How do I Tell the Difference Between Skin Rashes and Hives?

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  • Written By: K.C. Bruning
  • Edited By: John Allen
  • Last Modified Date: 12 November 2018
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It is possible to tell the difference between skin rashes and hives from visual appearance, determining possible causes of the outbreak, and patient reaction to treatment. Hives typically appear as raised, itchy bumps. Rashes are primarily an inflammation that changes the texture and color of skin.

One of the main differences between skin rashes and hives is the way that they appear on the skin. The raised, red bumps that are hives are eruptions on the surface of the skin. Rashes are a skin discoloration and will only appear slightly raised from the skin’s surface.

The causes of skin rashes and hives also tend to be different. Hives are almost always the result of an allergic reaction. In some cases they may also appear due to pressure changes, sun exposure, or high temperatures. Rashes can also appear due to allergic reactions, but there are several other possible causes. These include menstruation, skin chafing, anxiety, or a bad reaction to an immunization. A rash can also be the result of a fungal, bacterial, or viral infection.

There are several different kinds of conditions that result in rashes. Some of the most common include eczema, psoriasis, impetigo, and shingles. Illnesses contracted primarily in childhood such as measles, roseola, chicken pox, and rubella can also cause rashes.


There are also differences in the ways skin rashes and hives are treated. There are drugs available to treat both conditions; while there are several over-the-counter remedies for rashes, products for hives are typically prescribed. Over time, hives can become resistant to drugs, while rashes are usually more responsive to medication.

Hives appear when an allergic reaction releases chemicals that cause the skin to swell. When the element that caused the reaction goes away, the hives will usually also go away on their own. For more severe or persistent hives, drugs like loratadine can be prescribed. Such drugs can take a couple of days to reach full effect. If hives keep recurring, they may have built up a resistance to the drug, in which case a new medication is usually prescribed.

Several kinds of medications can be used to treat rashes. They include antihistamines to reduce swelling and itching, extra moisturizing lotions for itch, and creams to reduce redness in addition to discomfort. Severe rashes may need medical intervention, though an over-the-counter product can still be used to help treat the condition.


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Post 4

Hives can also be caused by a food allergy. In fact, that is the most common cause. A rash can be raised as well; that's what makes this tricky -- hives look more like welts. So, if you know a child / adult has a food allergy, like peanuts, you are going to treat quickly versus if you notice a rash without any itching, difficulty breathing, etc.

Post 3

@ddljohn-- Hives are not always caused by allergies though. My toddler gets hives when she gets too hot for example.

The difference between hives and rashes is that hives develop in response to an environmental stimuli like heat, an insect bite or pressure; whereas a rash is a response to an internal change like an infection or food allergy.

Hives can be called reactive skin rashes that itch.

Post 2

@fify-- Hives (urticaria) and different rashes can look very similar. But yes, hives are raised whereas a rash might not be. The reason is because hives are caused by a histamine release in the body as an allergic reaction. Histamine causes swelling and that's how you can know that you're dealing with hives rather than a rash.

There have been a few times when I couldn't tell whether I had a rash or hives. When I suspect hives, I take an allergy medication or I use an OTC corticosteroid topical cream from the pharmacy. If it goes away with these treatments, I know that I had hives. A rash usually doesn't go away with allergy medication.

Post 1

I always thought that hives was a type of skin rash.

I'm still not sure I understand the difference between these two. So hives are raised and a rash is not? Is that the main difference?

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