What to Know About Hives vs. Rash

Medically Reviewed By Bukky Aremu, APRN

Hives are a type of rash that causes small, itchy bumps. Hives
can resemble other rashes. However, they may have a few distinctive features, such as their duration, appearance, and causes. For example, hives often appear and disappear quickly.
The word “rash” is a general term for skin irritation. A rash is a skin symptom, not a specific condition, so can have many different types and causes.

Hives, or urticaria, are one type of rash that produces itchy bumps or raised patches of skin. 

Read more about hives versus rash, including identification, key differences between hives and other rashes, and treatment.

Symptoms and identification

Someone touches the skin on their arm while in direct sunlight.
Ivan Andrianov/Stocksy United

The main symptoms of hives include:

  • a rash that may be itchy, sting, or burn
  • welts or bumps on the skin
  • patches that are raised or swollen
  • symptoms on just one body area or spread over wider areas

Hives can vary in size and color. On dark skin, hives may appear the same color or slightly darker than your typical skin tone. On light skin, hives may appear red or pink. Sometimes, hives are red or discolored around the edge with a pale center.

Key features and differences

You could be experiencing hives rather than another type of rash if:

  • welts appear and disappear quickly, usually within a span of about 24 hours
  • the skin recovers within a few minutes to a few days
  • welts occur in reaction to a trigger, such as warm water, pollen, or exercise
  • pressing or rolling a glass gently over the affected skin causes the rash to lose color or appear pale
  • you do not have:
    • blisters
    • broken skin
    • flaking or cracking skin

However, some of these features can be the same for multiple conditions affecting the skin. Also, not all hives have all of these features. For example, rarely, hives become chronic and last for weeks to years, rather than a few days.

It is also possible to have multiple rashes at once.

Contact your doctor for an accurate diagnosis if unsure about your skin symptoms.

Hives vs. other rashes

Other rashes or skin conditions that may cause symptoms similar to hives include:

Main featuresDifferences from hives
Keratosis pilaris

Keratosis pilaris is a harmless skin condition causing tiny, painless bumps to appear on the skin.

These bumps may be your usual skin color, but can also be red, brown, or black.

Hives may appear as small raised bumps or merge together to form larger areas of inflammation.
EczemaEczema can cause itchy and inflamed skin. Hives do not typically cause dry, scaly, or flaky skin.
Heat rash

Heat rash is a reaction to hot, humid
weather. It can resemble a cluster of small blisters or pimple-like lesions.

Heat rash often develops in areas with friction between the skin, such as underneath the breasts or armpits, elbow creases, neck, or groin.

Hives do not typically cause blistering and can have other triggers besides heat.
Insect bites

Common symptoms include a small, swollen lump and pain where you were stung or bitten. One or multiple bumps may appear, depending on how many times the insect stung or bit you.

You may also see a small puncture mark on the skin at the site of the bite or sting.

Hives usually appear as multiple welts or larger patches of swelling.

Hives do not typically show puncture marks.

Skin infection

Skin infection symptoms include Trusted Source Centers for Disease Control and Prevention (CDC) Governmental authority Go to source painful skin that blisters, oozes fluid, or feels warm to the touch.

You may also experience symptoms such as fever, headache, and a general feeling of being unwell.

Hives do not typically cause blistering and pus.

Symptoms that affect body systems other than the skin, such as fever, are atypical with hives.

See pictures and learn more about skin infection symptoms and contacting a doctor.

When to contact a doctor

Talk with your doctor if you have questions about skin symptoms.

Also, contact a doctor as soon as possible if you have skin symptoms that:

  • do not improve within a few days
  • appear alongside other symptoms, such as headache or nausea
  • affect a large area
  • surround broken skin or a wound
  • show signs of infection, such as oozing fluid, beginning to blister, or feeling warm to the touch

Some hives and rashes can be medical emergencies, such as severe allergic reactions or infections. Call 911 or your local emergency services for severe symptoms, such as:

Learn when to contact a doctor for allergic reactions or rashes.

Causes

Another key feature of hives is that they often occur in response to a trigger, such as:

Read more about the possible causes of hives.

Other times, the exact cause or trigger of hives remains unknown.

Still, other rashes may appear from the same causes or triggers. As a result, diagnosis by a doctor is key to understanding and treating symptoms.

Treatment

Most hives clear up on their own within a few hours or days. Self-care may help alleviate discomfort in the meantime.

Hives caused by severe conditions, such as allergic reactions or infections, may require emergency treatment.

If you experience severe or chronic hives, doctors may recommend further treatment, such as:

  • steroid medications
  • prescription antihistamines
  • prescription medications to relieve itchiness, such as menthol ointments

Learn more about treatment options and self-care for hives.

Summary

Hives are a type of rash that causes raised, discolored welts or patches. Hives may be itchy and can range from covering one specific patch to wider body areas.

Another distinguishing feature of hives is that they often appear and go away within a few minutes to a few days.

However, only a doctor can tell the difference between hives and other rashes with certainty. Also, some skin symptoms may require medical treatment. Talk with a doctor if you have new, persistent, or concerning skin symptoms.

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Medical Reviewer: Bukky Aremu, APRN
Last Review Date: 2023 Nov 30
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.