the pharmacist if you have a long-term condition, because you might not be able to take antihistamines.

This treatment might not be suitable for young children.

Non-urgent advice: Ask for an urgent GP appointment or get help from NHS 111 if:

• symptoms of hives do not improve after 2 days
• you’re worried about your child’s hives
• the rash is spreading
• hives keeps coming back (you may be allergic to something)
• you also have a high temperature and feel unwell
• you also have swelling under your skin (this might be angioedema)

Immediate action required: Call 999 if:

• your lips, mouth, throat or tongue suddenly become swollen
• you’re breathing very fast or struggling to breathe (you may become very wheezy or feel like you’re choking or gasping for air)
• your throat feels tight or you’re struggling to swallow
• your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
• you suddenly become very confused, drowsy or dizzy
• someone faints and cannot be woken up
• a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)

You or the person who’s unwell may also have a rash that’s swollen, raised or itchy.

These can be signs of a serious allergic reaction and may need immediate treatment in hospital.

Treatment for hives from a GP

A GP might prescribe menthol cream, antihistamines or steroid tablets.

If hives does not go away with treatment, you may be referred to a skin specialist (dermatologist).

You cannot always prevent hives

You get hives when something causes high levels of histamine and other chemicals to be released in your skin. This is known as a trigger.

Triggers can include:

• eating certain foods
• contact with certain plants, animals, chemicals and latex
• cold, such as cold water or wind
• hot, sweaty skin from exercise, emotional stress or eating spicy food
• a reaction to a medicine, insect bite or sting
• scratching or pressing on your skin, such as wearing itchy or tight clothing
• an infection
• a problem with your immune system
• water or sunlight, but this is rare

Try to find out what triggers hives for you, so you can avoid those triggers, if possible. This may help prevent an episode of hives.

Page last reviewed: 26 April 2024
Next review due: 26 April 2027

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