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What Causes Hives?

Hives can come from allergic reactions, certain foods, medications, and even stress.

What causes hives 2 1

At first glance, the red blotches of hives – medically known as urticaria – look alarming. They cover an area of your body, disappear, only to reappear elsewhere. There is also the fact that hives are itchy, so you get little sleep at night as you scratch the skin lesions.

In this article, we will be discussing what causes hives and how we can use Traditional Chinese Medicine and techniques to treat them.

What Are Hives?

Hives are an allergic reaction to something you may have eaten or been in contact with (allergens). This causes your body to release chemicals, the most notable of which is histamine. Histamines are produced to defend the body against infection and other outside invaders. It is histamines that cause swelling, itching and other symptoms of hives.

What Causes Hives?

Here are the most common causes of hives:

  • Certain foods (the most notable being peanuts and other nuts, eggs, milk, and shellfish)
  • Medications, such antibiotics (especially penicillin and sulfa), aspirin, and ibuprofen
  • Insect bites or stings
  • Physical stimuli, namely pressure, heat, cold, exercise, or sun exposure
  • Blood transfusions
  • Latex
  • Bacterial infections, such as urinary tract infections (UTI) and strep throat
  • Viral infections, such as the common cold, infectious mononucleosis (mono), and hepatitis
  • Pet Dander
  • Pollen
  • Certain plants

Some of the common allergens are dairy, nuts, seeds and eggs. 

Hives Symptoms

Hives appear as red or skin-colored welts called “wheals” with clear edges. They may appear on any part of the body, move around, disappear and then reappear in short periods of time. Hives have a distinct characteristic. When pressed in the center, the red hive turns white in a process called “blanching”.

There are two types of hives. Acute hives last for a short term, usually a few hours up to two or six weeks. Chronic hives may last for months or even years. Hives are typically very itchy, which are uncomfortable and can even disturb sleep.

Another condition called angioedema – tissue swelling beneath the skin surface – may be mistaken for, or associated with hives. Like hives, angioedema may be caused by allergies, medications, or a hereditary enzyme deficiency.

You can distinguish angioedema from hives when the swelling appears in the eyes or mouth, hands, feet, or throat, and exhibits difficulty of breathing, stomach cramps, and swelling of the eye linings.

Treatment of Hives

Mild cases of hives may not need prescription treatment. In some cases, antihistamines may be needed. Avoid scratching or irritating the hives. Avoid hot water as this may aggravate the hives. Take a cool or lukewarm batch with colloidal oatmeal or baking soda.

Hives and TCM

There are complex and varied perspectives of hives in Traditional Chinese Medicine (TCM). In one perspective, hives are a manifestation of internal imbalances which disrupt the natural flow of energy or qi. It could also be a sign of blood flow stagnation. These imbalances can be attributed to an external invasion of wind-heat or wind-cold, induced by Lung and/or Spleen Qi imbalance.

When there is Lung Qi Deficiency, the invasion of allergens occurs through the skin or respiratory tract when the patient is exposed to pollens and other irritants. There is an accumulation of damp-heat when the Spleen Qi is affected. This manifests in the skin after exposure to shellfish and other specific triggers. Chronic hives are due to an internal stirring of wind and heat, usually associated with blood deficiency.

Another perspective relates to the concept of defensive Qi or Wei Qi. Wei Qi is the energy barrier that runs beneath the surface of the skin. When Wei Qi is weak or had broken down, it allows pathogenic factors, such as Wind and Heat in hives, to enter the body. Hives in TCM is called “Feng Zhen Kuai” or “wind rash patch”, perfect describing its fleeting, transient nature just like the Wind.

There are also three common factors why people get hives:

  1. Yin deficiency/Dryness – If the body is too dry, when the allergens get in, there is not enough moisture to wash them away, causing an outbreak of hives.
  2. Fire/Heat – In the presence of too much heat, fire and inflammation, the body becomes overloaded with allergens, resulting in a hives breakout.
  3. Liver stagnation with Heat – Chronic stress can exacerbate Qi stagnation in the Liver system. Over time, heat builds up and the body is unable to cope with these minor irritations. The Liver and Kidneys work hard to filter the toxins out of the body, but when they are overstressed, the body will try to get rid of the excess heat through the skin.

Treatment of Hives with TCM

Acupuncture has been found to be effective in the treatment of hives because it stimulates Qi flow and blood circulation. Herbal medicine also plays an integral role in hives treatment. TCM physicians will assess your body constitution and determine the existing patterns of disharmony. Based on this information, the TCM physician will prescribe specific formulas that are customized to your needs. 

Herbal commonly used to treat hives include:

  • Folium Mori
  • Radix Scrophulariae
  • Radix Saposhnikoviae
  • Radix Paeoniae Alba

The best way to treat hives is to avoid the factors that cause or trigger them in the first place. Avoid factors that are irritating, such as cold wind from a fan or air conditioner, or hot showers and baths. Get enough exercise to keep Qi and blood circulation flowing. Get good quality sleep to help build up Wei Qi.


  1. ACAAI. Hives. [Last accessed March 15, 2024]
  2. Tangs Clinical. Hives TCM. [Last accessed March 15, 2024]
  3. My Art of Wellness. How to Treat Hives With Acupuncture and TCM. [Last accessed March 15, 2024]
  4. Eastential. Urticaria (Hives) – How can Acupuncture and Chinese medicine help with wind Skin Condition? [Last accessed March 15, 2024] 

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