What are different types of hives?

Hives are an itchy rash or itchy bumps with raised welts over the affected skin. Acute hives or acute urticaria are usually caused by allergic reactions or viral infections. These types of hives due to environmental allergies, food allergy or viral infections are mostly short-lived.

Some people develop hives that last more than six weeks. These are called chronic hives or chronic urticaria. There are different types of chronic urticaria. Chronic hives are rare. About 23 out of every 10,000 adults have chronic urticaria in the United States. In addition, there are different types of chronic urticaria.

What are rare types of hives?

 

Most types of chronic urticaria have unknown triggers. They are not caused by an allergic reaction or a virus. Chronic urticaria is not contagious.

Chronic urticaria is grouped into two categories: chronic spontaneous urticaria (CSU) and chronic inducible urticaria.

Chronic spontaneous urticaria

Chronic spontaneous urticaria is sometimes called chronic idiopathic urticaria (CIU). When someone has chronic idiopathic urticaria, hives develop without a known trigger.

Chronic inducible urticaria

Chronic inducible urticaria (CIndU) is characterized by hives and/or angioedema. CIndU is a form of chronic urticaria that has a known trigger). The triggers can be either physical stimuli or environmental stimuli.

Chronic inducible urticaria can be further grouped as either physical urticaria or non-physical urticaria based on what causes the chronic hives. (Some of these conditions are very rare.)

 

Types of physical chronic urticaria (physical hives)

• Dermographism is a form of chronic hives triggered by skin friction such as rubbing, scratching or pressure. This is the most common form of CIndU.
• Delayed-pressure urticaria are chronic hives triggered by sustained pressure to the skin. Symptoms may appear 4-6 hours after contact.
• Exercise-induced urticaria are chronic hives triggered by exercise or sustained physical activity.
• Cold urticaria are chronic hives triggered by skin exposure to cold or cold water. It is typically limited to exposed skin.
• Heat urticaria are chronic hives triggered by exposure to heat.
• Solar urticaria, or solar hives, are chronic hives triggered by sun exposure to UV rays.
• Vibratory urticaria are chronic hives triggered by exposure to vibration.

Types of non-physical chronic urticaria (non-physical hives)

• Cholinergic urticaria are chronic hives triggered by active or passive body warming or excessive sweating.
• Contact urticaria are chronic hives triggered by skin contact from an external substance.
• Aquagenic urticaria are chronic hives triggered by direct contact with water.

If you or a loved one are dealing with hives that last for more than six weeks, make an appointment with a board-certified allergist or dermatologist. An allergist or dermatologist can help you:

• find the exact cause for your hives;
• diagnose hives;
• learn how to treat chronic hives;
• learn how to relieve itching;
• learn how to prevent hives.

More information about chronic hives.

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Reviewed by:
Purvi Parikh, MD, FACAAI is an adult and pediatric allergist and immunologist at Allergy and Asthma Associates of Murray Hill in New York City. She is on faculty as Clinical Assistant Professor in both departments of Medicine and Pediatrics at New York University School of Medicine.