Skin Conditions

Hives (Urticaria): Causes, Treatment & UK Online Doctor

6 min readLast reviewed 24 April 2026

Educational information — not medical advice.

This article was prepared by the OnlineDoctor24 editorial team and reviewed for factual accuracy against UK clinical guidance (NHS and NICE). It is not written by a doctor and does not replace personal medical advice. For symptoms specific to you, book an online doctor consultation.

Key points

  • Hives are itchy raised welts that appear and disappear within 24 hours.
  • Acute hives usually settle within a few weeks; chronic urticaria lasts more than 6 weeks.
  • Non-drowsy antihistamines are first-line — up to 4× standard dose under medical supervision.
  • Severe cases may need oral steroids or specialist treatment.
  • Watch for face/lip swelling or breathing difficulty — that's an emergency.

What causes hives?

  • Viral infections (most common in children)
  • Foods (nuts, shellfish, eggs)
  • Medications (NSAIDs, antibiotics)
  • Insect bites
  • Heat, cold, pressure, sunlight (physical urticaria)
  • Often no cause is found, especially in chronic cases.

Treatment

  • Non-drowsy antihistamine (cetirizine, loratadine, fexofenadine) at standard dose.
  • Doses can be increased up to 4× under medical supervision.
  • Oral steroids briefly for severe acute attacks.
  • Specialist options (omalizumab) for chronic refractory cases.

When an online doctor can help

An online GP can review your hives, prescribe high-dose antihistamines, manage flare treatment and refer to immunology if chronic.

Red flags — when to seek urgent help

Call 999 or go to A&E if you experience any of the following:

  • Swelling of lips, tongue, throat (angioedema)
  • Difficulty breathing or swallowing
  • Dizziness or feeling faint
  • Widespread rash with fever or feeling unwell

Frequently asked questions

Common questions UK patients ask about urticaria (hives).

How an online doctor can help

This article is for general information only and does not replace personal medical advice from a qualified doctor. Content is reviewed against UK NHS and NICE guidance by the OnlineDoctor24 editorial team and is not authored by a medical doctor. If your symptoms worsen or you are unsure, please book a consultation with a GMC-registered GP.

See a UK GP about this today

Same-day video or phone consultations with GMC-registered GPs. Prescriptions, sick notes and referrals when clinically appropriate.