What Triggers Hives and How to Get Relief

Hives cause your skin to become itchy and covered in raised welts that sometimes burn or feel hot to the touch. Sometimes the welts fade within hours; other times, they last for days and move from one part of your body to another. For many people, one episode is enough to say, “Never again.” But hives can come back again and again if you don’t know your triggers.

Without knowing your triggers, you’re stuck avoiding random foods, swapping soaps, or overusing allergy medication and hoping for the best. The smarter way is to see an allergy specialist who can run targeted tests, pinpoint your triggers, and help you prevent future flare-ups. 

That’s exactly what Dr. Patricia Gomez-Dinger and her team at Advanced Allergy, Asthma, & Immunology Center PA in San Antonio and Schertz, Texas, do best. Here we highlight the most likely culprits behind your hives and what you can do to get relief. 

What’s happening when you get hives

Hives are your skin’s reaction to something it sees as a threat. When triggered, your body releases histamine and other chemicals that make tiny blood vessels leak. That fluid collects under the skin, creating puffy, red, or skin-colored welts.

A single spot usually fades within 24 hours, but new ones can appear elsewhere as old ones disappear. In some cases, deeper swelling, especially around the eyes, lips, hands, or feet, can occur. It’s called angioedema, and while it often goes away on its own, it can be dangerous if it affects your throat or breathing.

The most common triggers

There’s no single cause of hives, but a few things are known to set them off:

Food

Peanuts, tree nuts, shellfish, fish, eggs, milk, soy, and wheat top the list. Symptoms can appear within minutes or hours after eating, depending on your sensitivity.

Medication

Pain relievers like ibuprofen or aspirin can trigger hives in some people. So can certain antibiotics. Always tell Dr. Gomez-Dinger everything you took in the 24 hours before a flare (including supplements).

Infections

Viruses like a cold or flu are a leading cause of hives in kids and can trigger adult flares, too. Bacterial infections and even dental infections occasionally play a role.

Environmental and physical factors 

Cold exposure, heat, pressure from tight straps or waistbands, scratching, sweat, sun exposure, or sudden temperature changes can cause some people to break out in hives.

Stress and hormones

Big life stressors, poor sleep, or hormonal shifts (for example, around a menstrual cycle) can lower the skin’s threshold and make flares more likely or more severe.

Everyone’s body reacts differently. What triggers hives in one person might not affect another at all; that’s why testing is so important.

How we figure out your triggers

Getting to the bottom of hives is part detective work, part science. At Advanced Allergy, Asthma, & Immunology Center PA, we start with taking your history: What did you eat, drink, or take before the breakout? Were you sick recently? Did you exercise, get too cold, or wear new clothing or sunscreen? Photos of the rash, if they’re already gone, help, too.

From there, Dr. Gomez-Dinger may use:

• Skin prick tests to check for specific food or environmental allergies
• Blood tests to measure antibody levels and rule out other causes
• Specialized tests for physical triggers, such as cold or pressure-induced hives
• Challenge tests to confirm or rule out a suspected trigger, especially for medications

Not everyone needs every test. Once Dr. Gomez-Dinger identifies your triggers, she creates a treatment plan that helps with the current flare and prevents future ones.

Getting quick relief during a flare

The most effective first-line treatment is antihistamines, the same type you might take for seasonal allergies. These block the release of histamine, easing itching and swelling. Cool compresses and loose, breathable clothing can also help soothe irritated skin. Try to avoid scratching; it only worsens inflammation and can make the welts spread.

Avoid alcohol and very hot, spicy foods during a flare, as both can dilate blood vessels and intensify itching. If you ever have trouble breathing, wheezing, throat tightness, repeated vomiting, or feel faint, treat it as an emergency and call for help. You may be experiencing anaphylaxis, which requires epinephrine and urgent medical attention.

Hives are itchy, unpredictable, and frustrating, but they’re also manageable. Once you understand your triggers and have a plan for managing flare-ups, you can stop worrying about the next breakout and focus on living a full life.

If you’re tired of guessing what’s causing your hives or relying on temporary fixes, it’s time to see an expert. Schedule an appointment with us today.