Q: What are some common triggers of urticaria (hives) and angioedema (swelling of the skin)? 

John B. Hagan, MD: Urticaria is more commonly called hives – itchy, raised or red welts on the skin. They are usually caused by physical triggers. These include:

  • Scratching the skin (also called dermatographia)
  • Infections (viral infections, for example)
  • Allergic reactions to pollen, pets, food, latex or insect stings
  • Exposure to cold (cold urticaria)
  • Heat, or sweating from exercise (cholinergic urticaria)
  • Vibrations (vibratory urticaria)

Certain medications such as aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) can cause hives or angioedema to flare.

Angioedema involves severe and painful swelling in the hands, feet, arms, legs or face, as well as the digestive system. It sometimes occurs with hives or is mistaken for hives. Triggers can include:

  • Stress or anxiety
  • ACE Inhibitors (blood pressure medications)
  • Surgery – particularly dental surgery
  • Estrogen in women

Allergists and immunologists can help you identify what’s causing your skin symptoms and ways to avoid your triggers.

Medications can help treat urticaria and angioedema symptoms and improve quality of life for patients. Talk with an allergist or immunologist about guidelines-based care and finding the right treatment and management plan.


John B. Hagan, MD, FACAAI, is a board-certified allergist and immunologist and a consultant for the Division of Allergic Diseases at the Mayo Clinic in Rochester, Minnesota. He is also an Associate Professor of Medicine at Mayo Clinic.


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