Rashes and Hives: Causes, Symptoms, and Treatment

Skin rashes and hives can be sources of significant discomfort or anxiety. Typically appearing as red, itchy, or inflamed patches, these skin conditions might arise due to various triggers, such as allergic reactions, environmental factors, or infections.

In this blog, we’ll provide some background on rashes and hives, their types, causes, and when it might be necessary to consult with a dermatologist.

What are rashes and hives?

It’s a good idea to seek medical advice if you’re dealing with a rash. Rashes and hives are your body’s alarm bells, signalling an environmental sensitivity, a disorder, a disease, or simply dry or irritated skin. 

Hives, also called wheals, welts, or urticaria, are a type of rash that can crop up due to trauma to the skin, like scratching or from a viral infection. Histamine gets released causing the tiny blood vessels (capillaries) to leak fluid into the skin causing these raised welts. While hives aren’t contagious, it’s best to avoid touching them as you may further irritate the skin.

Allergic reactions to food, medicine, or environmental irritants can also manifest in hives. A number of well-known allergic triggers can cause you to develop hives such as:

• Pollen
• Certain foods or alcohol and food additives
• Bug bites and stings
• Certain medications 
• Infection
• Latex
• Blood products 
• Animal dander

What are the common symptoms of skin rashes and hives?

Skin rashes encompass a broad category of abnormalities that can manifest as swollen, red, itchy, or blistered skin. Hives, or urticaria, are a specific type of rash characterized by raised, red, or skin-colored welts that are often very itchy and can also feel like burning or stinging. 

Both rashes and hives can be acute or chronic, localized to one area, or widespread across the body. They are common indicators of allergic reactions, irritations, or even systemic conditions.

Common symptoms of rashes include: 

• Redness or discoloration
• Itchy skin
• Swelling
• Blisters or welts
• Dry, scaly texture

What are the common types of skin rashes and hives?

Understanding the various types of rashes and hives can help in identifying them and deciding the best course of action.

Atopic Dermatitis (Eczema): A chronic condition featuring dry, itchy skin that can flake or become inflamed and red. Eczema often appears on the elbows, knees, and neck but can occur anywhere on the body.

Contact Dermatitis: This rash occurs when skin comes into contact with an allergen (like poison ivy or latex) or an irritant (such as chemicals in cleaning products). Symptoms include redness, itching, and sometimes blistering.

Psoriasis: A chronic inflammatory condition that leads to the rapid buildup of skin cells, resulting in thick, scaly patches or red, inflamed areas that can be itchy and painful.

Hives (Urticaria): Hives are a reaction that causes red or skin-colored welts on the skin. They are typically very itchy and can appear suddenly due to allergies, stress, or for unknown reasons.

Heat Rash (Miliaria): Overheating can stop your body from expelling sweat properly, trapping it in your skin. With nowhere else to go, this sweat can spread under the surrounding skin, triggering an itchy, inflamed rash known as prickly heat or heat rash. Because of its relationship with heat, many develop this skin rash during summer. It often appears as small, raised, red or skin-coloured bumps, or as clear, fluid-filled bumps.

How dermatologists treat rashes and hives

Below are some common treatments spanning common types of rashes and hives. They can be highly effective depending on the specific type and severity of the skin condition. Dermatologists will often combine several treatment approaches to achieve the best results while minimizing side effects.

Moisturizers and Creams

Moisturizers are foundational in treating many skin conditions, especially eczema, where they help hydrate the skin and repair the skin barrier. These are usually applied immediately after bathing to lock in moisture. For inflammatory conditions like eczema, psoriasis, and contact dermatitis, dermatologists often prescribe topical corticosteroids to reduce inflammation and alleviate symptoms. Non-steroid options like calcineurin inhibitors are also used to modify the immune response and reduce flare-ups, particularly in sensitive areas where prolonged use of steroids may be harmful.

Compresses

Cool and wet compresses can provide significant relief from itching and discomfort associated with rashes, especially in cases of severe eczema, contact dermatitis, and hives. These compresses can be simple to prepare and use at home, helping to soothe the skin and temporarily reduce inflammation. If heat rashes, in particular, don’t seem to get better even after moving to a cooler environment and using compresses, it could be a sign of something else like an infection. If you suspect this, speak to a doctor right away to confirm the diagnosis.

Medications

Oral medications play a crucial role in managing severe or chronic conditions. Antihistamines are commonly used to treat hives by blocking the effects of histamine, which is a major factor in itching and swelling. For more systemic conditions like severe psoriasis or persistent eczema, systemic medications such as methotrexate or biologic drugs target specific parts of the immune system to prevent the rapid growth of skin cells or to curb severe inflammation. These treatments are typically reserved for cases where topical treatments are not sufficient.

Light Therapy

For certain types of psoriasis, light therapy (phototherapy) is an effective treatment option. This involves exposing the skin to ultraviolet light under medical supervision to help control scaling and inflammation. It’s particularly useful for patients who do not respond adequately to topical treatments or who experience widespread psoriasis.

Connecting with a dermatologist

If over-the-counter remedies haven’t worked, antibiotics or prescription options are available through primary care providers. Primary care providers may refer to dermatologists if they are unsure about diagnoses or if more specialized treatments and maintenance are required. 

If you’re among the 6.5 million Canadians without a family doctor, getting referred to a dermatologist could mean long wait times at the walk-in clinic. 
. On top of that, getting a referral doesn’t guarantee a timely appointment. The average wait time to see a dermatologist for a non-urgent skin concern in Canada is between six to 18 months, depending on where you live and what your reason for referral is.

With Maple, Canada’s leading virtual care platform, you can book an appointment with a Canadian-licensed dermatologist appointment directly without a referral. Dermatologists on Maple are the same specialists you’d see in person, but they also practice outside of their own clinic hours to see patients virtually. 

There are some circumstances when an in-person dermatology visit is needed. Tell us about your skin concerns and see if virtual dermatology is right for you.

Information presented here is for educational purposes, and not to replace the advice from your medical professional. Virtual care is not meant for medical emergencies. If you are experiencing an emergency like chest pain or difficulties breathing, for example, please call 911 or go to your nearest emergency room.