Hives and infection: what to know

Hives are raised, itchy welts that often change shape, fade, and reappear in another place. They are not contagious and scratching does not turn them into an infection, although broken skin can become infected. Infection is more concerning when an area is persistently hot, painful, increasingly red, crusted, draining, or associated with fever. A viral or bacterial illness may occur around the same time as hives, but the rash pattern alone cannot identify the cause.

Avoid scratching, keep nails short, and use a cool compress for itch. Wash gently and leave blisters, crusts, or broken skin alone rather than applying leftover antibiotics or steroid creams. Record recent illness, medicines, foods, and products. A pharmacist can discuss oral antihistamine treatment, while a clinician should decide whether another treatment is needed. Do not take antibiotics for hives unless prescribed for a diagnosed infection.

Seek emergency help for hives with throat, tongue, or lip swelling, breathing difficulty, faintness, or rapid worsening. Arrange prompt medical assessment for fever, severe pain, pus, spreading redness, marked warmth, or welts that stay fixed and leave bruising. Recurrent episodes also merit a clinical review.

Ask whether the appearance fits hives or another rash, whether any broken skin looks infected, and which warning signs should prompt urgent review. Mention every new medicine and recent illness.