What should you know about hives on brown skin?

Hives, also called urticaria, are temporary raised areas caused by substances released in the skin. On brown skin, redness may be subtle or absent. Look for a change in texture: a smooth bump, ring, map-like patch or welt that feels swollen and itchy. Individual marks often shift or settle, whereas a fixed patch that becomes scaly, crusted or sore may have another cause. Swelling around the lips, eyelids, hands or feet can occur with hives and is called angioedema.

Possible triggers include an infection, heat, pressure, friction, a medicine, food or an insect sting, although a clear trigger is not always found. A photograph in natural light can help a clinician assess a flare.

Keep the skin cool, wear loose clothing and avoid rubbing or scratching the welts. Pause recently added fragranced products if they seem relevant, and record foods, medicines, exercise, heat and timing around each flare. A pharmacist or clinician may recommend an oral antihistamine; take it only as directed and check suitability if you are pregnant, have medical conditions or take other medicines. Do not apply strong steroid creams to the face or use someone else’s prescription. Learn more about Hives and Antihistamine Treatment.

Call emergency services immediately for trouble breathing, wheezing, throat tightness, faintness, confusion, or swelling of the tongue or throat. Seek urgent assessment for rapidly increasing facial swelling or hives with vomiting after a possible allergen. Arrange a medical review if episodes keep returning, last beyond a short period, interfere with sleep, or leave bruising, pain or marks that do not fade.

Could this be hives rather than another rash? What triggers or medicines should I review? Which antihistamine and dose are suitable for me? How should I track changes in colour, texture and swelling on my skin?