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Hives and angioedema - urticaria
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Hives and angiedema - urticaria

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Hives and angiedema are triggered when certain cells (mast cells) — which line the blood vessels in your skin — release histamine and other chemicals into your bloodstream and skin.

Allergic reactions to medications or foods can cause acute hives or angiedema. Many allergens have been identified. Examples include:

  • Foods. Many foods can cause problems in sensitive people, but shellfish, fish, nuts, eggs and milk are frequent offenders.

  • Medications. Almost any medication may cause hives or angiedema, but more common culprits include penicillin, aspirin, ibuprofen (Advil, Motrin, others), angiotensin-converting enzyme (ACE) inhibitors, and antibiotics containing sulfa and opiates.

  • Other allergens. Other substances that can cause hives and angiedema include pollen, animal dander, latex and substances injected into your skin from insect stings.

Additional triggers that may produce hives or angiedema include:

  • Physical factors. Environmental elements also can result in the release of histamine with subsequent hives or angiedema in some individuals. Examples of these factors include elements such as heat, cold, sunlight, water, pressure on the skin, emotional stress and exercise.

  • Dermatographism. The name of this rare condition literally means to "write on the skin." When pressure is applied to the skin or the skin is scratched, raised lines appear on those areas due to allergy-based angiedema that leads to swelling beneath the skin.

In addition to these triggers, hives and angiedema sometimes may occur in response to the body's production of antibodies. Some examples of situations in which this might occur include blood transfusions, immune system disorders, such as lupus or cancer, certain thyroid disorders and infections, such as hepatitis A or B, or even a cold.

Hereditary angiedema is an inherited form of angiedema and is related to low levels or abnormal functioning of certain blood proteins (C1 inhibitors). These inhibitors play a role in regulating how your immune system functions.

Risk factors

You may be at greater risk of hives and angiedema if:

  • You've experienced hives or angiedema before.

  • You've experienced other allergic reactions.

  • You have a family history of hives or angiedema.

  • You have a family history of hereditary angiedema.

When to seek medical advice

Mild hives and angiedema usually aren't life-threatening, and often you can treat hives and angiedema at home. However, seek emergency care if you feel lightheaded, have difficulty breathing, or if hives or swelling doesn't respond to treatment or continues to appear for more than a couple of days.

Screening and diagnosis

It's sometimes impossible to determine the cause of hives or angiedema. Your doctor will begin by asking you about your medical history. This may include asking you to create a detailed diary of exposure to possible irritants over a period of 2 to 4 weeks. It's important to tell your doctor about all medications you take, including over-the-counter (OTC) drugs and herbal remedies, even if you don't take them every day. Your doctor may also want to conduct allergy tests, such as skin tests.

If your doctor suspects HAE, he or she may ask for blood tests to check for levels and function of specific blood proteins. If allergy to food, latex, animal dander, pollen or medication is suspected, your doctor may recommend allergy skin or blood tests.


Hives and angiedema can, at the least, cause itching and discomfort. In more serious cases — where swelling occurs inside your mouth or throat — complications can include difficulty breathing or loss of consciousness. Anaphylactic shock (anaphylaxis) is a serious allergic reaction involving your heart or lungs. Your bronchial tubes narrow, it's difficult to breathe, and your blood pressure drops, causing dizziness and perhaps loss of consciousness or death. This occurs rapidly.

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This information is provided for general medical education purposes only and is not meant to substitute for the independent medical judgment of a physician relative to diagnostic and treatment options of a specific patient's medical condition.
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