Hives - Symptoms of urticaria

The main symptom of urticaria is a red, raised, itchy rash.

The rash is made up of raised marks in the skin, known as weals or hives. They're usually very itchy and range in size from a few millimetres to the size of a hand.

Individual weals usually fade after a few hours, but can be replaced by new ones elsewhere on the body. They may appear on just one part of the body or across a large part of it. The skin returns to normal as soon as the weal fades.

Pattern of symptoms

Most cases of urticaria are temporary (known as acute urticaria). The rash appears suddenly and is most severe after 8-12 hours, but usually goes away within 24 hours (although it can occasionally last for 48 hours).

The pattern of symptoms in long-term (chronic) urticaria can be unpredictable.

One small survey found that around half of people with chronic urticaria have outbreaks of symptoms that last for 6-12 weeks, followed by periods when their symptoms improve or disappear completely (remission).

Certain triggers such as stress or alcohol can make symptoms worse. Read more about the triggers of urticaria.

The same survey also found that 1 in 10 people had persistent symptoms of urticaria that lasted all year round.

Symptoms of chronic urticaria are often most troublesome in the evening, which can make falling asleep difficult.

When to seek medical advice

Visit your GP if your symptoms don't go away within 48 hours.

You should also contact your GP if your symptoms are severe, causing distress and disrupting daily activities.

You may need a short course of steroid tablets (oral corticosteroids) if other measures aren't able to control the symptoms.

Urticaria vasculitis

Urticaria vasculitis is a rare type of urticaria that causes the blood vessels inside the skin to become inflamed.

In urticaria vasculitis, the weals last longer than 24 hours, they're more painful and can leave a bruise. If you have urticaria vasculitis, you may be referred to a skin specialist (dermatologist).