Dr Tee Shwu Hoon, Consultant Dermatologist

1 November, 2023

Are you being troubled by intense itch due to hives (urticaria)?

We are here to help you to understand more about urticaria (medical term for hives).


What is Urticaria?

If you’re battling with urticaria, know that you’re not alone! Research reveals that urticaria is incredibly common, impacting up to 20% of the population, which means that 1 in 5 individuals will face it at some point in their lives.

Urticaria manifests as these intensely itchy, raised skin reactions called hives. These hives can take on various forms, such as being round, ring-shaped, or even joining together. They may appear in shades of pale, pink, or red. While they often adopt a circular appearance, they can crop up in diverse shapes and sizes, affecting any area of your body. Typically, each hive vanishes within 24 hours. However, don’t be surprised if new ones pop up in different spots.

In addition to urticaria, some individuals also experience a condition known as angioedema.



Angioedema mirrors hives but affects the deeper layers of your skin. This condition can lead to swelling in areas like your face, eyelids, ears, mouth, hands, feet, and genitalia. You might experience a sensation of fullness and discomfort in these affected areas.

Remember, urticaria can also be a component of a severe allergic reaction, which has the potential to be life-threatening! Your safety is paramount, so seek immediate medical attention if you suspect such a reaction.

You should seek URGENT medical attention as soon as possible if you develop urticaria or angioedema suddenly with other symptoms such as:

Difficulty in breathing

Swelling or tightness in the mouth or throat

Nausea or vomiting

Cramping abdominal pain

Passing out

Types of Urticaria

Acute urticaria

If you are experiencing short-lived hives that do not last beyond a few days to one week or two.

Chronic urticaria

Hives occur daily or almost daily and last longer than 6 weeks, sometimes for years.

Inducible urticaria

Hives triggered by physical factors such as:
Changes in body temperature/sweating, Exercise, Pressure, Vibration, Sunlight

What Causes Urticaria?

Urticaria is caused by the release of chemicals from cells in the skin called mast cells. The main chemical is called histamine.

If you just got hives for the first time, you might have a new allergy to something.

Known triggers for acute urticaria include:

  • Allergies
  • Medicines (including traditional medications, supplements)
  • Food such as eggs, nuts, shellfish, and food additives. It can occur even if you have eaten it many times before without any problem
  • Insect stings and bites
  • Infections e.g. viruses, bacteria, parasite
  • Contact e.g. chemicals, latex, plant, animal saliva, topical products

How it will affect me?

The itch stands out as the most troublesome symptom, and it can be extremely distressing. It has the potential to disrupt work, hinder sleep, and impact your social life significantly. When hives spread across your body, they can result in skin tightness and physical discomfort.

It’s worth noting that most individuals with urticaria are in good health. However, when angioedema is linked with urticaria, it can potentially affect your airway. This can give rise to breathing difficulties, necessitating immediate medical intervention! Your well-being is our top priority, so don’t hesitate to seek help if you encounter such a situation.

How is urticaria diagnosed?

The diagnosis of urticaria can usually be made from the history and appearance, or description, of the hives. Your doctor will ask you questions and examine your skin thoroughly.

If an allergic reaction is suspected, a specific blood test for allergic sensitization or a skin prick test may be performed.

In chronic urticaria, a blood test may be necessary to ensure that there is no underlying medical condition such as thyroid disease or infection.

Treatment of Urticaria

General measures include avoidance of triggers.

  • Oral antihistamines are the mainstay of treatment. They relieve itch and suppress hives. Your doctor will monitor your symptoms and adjust the dosage accordingly.
  • A short course of oral steroids may sometimes be prescribed in severe cases.
  • Additional medications such as ciclosporin and omalizumab may be required for patients who do not respond to antihistamines.

What can I do?

  • Do not take medications such as certain pain-killers unless it is essential, since these medications may aggravate urticaria
  • Avoid anything that may worsen urticaria, such as alcohol, heat, tight clothes, stress, and sleep deprivation. Triggers vary between individuals
  • Avoiding certain foods, coloring agents, and preservatives may be helpful for some patients.

It is important to remember that...

  • Urticaria is not contagious
  • Although the course of chronic urticaria is unpredictable, in about 50% of patients, the condition lasts for 6 to 12 months, and then gradually disappears.
  • The bothersome symptoms of urticaria are treatable and adequately controlled in most people.
  • The majority of people with urticaria are healthy.
  • We are here to assist and support you whenever necessary. 

Urticaria can be frustrating, but our specialists are equipped with the knowledge and experience to pinpoint the root causes of your hives and develop a personalized treatment plan just for you. Speak to our Consultant Dermatologist, Dr Tee Shwu Hoon today!

Dr. Tee Shwu Hoon


Consultant Dermatologist


Dermatology (Skin)


English, Malay, Mandarin


MBBS, MRCP (UK), Advanced Master of Dermatology (UKM)

License Number

MMC No.: 43312, NSR No: 129433


LifeCare Diagnostic Medical Centre, Cheras South

Thursday (9.30am - 5.00pm)

Dr. Tee Shwu Hoon

Consultant Dermatologist


Dermatology (Skin)


English, Malay, Mandarin.


MBBS, MRCP (UK), Advanced Master of Dermatology (UKM)

License Number

MMC No.: 43312, NSR No: 129433


LifeCare Diagnostic Medical Centre, Cheras South

Thursday (9.30am-5.00pm)