What Do Autoimmune Hives Look Like?

March 8, 2024

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Hives, also known as urticaria, are itchy welts that appear on the skin. While most hives clear up within a few weeks, autoimmune hives can be persistent and frustrating. This guide explains what autoimmune hives look like and how they differ from other types of hives.

Symptoms and Appearance of Autoimmune Hives

Red, Raised Welts (Wheals)

Like other forms of hives, autoimmune hives appear as sudden eruptions of red, raised, itchy skin bumps, also called wheals or welts. The lesions can be small isolated bumps or merge into larger swellings. Fluid leaking from blood vessels leads to swelling within skin layers.

Changing Location

A distinctive feature of autoimmune hives is that unlike allergic hives, the wheals shift location around the body over time rather than recurring in the same spots. New lesions appear as old ones resolve.


Individual hives generally resolve within 24 hours. But with autoimmune hives, outbreaks stubbornly persist beyond 6 weeks, classifying them as chronic hives. Symptoms may wax and wane in severity.

“Autoimmune hives can appear anywhere on the body and tend to move around over time, unlike allergic hives triggered by a specific allergen.” – American Academy of Dermatology

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Distinguishing Autoimmune Hives from Other Types

Allergic Hives

Allergic hives result from contact with a specific allergen trigger like food, pet dander or latex. Red itchy bumps emerge within minutes where the allergen touched the skin and fade within hours or days after avoidance.

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Physical Hives

Scratching, heat, cold or pressure on the skin provokes hives through direct release of histamine from skin cells. The red, itchy lesions correspond precisely to the point of contact and resolve shortly after stimulus removal.

“Consulting a doctor to distinguish autoimmune hives from other types is crucial for proper diagnosis and treatment.” – Mayo Clinic

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Importance of Diagnosis

Pinpointing the root cause determines whether antihistamines, immunosuppressants, biologics or other medications are most appropriate for treatment. Keeping a symptom journal tracking potential triggers, timing, and location of welts helps your doctor evaluate patterns guiding diagnosis and management.

Accurately differentiating between different types of urticaria ensures the right interventions are taken for establishing control and improving quality of life.

Frequently Asked Questions

What causes autoimmune hives?

The immune system erroneously attacks healthy cells, causing mast cells in skin to leak inflammatory chemicals like histamine leading to red, swollen welts. The reasons why this autoimmunity develops remain unclear.

Are there any other symptoms besides itchy welts?

Sometimes fatigue, joint/muscle aches, abdominal discomfort or swelling of deeper skin layers (angioedema) accompanies recurrent episodes of autoimmune hives.

How are autoimmune hives treated?

First line treatment involves antihistamines like cetirizine or loratadine to reduce swelling and itchiness. Doctors may also prescribe corticosteroids during severe flares to calm inflammation and immunosuppressants for refractory cases.

Is there a cure for autoimmune hives?

There is presently no definitive cure. But medications can effectively control symptoms, allowing patients to enjoy prolonged periods of remission from hives between periodic flares.

Can stress trigger autoimmune hives?

While stress does not directly cause initial autoimmune dysfunction, significant stressors can exacerbate outbreaks and severity in those with underlying autoimmune urticaria through activating inflammatory pathways. Relaxation techniques help reduce recurrences.

Key Takeaways

  • Autoimmune hives resemble other hives but unusually shift locations, recur chronically beyond 6 weeks.
  • Distinguishing autoimmune hives guides suitable medications – antihistamines, immunosuppressants etc.
  • Keeping a symptom journal noting timing, location helps diagnosis.
  • Allergy testing and ruling out infections/cancers is key during evaluation.
  • Preventing triggers and reducing stress aims to decrease flare-ups.
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