9 Symptoms Never to Ignore With Hives

Medically Reviewed By William C. Lloyd III, MD, FACS
  • Hives, also known as urticaria, often take the form of an itchy, red rash. They can pop up in reaction to a viral or bacterial infection, or as an allergic reaction. A localized case of hives can be irritating and annoying but not worrisome. You can typically take an over-the-counter (OTC) antihistamine to make the itching manageable until the hives start to go away. Some hives last longer, though, turning into chronic hives.

    Hives can also cause much more serious symptoms, like trouble breathing or swallowing. Those can be signs of an impending allergic reaction, and that could be very dangerous. It’s important not to ignore those symptoms or put off seeking medical care because you could be putting your health at serious risk.

    A few raised itchy bumps may not be a major cause for concern. In fact, the itch associated with hives is pretty normal. But other symptoms are not. And certain complications of hives may require immediate medical attention, so be vigilant and take action if you notice any of these symptoms developing.

  • 1
    Trouble Breathing
    young woman with hand on chest and concern on face and trouble breathing

    If you realize you are having trouble breathing, do not brush off this symptom. This could be a sign of a serious allergic reaction. You might be tempted just to call your doctor’s office and leave a voicemail with a message to call you back, but don’t wait. You need to seek medical attention right away, so go ahead and call 911 immediately.

  • 2
    Trouble Swallowing
    Young woman drinking water with hand on throat have difficulty swallowing

    If you notice you’re having trouble swallowing, this could be a sign that the tissues in your throat are swelling, which can happen for some people with hives. If your throat swells enough, it could potentially cut off your airway. Again, this is not the time to wait around to see if it gets better, because it could get worse suddenly and you may develop trouble breathing.

  • 3
    Joint Pain
    black or african american woman with wrist pain

    Joint pain or swelling is not a normal symptom associated with your average case of hives. In fact, if you have joint pain and a fever, you could be developing a condition called urticarial vasculitis. This condition occurs when blood vessels get inflamed and cause hives and red patches to develop on your skin, but it can also lead to restricted blood flow and damage to your tissues and organs.

  • 4
    A Sudden Cough
    Close-up of a woman coughing

    By itself, a cough might not be a big deal. But if you didn’t have a cough prior to developing a case of hives, and you start to notice that you’re coughing, it could be an early sign that something more serious is developing such as airway inflammation.

  • 5
    Slurred Speech
    Senior woman receiving help on care home

    If you start to have trouble speaking or forming words, or your speech becomes slurred, this can be a sign of an allergic reaction. And it could get worse, especially if you develop any of the other symptoms.

  • 6
    Hoarseness
    Unseen woman holding throat in pain

    All of a sudden, you realize that you sound hoarse, like you’re starting to lose your voice, or you’ve been coughing a lot lately. This can be yet another sign of an impending serious reaction that you should not ignore. You might notice it in tandem with coughing.

  • 7
    Swollen Eyes
    man-rubbing-eyes

    A very serious case of hives can cause your eyes to start to get very itchy and your eyelids to swell shut. If this happens, call your doctor right away. It’s also possible you might have a condition called angioedema, which is a swelling of tissue under your skin that can be mistaken for hives–but either way, you want to find out for sure so you can get the appropriate treatment.

  • 8
    Hives After Taking Medication
    Mail Order Prescription

    If you just took a prescription or an OTC medication and notice that hives are developing, call your doctor. This could signal that you’re experiencing an allergic reaction to the medication, and you definitely don’t want to take another dose without consulting your physician first.

  • 9
    Abdominal Pain or Vomiting
    Close-up of Caucasian woman's hands on stomach in pajamas

    Pain in your abdomen that develops along with those red, raised patches of skin is not typical. This could also be a sign of urticarial vasculitis, which may require treatment that will vary, based on how serious the case is. You might only need to take an antihistamine or OTC pain reliever. But if your doctor determines that you have more serious involvement of your organs or tissues, you might need a medication that affects your immune system.

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  1. Hives. Seattle Children’s Hospital. https://www.seattlechildrens.org/conditions/a-z/hives/
  2. Hives (Urticaria). American College of Allergy, Asthma & Immunology. https://acaai.org/allergies/types-allergies/hives-urticaria
  3. Hives (Urticaria) And Angioedema Overview. American Academy of Allergy, Asthma & Immunology. https://www.aaaai.org/conditions-and-treatments/library/allergy-library/hives-angioedema
  4. Saini S. Patient education: Hives (urticaria) (Beyond the Basics). UpToDate. May 1, 2018. https://www.uptodate.com/contents/hives-urticaria-beyond-the-basics
  5. Urticarial Vasculitis. Vasculitis Foundation. https://www.vasculitisfoundation.org/education/forms/urticarial-vasculitis/
Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2022 Mar 19
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