Hives (Urticaria)

Hives, also called urticaria, are a common reason patients seek the care of an allergist/immunologist. AllergySA, your trusted allergy and asthma specialists in San Antonio are experts in the diagnosis and management of this condition. Hives can be itchy, uncomfortable, and unpredictable, appearing suddenly and affecting daily life. Our board-certified specialists are experts in diagnosing the cause of hives and providing effective, long-term treatment options for patients throughout San Antonio and the surrounding communities.

What Are Hives?

Hives are raised, red or skin-colored welts that appear on the skin and often itch or burn. They may vary in size and shape and frequently move from one area of the body to another. Individual hives usually last less than 24 hours, but new ones can continue to develop.

Common Symptoms of Hives

• Itchy, raised welts on the skin
• Redness or swelling
• Burning or stinging sensations
• Hives that change size or location
• Swelling of the lips, eyelids, hands, or feet (angioedema)

Types of Hives We Treat

Acute Urticaria

Acute hives last less than six weeks and may be triggered by:

• Viral or bacterial infections
• Foods or food additives
• Medications
• Insect stings or bites

Chronic Urticaria

Chronic hives last six weeks or longer and may occur daily or intermittently. In many cases, chronic hives are related to immune system activity rather than a specific allergy. Chronic urticaria is rarely caused by food allergies, which is why evaluation by an allergist is important.

Why See an Allergist for Hives?

Allergists are specially trained to diagnose and manage immune-related skin conditions like hives. At AllergySA, our allergists help patients by:

• Identifying potential allergic or non-allergic triggers
• Avoiding unnecessary food or lifestyle restrictions
• Ruling out underlying immune or autoimmune conditions
• Developing an effective, personalized treatment plan

How Allergists Diagnose Hives

Your evaluation begins with a comprehensive medical history and physical exam at one of our two convenient San Antonio allergy clinic locations.

Depending on your symptoms, your AllergySA specialist may recommend:

• Allergy testing if an allergic trigger is suspected
• Blood tests to assess immune system activity
• Evaluation for physical triggers such as pressure, heat, cold, or exercise
• Medication and medical history review

For many patients with chronic hives, extensive testing is not required, and treatment focuses on symptom control.

Treatment Options for Hives and Urticaria

Our allergists offer evidence-based hives treatment tailored to each patient. These options may include:

Antihistamines

Non-sedating antihistamines are often the first step in controlling itching and swelling.

Advanced Medication Strategies

When symptoms persist, allergists may adjust medication dosing or combine therapies safely under medical supervision.

Biologic Therapy for Chronic Hives

For patients with chronic spontaneous urticaria that does not respond to antihistamines, biologic medications may be recommended. These targeted therapies address specific immune pathways and have significantly improved quality of life for many patients.

Trigger Identification and Management

When triggers are identified, your AllergySA provider will guide avoidance strategies and lifestyle adjustments to reduce flare-ups.

Hives and Angioedema

Some patients experience angioedema, a deeper swelling often affecting the lips, tongue, eyelids, or throat. Our allergists carefully evaluate angioedema to determine its cause and ensure safe, effective treatment.