The first step in managing hives is to find out the cause. You can then try to avoid that trigger.
A mild case often disappears on its own after a few hours. If it lasts longer, you can try an over-the-counter antihistamine.
See a doctor if your outbreak doesn't disappear in a few days, though. And get medical help right away if you notice symptoms of angioedema (such as swelling of the lips, tongue, or throat) or a severe allergic reaction (anaphylaxis).
If you often get hives, or if your outbreaks affect you a lot, your doctor will probably prescribe antihistamines. Treatment with corticosteroids, which you take by mouth, will sometimes reduce swelling when antihistamines don't work. But doctors usually save them for more severe cases. Your doctor may also consider a biologic drug, omalizumab (Xolair), for chronic hives in people age 12 and over.
If you're severely allergic to bee stings or other insect bites, certain foods, or medications, ask your doctor about prescribing an emergency kit with epinephrine shots. You would use these to treat anaphylaxis. Always carry two epinephrine kits with you.
When to Call Your Doctor
Tell your doctor if you keep getting bouts of hives that last a month or more.
Call 911 or get emergency medical help immediately if any of these things happen:
1. You start to get burning or itchy welts in your throat.
2. You get hives and a dry throat, cough, cold sweats, nausea, dizziness, or trouble breathing after a bee sting or insect bite or a new medication. This may be anaphylaxis. Give yourself an epinephrine shot, even if you're unsure whether your symptoms are allergy related. It’s safe to use. You'll still need medical attention even if your symptoms seem to stop.