Hives and Swelling

Hives are itchy raised welts that move around, each lasting less than a day. Angioedema is deeper swelling, often of the lips, eyelids, hands or feet. Most cases follow a viral infection or have no clear cause and settle within days to weeks. Hives most days for more than 6 weeks is called chronic hives, which is rarely due to allergy.

Treatment options

Ratings show how strong the research is.

• Strong evidenceNon-drowsy antihistaminesSuch as cetirizine, loratadine or fexofenadine, from a pharmacy. For hives that keep coming back, take them every day, not just when itchy.
• Strong evidenceSpecialist injectionsFor chronic hives not controlled by antihistamines, an immunologist or dermatologist can offer omalizumab injections.
• Moderate evidenceHigher antihistamine doseIf a standard dose isn’t enough, your doctor may advise up to 4 times the usual daily dose. Only do this on medical advice.
• Limited evidenceMontelukastA prescription tablet sometimes added for chronic hives.
• Limited evidenceShort course of steroid tabletsFor a severe flare, for a few days only. Repeated courses cause side effects.
• Not recommendedDrowsy antihistaminesOlder types cause next-day drowsiness and aren’t needed.
• Not recommendedAllergy tests or strict diets for chronic hivesRarely find a cause. Only with medical advice.

What you can do

• Cool showers or cool packs ease itch. Wear loose clothing.
• Avoid triggers such as heat, alcohol and spicy food. Use paracetamol instead of aspirin or anti-inflammatories, which can worsen hives.
• Note what you ate, took or did in the 2 hours before a sudden reaction.

See your GP if

• Hives last more than 6 weeks, or keep coming back
• Swelling happens without hives, especially if you take an ACE inhibitor blood pressure tablet (names end in "-pril"). Antihistamines don’t help this type.
• Individual welts last more than a day, bruise or come with fever or joint pain

Call 000 for swelling of the tongue or throat, trouble breathing or swallowing, a hoarse voice, wheeze, dizziness or collapse. Use an adrenaline autoinjector first if you have one, and lie down rather than stand.

Evidence and more information

• Healthdirect: Hives
• ASCIA: Hives (urticaria)
• ASCIA: Angioedema
• ASCIA: Chronic hives treatment guideline

Reviewed October 2026. General education, not personal medical advice. Treatment depends on your situation, so talk to your GP or pharmacist.

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