A more practical question about why hives show up may be: What are the factors that trigger the above reactions in your body? The list of possible suspects is long, and does not differ greatly for acute versus chronic hives. “Some people with chronic hives can be exposed to the same acute trigger over and over again,” Elmariah says.
Some of the most common causes of hives are food, drugs, and infections.
Foods That Trigger Hives
Hives from food are usually related to food allergies, including peanuts, eggs, milk, fish, shellfish, and other kinds of nuts. You may even have hives as a result of a pseudoallergic reaction, a reaction to a food or chemical that mimics the symptoms of an allergic reaction, but without IgE antibodies being produced against the offending item.
Pseudoallergic reaction triggers can include artificial food dyes, tomatoes, preservatives, sweeteners, herbs, wine, high dietary fats, alcohol, orange oil, strawberries, and some yellow and red food dyes.
Drugs That Trigger Hives
On the drug front, there are several that can cause hives, including nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, muscle relaxants, antibiotics (especially penicillin and sulfa), diuretics, IV radiocontrast, angiotensin converting enzyme (ACE) inhibitors, and angiotensin receptor blockers, says Anthony M. Rossi, MD, a dermatologist and Mohs surgeon at Memorial Sloan Kettering Cancer Center in New York City.
Infections That Trigger Hives
Infections might include viral ones like the common cold and hepatitis or bacterial ones like strep throat or urinary tract infections, Dr. Rossi says.
Other Things That Trigger Hives
You can also get hives from touching things you may be allergic to. For instance, if you’re allergic to latex, you might get a hive if you touch a balloon or latex glove. The same is the case if you’re allergic to dogs and you’re exposed to dander.
Other things that can cause hives include blood transfusions, insect bites or stings, plants, and to a smaller degree, stress (usually it takes emotional stress combined with some other factor to trigger hives, rather than emotional stress triggering hives on its own).
Environmental stimuli may cause hives, something experts call inducible urticaria (often referred to as physical urticaria). Things like pressure on your skin, exercise, cold, heat, water, sun exposure, and vibrations can instigate an episode of hives.
“You might simply be walking by a construction site or riding a train, and because of the vibrations from these things, you break out,” Elmariah says. These types of hives occur less frequently than those caused by food, drugs, or infections.
Chronic hives, meanwhile, can be caused by any of the above, but they may also be a sign of a health issue or autoimmune disease. “Autoimmune diseases in general have been strongly associated with the development of chronic hives,” Elmariah says.
Yet some have a stronger link to hives, such as thyroid disease, type 1 diabetes, celiac disease, lupus, and rheumatoid arthritis.
