When it comes to skin conditions, the terms “rash” and “hives” are often used interchangeably. “Rash,” however, is a broad, general term used to describe any skin inflammation or discoloration. In contrast, hives are a specific type of rash. In other words, hives are an example of a rash, but not all rashes are hives.

In this article, we’ll dive into the hives vs rash question. We will:

• Look at the differences between hives and other types of rashes.
• Compare symptoms and treatments.
• Discuss when to seek medical attention.

Rashes

There are countless causes for skin rashes, but here are some of the most common:

• Allergic reactions to foods, medications, pollen, dust mites, pet dander, insect bites, poison ivy.
• Environmental factors such as exposure to harsh chemicals or extreme heat or cold.
• Stress, depression and other psychological factors.
• Infections like impetigo, cellulitis, or Lyme disease.
• Fungal infections like ringworm or candidiasis.
• Parasitic infections like scabies and hookworm.
• Eczema, psoriasis, rosacea, and other persistent skin conditions.

A skin rash can also be a sign of many different viral infections, including shingles, measles, and HIV.

The symptoms of a rash vary depending on the cause, but generally include redness, swelling, itching, and discomfort.

Treatments such as over-the-counter creams, lotions, and ointments can provide relief for the itching and pain. However, people with allergies should use hypoallergenic OTC remedies. Anti-inflammatory ointments such as cortisone cream can also help. Bacterial infections can be treated by medical personnel with antibiotics. Other prescription medications are available for treatment of skin conditions and diseases.

In any case, it’s always best to avoid scratching a rash, because this can lead to infection, further irritation, or scarring.

Hives

Hives, also known as urticaria, are a particular type of rash characterized by raised, smooth, itchy bumps on the skin. These bumps can be different sizes and shapes and often appear suddenly and disappear quickly (within hours or a day). Hives sometimes join together to form larger areas of swelling called angioedema. Acute hives can last for less than an hour or up to six weeks. In chronic hives, the raised welts last more than six weeks and may recur over months or years.

How can you tell the difference between hives and other types of rashes? Only trained medical professionals like the experts at Florida Medical Clinic Orlando Health can make a diagnosis. However, generally speaking, the welts from hives:

• Appear shortly after exposure to a trigger.
• Change color when a person presses them.
• Do not cause flaking or broken skin.
• Affect a well-defined area of the skin.

People often confuse hives with other skin conditions such as heat rash, insect bites, and dermatitis. Heat rash, though, is a prickly rash typically occurring when a person gets overheated. This type of rash is made up of tiny bumps consisting of blocked sweat glands.

In an insect bite, there’s generally just one small area of itchy swelling, and it’s located around the bite. However, if someone gets bitten by multiple bugs, such as mosquitoes, the appearance can resemble hives.

When it comes to dermatitis, the answer is more complex. There are two main types of dermatitis. Much like hives, contact dermatitis often appears after exposure to an allergen or some other irritant. It can look a lot like hives, except that the welts in dermatitis are more like blisters. It can be both itchy and painful. Contact dermatitis generally lasts longer than acute hives, too, with a duration of 14 to 28 days or longer.

In contrast, atopic dermatitis, also known as eczema, is a long-term condition that often begins in childhood. In eczema, the inflammation is connected to an irregular immune response and a disrupted skin barrier. Atopic dermatitis causes a dry, scaly rash. Dryness can be so severe that a person’s skin will bleed or crack.

Allergens are a major trigger for both hives and dermatitis. OTC antihistamines can help to soothe irritation and relieve itching for either skin condition. For additional relief, medical personnel sometimes prescribe systemic corticosteroids or monoclonal antibody medications such as omalizumab to treat chronic hives.

Also, the angioedema that sometimes accompanies hives can in some cases make it more difficult for people to breathe. What’s more, allergic hives can sometimes lead to a severe allergic reaction called anaphylaxis. If this occurs, the patient must immediately seek emergency care.

When to Seek Medical Attention

While both hives and other rashes can be uncomfortable, they are typically not serious and can be managed with at-home treatments. However, certain symptoms indicate the need for emergency care.

Signs of a potentially life-threatening allergic reaction include:

• Difficulty breathing or swallowing.
• Swelling of the face, lips, tongue, or throat.
• Rapid heartbeat.
• Loss of consciousness.

Also, it’s important to seek medical treatment from a primary care provider, dermatologist, allergist, or immunologist any time that hives or some other type of rash is:

• Severe or spreading rapidly.
• Accompanied by other symptoms (fever, dizziness, etc.).
• Interferes with daily life.
• Leading toward complications.

Hives vs. Rash

Hives are only one type of rash, and each one is a distinct condition with its own causes, symptoms, and medical treatments. To manage symptoms and prevent complications, you need to properly identify the condition and its triggers. The specialists at Florida Medical Clinic Orlando Health can help you with that. And if the symptoms persist or are severe, they can provide all the necessary medical attention.

Get to Know Dr. Sami Nallamshetty

At the Florida Medical Clinic Orlando Health, Dr. Sami Nallamshetty specializes in pediatric and adult allergy and immunology. She is board-certified and completed her allergy/immunology training at Harvard Medical School. Her studies on allergies and asthma have been published in top scientific journals

Dr. Nallamshetty calls on her extensive education, fellowships, and experience to assist patients of all ages with their medical conditions. A native of New Jersey, she’s lived in Tampa Bay since 2008, so she’s seen many allergy seasons come and go. Through her passion for patient care, she has helped many people alleviate and overcome their symptoms so they can get the most out of life. Happily married with two children, she enjoys spending time with her family, traveling, and volunteering in the community.