Chronic Hives vs. Acute Hives: When Should You See a Specialist?

Hives (urticaria) are itchy, red welts that can appear suddenly and disappear just as fast. While most cases resolve on their own, some persist for weeks or even months. So how do you know if your hives are acute or chronic—and when should you see a specialist? Let’s break it down.

Acute vs. Chronic Hives: What’s the Difference?

When to See a Specialist

While mild hives often resolve on their own, you should see an allergist or immunologist if: ✔️ Hives last longer than 6 weeks (chronic hives).
✔️ Symptoms occur frequently without a clear trigger.
✔️ You experience swelling of the lips, tongue, or throat (could indicate a serious allergic reaction).
✔️ Over-the-counter antihistamines aren’t controlling symptoms.
✔️ Hives interfere with daily life or sleep.
✔️ You have other autoimmune symptoms (such as joint pain or fatigue).

Common Causes of Hives

• Acute Hives: Allergies (food, medications, insect stings), viral infections, stress, exercise.
• Chronic Hives: Autoimmune reactions, thyroid disease, chronic infections, or idiopathic (unknown cause).

Treatment Options

• Antihistamines (e.g., cetirizine, loratadine, fexofenadine) – First-line treatment.
• Avoidance of Triggers – If an allergen is identified.
• Biologic Medications (e.g., omalizumab/Xolair) – Used for chronic, severe cases.
• Steroids – Occasionally used for short-term relief in severe flare-ups.

FAQ: Understanding Hives

Q: Can stress cause hives?
A: Yes! Stress can trigger or worsen both acute and chronic hives due to immune system activation.

Q: Are chronic hives dangerous?
A: They are usually not life-threatening but can be frustrating and impact quality of life.

Q: Will allergy testing help with chronic hives?
A: Allergy testing is useful for acute hives, but chronic hives are often not allergy-related.

A Personal Story

One of my patients, Laura, dealt with daily hives for months with no clear trigger. Allergy tests were negative, but further evaluation showed an autoimmune component. After starting Omalizumab (Xolair) medication, her symptoms improved dramatically, and she finally found relief.

If you’re dealing with persistent or unexplained hives, don’t wait it out—seeing a specialist can help you find answers and better treatment options!

What are you waiting for?  If you or your child need help controlling allergies or if you think you need testing or treatment or that you might be a good candidate for allergy shots, Dr. Wendt and her team staff at Relieve Allergy, Asthma & Hives would love to help. Call for testing or treatment today!

Call 480-500-1902 or request an appointment at https://relieveallergyaz.com/contact now!  Begin your allergy testing journey with Dr. Wendt at Relieve Allergy in Scottsdale, Arizona—It’s time to take care of yourself!

Learn more about Dr. Wendt and Relieve Allergy Asthma & Hives at www.relieveallergyaz.com or connect with us: https://www.facebook.com/RelieveAllergy/, https://www.linkedin.com/in/julie-wendt/, https://x.com/RelieveAllergy, https://www.instagram.com/relieve_allergy/ or https://www.youtube.com/@JulieWendt-qx7jm.

Did you know? Dr. Wendt wrote the book on allergies.  Buy it NOW!

Relieve Allergy Asthma & Hives is located near Kierland Commons, 21803 N. Scottsdale Road Ste. 200, and has convenient evening and morning hours to accommodate your schedule. Dr. Wendt is also available for telemedicine appointments as appropriate. Most insurance plans are accepted.

DISCLAIMER: This blog is not meant to substitute for medical care by an Allergist-Immunologist nor is it intended to provide medical advice or imply a Physician-Patient relationship with its readers or their family. It is intended to provide guidance, direction, and moral support from someone experienced in testing and treating allergies. This is also not meant to be a “do-it-yourself” manual or a “how to” overcome your allergies. Some of the issues mentioned, whether allergic or look-a-like, can be dangerous or if left unchecked, deadly. Please develop a relationship with a Physician you trust to help you with diagnosis, advice, questions, and treatment regarding your and your family’s medical conditions.