Allergic Urticaria ICD-10: L50.0

Allergic skin reaction

Often searched as: hives on skin, itchy red welts, rash after taking medication, allergic reaction on skin, raised bumps that itch, hives that move around body, skin reaction to medicine, red splotches that come and go…

Clinical urgency level

lowmediumhigh

Systems Affected

skinmucous membranesupper airways (in severe anaphylactic reactions)

Severity Levels

mild

A few scattered hives that resolve within hours, no swelling of lips or throat, no systemic symptoms — manageable with antihistamines.

moderate

Widespread hives covering large body areas, significant itching, lasting more than 24 hours or recurring over days despite antihistamines.

severe

Hives accompanied by angioedema (swelling of lips, tongue, or throat), difficulty breathing, drop in blood pressure, or dizziness — constitutes anaphylaxis, a medical emergency.

Red Flags

  • Swelling of the lips, tongue, or throat
  • Difficulty breathing or wheezing
  • Dizziness, fainting, or feeling of impending doom
  • Hives spreading rapidly over the entire body
  • Hives lasting more than 6 weeks (chronic urticaria — needs evaluation)
  • Reaction occurring after a bee sting, food, or medication — allergy assessment needed

Clinical Presentation

Classic urticaria — raised red itchy welts on the forearm

Classic urticaria — raised red itchy welts on the forearm

Source: Wikimedia Commons (CC BY-SA 3.0 )

Urticaria image gallery — DermNet NZ

View gallery on DermNet NZ (image gallery reference)

When to See a Doctor

Call emergency services immediately if hives are accompanied by throat swelling, difficulty breathing, or dizziness — this may be anaphylaxis. See a doctor or allergist if hives last more than a few days, keep coming back, or if you don't know the trigger. Chronic hives (lasting more than 6 weeks) always require medical evaluation.

Differential Diagnosis

  • Chronic spontaneous urticaria (no identifiable trigger)
  • Physical urticaria (triggered by cold, pressure, or exercise)
  • Urticarial vasculitis (hives lasting >24h with bruising)
  • Contact dermatitis
  • Erythema multiforme
  • Insect bite reactions
  • Angioedema (without hives)

Comorbidities

  • Allergic asthma
  • Allergic rhinitis (hay fever)
  • Atopic dermatitis
  • Food allergies
  • Anaphylaxis history
  • Thyroid disease (in chronic urticaria)
  • Anxiety (chronic hives have significant psychological impact)

Prognosis

Acute allergic urticaria from an identifiable trigger (medication, food, insect sting) typically resolves within hours to days once the trigger is removed and antihistamines are taken. Recurrence is prevented by avoiding the trigger. Chronic urticaria (lasting >6 weeks) is more challenging — it resolves spontaneously in 50% of patients within 1 year, but can persist for years. Omalizumab (Xolair) is an effective treatment for chronic cases unresponsive to antihistamines.

Detailed Overview

Causes, Symptoms, and When to Take Action Allergic urticaria is a skin reaction characterized by the sudden appearance of itchy, raised welts caused by an allergic response — most often to medications. It is a form of hives triggered by the immune system's reaction to a specific substance. How It Looks Texture: Raised, swollen welts that may feel warm or firm Color: Red or skin-colored Shape: Round, oval, or irregular patches; welts may merge into larger areas Location: Can appear anywhere on the body, often shifting location as old welts fade and new ones appear Why Does It Appear? Triggered by an allergic reaction to certain medications The immune system releases histamine and other chemicals into the skin, leading to inflammation, swelling, and itching The reaction can occur minutes to hours after exposure to the medication Should You Be Concerned? Most episodes of allergic urticaria are temporary, but medical attention is necessary if: The welts are widespread or last more than a few days Swelling involves the lips, tongue, or throat There is difficulty breathing, dizziness, or other systemic symptoms Can You Prevent It? Avoid the medication or trigger once identified Inform healthcare providers about previous allergic reactions before taking new medications Monitor for early signs of skin changes when starting a new treatment 👉 How Piel AI Can Help Piel AI allows you to track how welts appear and resolve over time through regular photos. While not diagnostic, it helps identify recurring reactions or patterns to share with your healthcare provider. Summary Allergic urticaria is a type of hives caused by an allergic reaction to medications. It appears as red or skin-colored welts that may come and go quickly. Though often short-lived, severe reactions require prompt medical evaluation. Avoiding known triggers and close monitoring help prevent recurrence.

Tags

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