Have you ever had intensely itchy skin and wondered what was going on? Both eczema and hives can cause itchy skin, but there are a few key differences to be aware of so you know how to address each condition. Living with itchy skin can be disruptive and affect your quality of life. This article will cover the main differences in symptoms, causes, and treatments between eczema and hives so you can get that itchy skin under control.

What Causes Eczema and Hives?

Although both eczema and hives leave the skin very itchy, a few key differences can help you tell the conditions apart from each other. They have some different causes and triggers, as explained below.

Eczema

Eczema is an inflammatory skin condition. There are seven different types of eczema, each with different causes. Some causes include genetics, allergic reactions, dry skin, and stress.

Atopic dermatitis, the most common form of eczema, occurs when a trigger causes the immune system to overreact, leading to a flare of eczema symptoms.

Common eczema triggers include:

• Household products — Soaps, shampoos, body washes, laundry detergents, and disinfectants
• Metals — Kitchen utensils, jewelry, and clothing clasps
• Fabrics — Clothing and sheets
• Environment — Extreme temperatures, dry or humid environments, altitude, dirty spaces, and poison ivy
• Certain chemicals

Hives

Hives, on the other hand, develop when the body releases histamine in response to a trigger. Histamine is part of the body’s natural immune system, which protects us against illness and infections. Common causes of hives include allergic reactions, stress, and skin irritation (from scratching or tight clothing, for example).

Hives can be triggered by:

• Foods or medications you’re allergic to
• Skin allergies, like a latex allergy
• Inhaled allergens like pollen or pet dander
• Environmental allergies like sun exposure, extreme temperatures, poison ivy, bug bites, and bee stings

Eczema and hives can both develop as a response when your body has an allergic reaction.

Who Is at Risk of Eczema and Hives?

In addition to the triggers mentioned above, there are a few conditions that may increase your likelihood of developing eczema or hives.

Eczema

People with contact allergies can end up with contact dermatitis, which is a type of eczema. Hay fever, as well as certain food allergies (like oat allergy), can also cause eczema to flare. People with autoimmune disorders and mental health conditions such as depression may be more prone to eczema flare-ups. COVID-19 and asthma have also been associated with eczema.

Hives

People with atopic dermatitis have a higher risk of developing hives. Because hives can be triggered by topical allergens, they may develop in response to topical ointments used for eczema treatment. One member of MyEczemaTeam noted that her child “got white patches after she used steroid cream prescribed by the pediatrician.”

Many other factors can cause hives. Infections like the flu or COVID-19 can be a trigger, as can smoking cigarettes. The American Academy of Dermatology notes that African American women have a particularly high risk of developing hives. People getting medical treatments such as radiation therapy or blood transfusions can also develop hives in response to those treatments.

How Can You Tell the Difference Between Eczema and Hives?

Because the symptoms of eczema and hives can be quite similar, you may need to consult a health care provider if you’re unsure what’s causing your itchy skin. They can make an accurate diagnosis and figure out a treatment plan that works for your skin.

Where Does Eczema Occur?

Eczema often affects areas where the skin rubs against itself, like behind the knees, on the elbows, or lower legs. Itchiness is by far the most common symptom that people with eczema experience. Other common symptoms include dryness, oozing, crustiness, and thick skin with rough and scaly patches.

Eczema can look different in different people. On lighter skin, eczema typically looks red or pink. On darker skin, it causes small and raised bumps that may be brown, purple, or gray.

Where Do Hives Occur?

Hives can develop anywhere on the body. They appear as raised bumps or raised patches (called plaques) of skin that are typically very itchy. Hives are often warm to the touch, and if you press on the area, it will turn white. Hives develop suddenly and can appear in the same spot or different spots.

Like eczema, hives will appear differently on different skin colors. On darker skin, hives will typically be the same color as your skin or a slightly lighter or darker color. On lighter skin, hives are typically red or pink. Sometimes, the skin around the hive also swells. This can happen anywhere, but it most frequently affects the face. Any swelling around the throat or face can lead to difficulty breathing and should be treated as a medical emergency.

Though both eczema and hives can be very itchy, neither is contagious. Hives and eczema can also occur at the same time. Hives will typically go away on their own within a few days. Eczema tends to last a bit longer when a flare-up occurs. There are treatment options to help deal with the symptoms of both conditions.

How Do You Treat Eczema and Hives?

Neither eczema nor hives is curable, but they both have many treatment options.

Eczema Treatment

People with eczema typically have treatments centered around managing the itchiness. Identifying triggers can prevent some eczema flare-ups. But even when a cause can’t be found, you can focus on treating the symptom (itchiness).

Treatments and suggestions for people with eczema include:

• A gentle daily skin care routine that includes bathing, applying sunscreen, and using fragrance-free lotions and skin care products
• Moisturizers
• Topical treatments like creams, ointments, cold compresses, and wet wraps
• Medications like immunosuppressants
• Short fingernails or barriers like gloves to prevent scratching
• Light therapy, also known as phototherapy
• Behavior modification training to help you stop scratching

One member of MyEczemaTeam suggested keeping lotion in the fridge so it has soothing and cooling effects at the same time. If home remedies don’t seem to be helping, contact your doctor to see if a prescription treatment might work for you.

Hives Treatment

Mild hives typically will go away in a few days. If you or a loved one experiences severe symptoms associated with hives (throat swelling, difficulty breathing, or feeling faint), seek emergency treatment right away. For chronic hives with mild symptoms that last longer than six weeks, it’s best to schedule an appointment with a dermatologist.

Treatments for hives include:

• Topical treatments — Lotions or creams
• Medication — Antihistamines, cyclosporine (Neoral), corticosteroids, omalizumab (Xolair), epinephrine auto-injector pens
• Light therapy

If you have questions about treatments, it’s best to consult a health care provider so they can work with you to find the best treatment for your specific symptoms.

How Do Hives and Eczema Affect Children?

Both eczema and hives can develop at any age, and they are quite common in children. If eczema, food allergies, or hay fever run in the family, young children and babies are more likely to develop eczema. Like adults, babies can be sensitive to topical products listed above (ointments, soaps, lotions) and to extreme temperatures in the environment.

The triggers listed above can also make babies develop hives. Infections, especially viral infections, are the most common trigger for hives in babies. Hives may appear as itchy raised bumps or welts in both adults and babies, but in babies, they may also appear smaller, like a mosquito bite.

Talk With Others Who Understand

MyEczemaTeam is the social network for people with eczema and their loved ones. On MyEczemaTeam, more than 53,000 members come together to ask questions, give advice, and share their stories with others who understand life with eczema.

Are you living with eczema? Have you wondered if you also have hives? Share your experience in the comments below, or start a conversation by posting on your Activities page.