HivesDiagnosis
How Hives Are Diagnosed
Updated on July 8, 2026
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Hives are a common skin condition, appearing as reddish bumps on the skin that can sometimes be itchy or painful. Hives (also called urticaria) can appear anywhere on the body and can range in size from the tip of a pin to the diameter of a dinner plate.
There isn’t always a clear-cut reason for hives — they could be the skin’s response to an allergen, an infection, or a physical stimulus like pressure, temperature, or exposure to the sun.
In most cases, hives will go away on their own, with each individual welt healing within 24 hours. But sometimes hives could last for months or even years, in which case they are chronic hives and could be a sign that something else is going on, such as an underlying autoimmune disorder.
Here’s what you need to know about identifying and diagnosing hives.
What You Need to Know About Self-Diagnosing Hives
Hives are extremely common, with about 20 percent of people experiencing them at some point in their lives. So seeing them on your body isn’t necessarily a signal to panic.
Sapna Palep, MD, a dermatologist at Spring Street Dermatology in New York City, says that it is possible to diagnose yourself with hives at home, especially if you’re dealing with acute hives, which are relatively straightforward and typically respond to treatment with antihistamines like loratadine (Claritin), levocetirizine (Xyzal), and diphenhydramine (Benadryl).
The reddish welts may be raised and swollen, and may be accompanied by itchiness, pain, burning, or stinging. They should go away within 24 hours.
Red bumps on the skin can be a sign of a number of skin issues, so how can you tell if it’s hives? Sourab Choudhury, DO, a dermatologist in private practice with Dermatology Specialists in New York City, says to look for welts that come and go. That’s “highly indicative of hives,” he says.
When to See a Doctor About Hives
Sometimes, though, hives aren’t something you should handle yourself. Pay attention to other symptoms to know how you should respond. If you experience dizziness, trouble breathing, or swollen lips, eyes, and tongue along with hives on the skin, consider it an emergency. You may be experiencing anaphylaxis, which is a life-threatening allergic reaction, and you should call 911 immediately.
If you’re not having difficulty breathing, it may still be a good idea to seek professional medical help, though you don’t need to visit the emergency room if the rash isn’t accompanied by anaphylaxis symptoms. These are a few indications that it’s time to see a doctor:
- If the rash does not go away and lasts longer than six weeks, which could indicate you’re dealing with chronic hives
- If the welts are causing discomfort
- If an individual welt lasts longer than 24 hours and is accompanied by pain
Dr. Choudhury says if any of these symptoms occur, it’s appropriate to see a doctor for a formal diagnosis. You should schedule an appointment with your primary care doctor first. At that appointment, they may refer you to a dermatologist or an allergist. “Both dermatologists and allergists are experts in treating hives,” Choudhury says.
What to Expect When You See a Doctor About Hives
If the hives trigger is known, your doctor’s visit will likely be relatively straightforward. Say you suspect the hives are in response to a food allergy: An allergist should be able to conduct tests to confirm the trigger and can suggest medications to either prevent hives from occurring or reduce the intensity and severity of your symptoms.
A large percentage of time, however, the reason for hives is not clear, so you and your doctor will need to work together to figure out the cause.
When you visit your doctor, they will likely start with a physical exam and will take a look at the welts on your skin. There’s little doubt about how to manage acute hives. Providers prescribe antihistamines, and hives usually go away, Choudhury says.
When it comes to chronic hives, however, your doctor may recommend additional blood tests and skin tests to determine if there’s an underlying issue. A blood test, for instance, could pick up on a blood protein that’s associated with hereditary angioedema, though sometimes a genetic test is also performed. This uncommon disorder is associated with severe swelling, with or without hives, and is important to rule out.
If you visit an allergist, they may call for skin tests, blood tests, or urine tests to try to figure out what’s going on. In rare instances, they may suggest an oral food challenge, during which a doctor monitors you after eating a small amount of a suspected food trigger to see if hives develop.
A dermatologist will likely diagnose hives simply by looking at your skin, though it’s possible that they may do a skin biopsy, too, during which the affected skin is examined under a microscope.
Questions to Ask and Be Prepared to Answer at Your Appointment
If you see your doctor about a rash or skin problem you suspect might be hives, your doctor will likely ask questions to help identify the problem, starting with how long you’ve been experiencing symptoms. That will help determine if you have acute hives, chronic hives, or something else, Choudhury says.
They may also ask:
- What are your symptoms, and when did they begin? Have you done anything or taken any medication that has made the symptoms better or worse?
- How large are the hives? Where on the body have they appeared?
- How long does it take for a welt to go away?
- Are the hives painful or accompanied by swelling?
- What other medications and supplements do you currently take? Did you recently start taking any of them? (Common medications can trigger hives in certain individuals.)
- Have you recently: Had an infection, either viral or bacterial? Experienced any difficulty breathing, feelings of nausea, or lightheadedness? Tried a new food? Returned from a trip to a new place?
- Do you know if anyone else in your family has experienced hives?
You’ll also want to be prepared to ask your doctor questions at your appointment to help you better understand what’s going on. Plan to ask:
Questions to Ask Your Doctor
- What’s causing my symptoms?
- What tests will you need to do?
- How long will the hives last?
- What are the treatment options? And what side effects do each of these treatments come with?
- Is it necessary that I take prescription medication? Is there an over-the-counter version I can use instead?
- Will this treatment interfere with my existing health issues or the medications I take for them?
Dr. Palep says to also ask how long it will take for treatment to start working, whether the areas of the skin affected by the hives will scar, and how to relieve itchiness, pain, or burning.
Resources We Trust
- Cleveland Clinic: Hives
- Mayo Clinic: Hives and Angioedema: Symptoms and Causes
- MedlinePlus: Hives
- Allergy & Asthma Network: Chronic Urticaria: Causes, Symptoms, Diagnosis, and Treatment
- American College of Allergy, Asthma & Immunology: Chronic Spontaneous/Idiopathic Urticaria (Chronic Hives)
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
- Hives. MedlinePlus. August 6, 2025.
- Hives (Uticaria). Australasian Society of Clinical Immunology and Allergy. June 2024.
- Hives. American College of Allergy, Asthma & Immunology.
- Hives/Urticaria. Columbia University Irving Medical Center.
- Chronic Hives: Symptoms & Causes. Mayo Clinic. October 1, 2024.
- Chronic Hives: Diagnosis & Treatment. Mayo Clinic. October 1, 2024.
- Hives. Seattle Children’s. January 25, 2025.
- Chronic Hives: Diagnosis & Treatment. Mayo Clinic. October 1, 2024.
- Hereditary Angioedema. ThinkGenetic Foundation.
- Hives and Angioedema: Symptoms & Causes. Mayo Clinic. October 27, 2023.
- Hives and Angioedema: Diagnosis & Treatment. Mayo Clinic. October 27, 2023.
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