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Conditions
Hives(Urticaria)
Raised, itchy welts on the skin that appear suddenly. Can be triggered by allergies, stress, infections, or medications. Usually harmless but can be very uncomfortable.
Get assessed
From $24.95 · No appointment needed
6 min
avg cert turnaround
13 min
avg doctor review
2
days a week
30%
refund if declined
Symptoms
CommonsymptomsofHives(Urticaria)
An AHPRA-registered doctor assesses these symptoms online - no in-person visit required.
Raised, red or skin-coloured welts (wheals)
Intense itching
Welts that change shape or move around the body
Welts that blanch (turn white) when pressed
Swelling of lips, eyes, or throat (angioedema)
Burning or stinging sensation
Our Scope
Howwecanhelp
InstantMed handles many common conditions entirely online. Here's what fits our service.
What we can help with
- Assessment and treatment advice for acute hives
- Discussion of antihistamine options
- Help identifying possible triggers
- Medical certificates if hives are severe
What needs in-person care
- Emergency treatment for anaphylaxis (call 000)
- Allergy testing (requires specialist referral)
- Assessment for chronic urticaria (may need specialist)
Depending on your situation, an AHPRA-registered doctor may be able to issue a medical certificate or arrange a repeat prescription after reviewing your request online.
Clinical Guidance
Whentoseeadoctor
These indicators suggest you should seek professional medical advice promptly.
Signs you need a doctor
- 1Hives lasting more than 6 weeks (chronic urticaria)
- 2Hives that keep recurring
- 3Hives not responding to antihistamines
- 4You need a medical certificate
Seek emergency care if
- Swelling of the throat, tongue, or lips (anaphylaxis risk)
- Difficulty breathing or swallowing
- Dizziness or feeling faint
- Hives with abdominal pain and vomiting
Call 000 or go to your nearest emergency department
Clinical Insight
Adoctor'sperspectiveonHives(Urticaria)
InstantMed Clinical Team
AHPRA-registered medical team · Reviewed 2026-03
Hives (urticaria) are extremely common - about 20% of people will experience at least one episode in their lifetime. The most important thing I assess is whether the hives are part of an allergic reaction that could progress to anaphylaxis. The warning signs are swelling of the lips, tongue, or throat, difficulty breathing, dizziness, or abdominal pain - these require immediate emergency care (call 000). In the vast majority of cases, hives are benign, self-limiting, and respond well to antihistamines. What frustrates many patients is that a specific trigger is identified in fewer than 50% of acute hives cases. Chronic urticaria (lasting more than 6 weeks) is almost never allergic in origin - it is typically autoimmune and requires a different treatment approach. Via telehealth, I can assess the pattern, recommend appropriate treatment, and determine whether specialist referral is needed.
Treatment
TreatingHives(Urticaria)
Urticaria (hives) is primarily treated with non-sedating antihistamines. Second-generation antihistamines (cetirizine, loratadine, fexofenadine) are first-line for both acute and chronic urticaria. For chronic urticaria unresponsive to standard antihistamine doses, up-dosing (2-4x standard dose) is recommended by ASCIA before adding other agents. Short-course oral prednisolone is used for severe acute episodes. Adrenaline (EpiPen) is required if anaphylaxis is present -- hives with throat swelling, breathlessness, or cardiovascular symptoms are a medical emergency.
Cetirizine
Zyrtec, Zirtec, Cetirizine Sandoz
Class:Second-generation antihistamine (H1-receptor antagonist)
Typical dose:10mg once daily (morning or evening); may up-dose to 20mg daily if inadequate response under medical guidance
PBS:Available OTC without prescription
- First-line antihistamine for urticaria -- effective in approximately 85% of acute cases
- Second-generation antihistamine: less sedating than older agents (promethazine, diphenhydramine)
- For chronic urticaria, regular daily dosing is more effective than on-demand use
- ASCIA guidelines support increasing to 20-40mg daily for insufficient response before adding other agents
Fexofenadine
Telfast, Fexofenadine Sandoz
Class:Second-generation antihistamine
Typical dose:180mg once daily
PBS:Available OTC (S3, pharmacist supply) without prescription; 180mg and 60mg strengths available
- Non-sedating antihistamine; ASCIA evidence confirms effectiveness for urticaria
- Minimal CNS effects -- suitable for those who need to drive or operate machinery
- Alternative to cetirizine for patients who experience sedation
Prednisolone (oral)
Predmix, Panafcort
Class:Systemic corticosteroid
Typical dose:25-50mg daily for 3-5 days for severe acute urticaria flares
PBS:PBS listed; $25.00 general / $7.70 concession (PBS, 2026)
- Reserved for severe acute urticaria not controlled by antihistamines alone
- Short 3-5 day course provides rapid suppression without significant adrenal effects
- Not recommended for chronic urticaria management -- antihistamines are first-line
- A telehealth consult can prescribe prednisolone for severe acute urticaria requiring systemic treatment
Source: ASCIA (Australasian Society of Clinical Immunology and Allergy) urticaria clinical practice guidelines, 2023; Therapeutic Guidelines -- Dermatology, 2024. This information is educational only and does not replace clinical assessment.
Specialist referral: Seek emergency care immediately if urticaria is accompanied by throat swelling, breathing difficulty, hypotension, or loss of consciousness (anaphylaxis -- call 000). Refer to an allergist/immunologist for: chronic urticaria (lasting more than 6 weeks), urticaria unresponsive to antihistamines, physical urticaria (cold, pressure, dermographism), or urticaria with recurrent anaphylaxis requiring adrenaline autoinjector prescription. Allergen identification via formal testing can guide management.
Hives (Urticaria) in Australia
Approximately 20% of Australians will experience hives at least once in their lifetime
Chronic urticaria (lasting >6 weeks) affects 0.5-1% of the population
A specific trigger is identified in fewer than 50% of acute hives cases
Antihistamines are effective in approximately 85% of acute urticaria cases
Recovery
Whattoexpect
Typical recovery timeline and return-to-work guidance for most patients.
Typical recovery
Individual welts resolve within 24 hours. An acute episode typically lasts days to weeks. Most acute hives resolve completely within 6 weeks. Chronic urticaria can persist for months to years but is manageable with ongoing treatment.
Return to work
Most people can work with hives, though severe itching and visible welts on the face or hands may be distracting or distressing. If hives are widespread and severely itchy, a day off during the acute phase is reasonable.
When to reassess
Seek emergency care immediately if hives are accompanied by throat swelling, breathing difficulty, or dizziness. See a doctor if hives persist beyond 6 weeks, recur frequently, or are not controlled by over-the-counter antihistamines.
Self-Care
ManagingHives(Urticaria)athome
Evidence-based tips to support your recovery alongside medical treatment.
Take a non-drowsy antihistamine (cetirizine, loratadine, or fexofenadine) at the first sign of hives - available over the counter
Apply a cold compress or ice wrapped in cloth to affected areas - cold constricts blood vessels and reduces swelling
Avoid hot showers, tight clothing, and vigorous exercise during an episode - heat worsens hives
Keep a diary of when hives appear to help identify triggers (food, stress, exercise, temperature)
Avoid aspirin and ibuprofen during hives episodes - NSAIDs can worsen urticaria in some people. Use paracetamol instead
Wear loose, cotton clothing - friction and pressure on the skin can trigger new welts
FAQ
CommonquestionsaboutHives(Urticaria)
Answers to the most common questions from patients.
Common triggers include allergic reactions (food, medication, insect stings), viral infections, stress, heat, exercise, and pressure on the skin. In many cases, no specific trigger is identified.
Hives themselves are not dangerous, but they can be part of a more serious allergic reaction (anaphylaxis). Seek emergency care if hives are accompanied by throat swelling, difficulty breathing, dizziness, or a rapid heartbeat.
Individual welts typically last 30 minutes to 24 hours, but new welts may continue appearing. Acute hives resolve within 6 weeks. Chronic hives (lasting beyond 6 weeks) require investigation.
Non-drowsy antihistamines (cetirizine, loratadine, fexofenadine) are first-line treatment. For severe episodes, a short course of corticosteroids may be needed. Avoid triggers if identified.
Ready to get help with Hives (Urticaria)?
Australian-registered doctors review your request when available.
Full refund if the doctor declines.