Hives Vs Eczema: How to Tell the Difference

Skin-related issues can be difficult to differentiate because many of them present similarly. Hives and eczema, for example, look and feel very similar in most cases. They are both allergic skin conditions that are caused by a heightened reaction by the body’s immune system. They may seem and feel similar, but there are vast differences between these two conditions.


Hives are associated with acute allergic reactions, although they can also be chronic. They occur due to the release of histamine by the mast cells which do so in response to an allergen. Hives can also be triggered by autoimmune and physical triggers such as heat, vibrations, and stress. Once the reaction is triggered, fluid can ooze out of the blood vessels found near the surface of the skin.

Due to the many triggers that can cause the condition, there are different manifestations of hives, each given its own name. To learn more about these different types of hives, you can find more information on Patient is a health information portal with all the information you need on different health conditions, their symptoms, medications, and everything else you would like to know. It also contains in-depth guides on various health topics, standing out as a premier source of health-related information.

Eczema, on the other hand, is a chronic issue that is tied to the immune system and chronic inflammation. It occurs due to an exaggerated immune response by the body when allergens land on the skin and can also be caused by breaches in the skin’s protective barriers. It is very common in young children but can also appear in young and older adults.

There are many triggers for eczema including detergents, soaps, sweating, scratching, and many others.

Manifestation and Appearance

Hives appear as raised spots on the skin which are characterised by itching. The lesions caused by the conditions can vary in shape and size, disappearing and appearing within hours. The shape can be squiggly, oval or round and the colour can range from red on people with lighter skin, to the same colour as the surrounding skin in people with darker skin. Hives feel tender, itchy, and warm to the touch.

Some people who have hives can also develop angioedema. This is a deep swelling of the tissue that can affect the area around the eyes, lips, lungs, tongue, and throat. Angioedema in the throat or lung can cause serious medical complications and require emergency care.

Eczema manifests as skin lesions that are dry, blistering, cracking, bleeding, or oozing. The lesions can appear red on lighter skin or dark brown, ashy, or purple in those with darker skin. The skin can also be thick and appear scaly.

Eczema starts in infancy and, if not treated, can go on well into adulthood. It is a chronic condition that affects the scalp, ears, and face. Many people who have eczema can also have bleeding due to scratching of the itchy skin which breaks because it is dry. This eventually makes the skin turn black and thicken. The skin feels dry and is itchy and painful if it is scaly or cracked.

If you see changes on the skin and do not know whether they are hives or eczema, the best thing you can do to differentiate between the two is to gently press the skin. The bumps caused by hives will turn white briefly, while the areas affected by eczema will feel itchy and harder than the surrounding skin.

Differences in Treatment

After learning how to differentiate the two, it is also important to understand how they are both treated. The good news is that hives are self-limiting. This means they usually go away on their own without needing treatment. However, the itch might persist so you can use an antihistamine or calamine lotion to soothe the area. Also, resist the urge to scratch the itchy area and get in touch with a doctor if the hives do not go away after a few days.

Eczema can be treated using hydrocortisone cream vitamins, supplements, and different medications. As with hives, do resist the urge to scratch the affected area as you can cause bleeding and additional damage. Because eczema is a chronic condition, there is no outright cure but management using antihistamines, moisturizers and topical steroids will help. If eczema starts causing difficulties in your daily life, talk to a doctor so they can create a personalised treatment and management plan.

Both eczema and hives are caused by the overreaction or overstimulation of the immune system by various triggers and allergens. Both present in similar ways, a similarity being the itching. Apart from the angioedema caused by hives, both of these conditions do not usually lead to life-threatening situations. Although both conditions can cause a lot of discomfort, they can be managed successfully even in the long-term in the case of eczema.

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