How to Tell the Difference Between Hives and Rashes

Rashes cause changes in skin color or texture. Hives are a type of rash that involves raised itchy bumps. Not all rashes cause hives to develop.

Many people think that hives and rashes are the same, but that’s not exactly accurate.

If you’re concerned about your skin, it’s important to know when a rash is caused by hives and when it might be caused by something else.

In this article, we’ll explore the difference between hives and rashes, plus identify the symptoms, causes, and treatment of each.

How to identify hives vs. rashes

Hives characteristics

Hives (urticaria) are raised, itchy bumps that can be large or small in size. They may be red in color or the same color as your skin. They may also come and go quickly or last a long time.

A breakout of hives can occur all over the body or only in one or two localized areas.

Click here to see an image gallery of hives.

Rash characteristics

Rashes are earmarked by changes in the color or texture of the skin. They may or may not have itchy bumps. They may also cause the skin to feel rough and look scaly or cracked.

Unlike hives, rashes don’t always itch. Sometimes, they hurt or make your skin feel irritated, scratchy, or uncomfortable. You may have a rash all over your body or in one or two areas.

Click here to see an image gallery of rashes.

This table provides an overview of the characteristics of hives versus rashes:

CharacteristicsHivesRashes
Appearancered or flesh-toned bumps that can change in size, shape, and colorif you press on the bumps, they may blanch and briefly turn whiteappear in clusters on any area of the body (the clusters may spread, or they may remain contained)bumps may morph together and become plate-sizedthey may appear briefly or be long-lastingredchanges in skin texturemay look bumpy, scaly, or roughmay have blisters or weltsswollen
Symptomsitching, which can be intense and of long or short durationred skinitchypainfulirritated, raw-looking skinskin that feels warm to the touch

Symptoms and causes of hives

Symptoms of hives

Hives are itchy. The itch can be intense or mild, long-lasting or of short duration. Often, the bumps caused by hives will be preceded by itching skin. Other times, the bumps and itching will occur simultaneously.

Hives usually occur in clusters, which can erupt anywhere on the body. Hives may be as tiny as pin dots or much, much larger. Their size and shape can also change.

In some instances, hives may morph together, causing very large, itchy areas of skin. The skin surrounding the area where hives occur may look red, swollen, or irritated.

Hives can come and go quickly. They may also linger or recur for weeks, months, or years.

Causes of hives

Hives can occur when too much histamine is released into the body by the immune system. This often is caused by an allergic reaction.

Allergies are thought to be the major cause of hives. You can get hives if you eat or drink something you’re allergic to or if you come into contact with something in the environment that you’re allergic to.

Additional causes include:

  • medications
  • external temperatures
  • sunlight
  • anxiety and nervousness
  • certain bacterial or viral infections, such as strep and urinary tract infections
  • In some instances, it may not be clear what’s causing your hives.

    Symptoms and causes of rashes

    Symptoms of rashes

    Skin rashes sometimes look and feel like hives. Other times, no bumps on the skin will form.

    Skin rashes can be scaly, red, and raw-looking. They may be dotted with blisters, plaques, or welts. They may also hurt, itch, or make skin feel warm to the touch. Sometimes, the areas of affected skin may also become swollen.

    Based on the underlying cause, a rash can occur all over your body or only in one or two spots.

    Causes of rashes

    Rashes have a wide range of potential causes, including allergic reactions. The causes of rashes include:

  • contact dermatitis
  • allergic eczema
  • psoriasis, and other medical conditions, such as lupus, fifth disease, and impetigo
  • bug bites from fleas, bed bugs, and other critters
  • viral and bacterial skin infections, such as cellulitis
  • How are hives treated?

    Hives often disappear on their own. But it’s helpful if you can identify what’s triggering your hives.

    If you can avoid exposure to the allergen causing the reaction, your hives will hopefully disappear and not return. Unfortunately, it isn’t always that simple.

    If you continue to have hives, there are several at-home treatments you can try to get rid of them. These include:

  • taking oral antihistamines
  • applying cortisone cream to the area
  • applying calamine lotion to the area
  • soaking the area with a cool compress of witch hazel
  • using a cold water compress on the area
  • wearing loose clothing that doesn’t irritate the skin
  • avoiding sun exposure
  • Hives can last for hours, days, weeks, or longer.

    Chronic, long-lasting hives may need more aggressive, medical treatment, such as prescription antihistamines, oral corticosteroids, or biologic drugs. Severe cases of hives may require an epinephrine injection.

    How are rashes treated?

    Rashes can be acute or chronic. If you have a mild rash, at-home treatments such as those used for hives may be effective.

    When determining the best treatment for your rash, it’s important to consider the cause. Some possible treatments include:

  • soaking in a colloidal oatmeal bath
  • applying topical corticosteroids to the area
  • taking oral antihistamines
  • applying topical retinoids to the area
  • applying aloe vera to the area
  • taking oral or injected prescription medications
  • Are some people more prone to hives or rashes?

    Hives and rashes have many potential causes and are fairly common.

    People who are prone to allergies may be more likely to get hives or rashes than those who are not. However, a rash or hives can happen to anyone at any age.

    Should you see a doctor?

    If you have long-term hives or rashes, talking to a doctor such as an allergist or dermatologist may help you uncover their cause and determine the best course of treatment.

    Hives or rashes may be the result of an allergic reaction or medical condition that warrants immediate medical treatment.

    See a doctor if your skin condition is accompanied by any of these symptoms:

  • difficulty breathing
  • itching or a feeling of constriction in the throat
  • severe pain at the site of the rash
  • severe pain in the head, neck, or abdomen
  • swelling in the face, eyelids, lips, throat, or extremities
  • fever
  • dizziness
  • confusion
  • muscle weakness or sudden lack of coordination
  • diarrhea
  • vomiting
  • rash with open sores or blisters
  • rash involving the mouth, eyes, or genitals
  • Just like adults, infants and toddlers can get hives or a rash. These may be caused by nothing more than a bug bite or exposure to new foods.

    However, if your baby has hives or a rash, call their pediatrician to discuss their condition, especially if they have any of the symptoms listed above.

    Key takeaways

    Hives and rashes have a wide range of causes and are very common.

    Hives are a type of rash, although not every rash looks like hives. Both skin conditions can be acute or chronic.

    It’s important to try to determine the underlying cause of your hives or rash, as this can help you decide on the best treatment. Often, at-home treatments are enough to treat both conditions.

    When accompanied by other symptoms, such as trouble breathing, hives and rashes may require immediate medical treatment.

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