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DMV Allergy & Asthma Center – Allergist Washington DC, Frederick & Alexandria

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Hives (Urticaria) Treatment & Specialists in Alexandria, VA, Washington DC & Frederick, MD

Whether you have a sudden outbreak of hives or a recurring urticaria rash that won’t go away, our board-certified hives specialists at Alexandria, VA, K Street, DC, Foxhall, DC, and Frederick, MD identify the underlying trigger and deliver personalized hives treatment, including care for chronic urticaria and angioedema, to bring you lasting relief.
Board-Certified Hives & Urticaria Specialists
Personalized Hives Treatment Plans
Most Insurance Accepted
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4.9/5 from 2,000+ patient reviews

What is Hives (Urticaria)?

Hives, medically known as urticaria, are raised, red, itchy welts that appear on the skin when the immune system releases histamine and other chemicals in response to a trigger. They can appear anywhere on the body, vary in size from a small spot to a large patch, and may move, merge, or disappear and reappear within hours.

Hives are classified into two main types based on how long they last:

  • Acute Urticaria: Hives that last less than 6 weeks, often triggered by a food, medication, insect sting, or infection. These typically resolve once the trigger is removed.
  • Chronic Urticaria: Hives that recur or persist for more than 6 weeks. When no identifiable trigger can be found, the condition is called chronic spontaneous urticaria (CSU) or chronic idiopathic urticaria — an immune-driven condition that requires specialist management.

Hives frequently occur alongside angioedema — a deeper swelling beneath the skin, typically around the eyes, lips, hands, or throat — which can be more serious and requires prompt evaluation.

At DMV Allergy & Asthma Center, our allergists and immunologists are trained to evaluate, diagnose, and treat the full spectrum of urticaria, from a first-time acute outbreak to complex, long-standing chronic hives, across all four of our DMV locations.

Common Symptoms of Hives (Urticaria)

Urticaria symptoms can vary in severity and may appear suddenly, shift locations, or change in size. Common hives symptoms include:
  • Raised, red or skin-colored welts (wheals) that appear anywhere on the body
  • Intense itching, burning, or stinging on or around the welts
  • Welts that change shape, move locations, or disappear and reappear within 24 hours
  • Individual hives that merge into larger rash-like patches covering a broad area
  • Angioedema - deep swelling of the lips, eyelids, hands, feet, or throat occurring alongside hives
  • Hives triggered by pressure, cold, heat, exercise, or sun exposure (physical urticaria)
  • Disrupted sleep and reduced quality of life in chronic or recurring cases
Seek emergency care immediately if your hives are accompanied by throat tightening, swelling of the tongue or face, difficulty breathing, dizziness, or a drop in blood pressure; these are signs of anaphylaxis.

Common Hives (Urticaria) Triggers

Identifying what is causing your hives is a critical step toward lasting control. Common triggers our hives specialists evaluate include:
  • Allergens: Foods (peanuts, shellfish, eggs, nuts, berries), medications (penicillin, aspirin, ibuprofen, ACE inhibitors), insect stings, latex, and pet dander
  • Infections: Viral or bacterial infections, including the common cold, strep throat, UTIs, and hepatitis, can trigger acute urticaria
  • Physical triggers: Cold air or water (cold urticaria), heat, pressure on the skin, exercise, sunlight, and vibration
  • Stress and emotional responses: Psychological stress can trigger or worsen hives episodes in susceptible individuals
  • Autoimmune conditions: In some chronic hives cases, the immune system attacks its own cells, a common driver of chronic spontaneous urticaria
  • Environmental allergens: Pollen, mold, and dust mites can trigger hives in allergen-sensitive patients
  • Idiopathic (unknown) triggers: In up to 50% of chronic urticaria cases, a specific cause cannot be identified even after thorough evaluation, and these patients benefit from specialist-guided immune management

How We Treat Hives (Urticaria)

At DMV Allergy & Asthma Center, we treat both acute and chronic hives by identifying the underlying immune trigger and building a step-by-step treatment plan that manages symptoms and reduces the frequency of flare-ups.

Comprehensive Hives Evaluation

We begin with a thorough review of your hives' history, when they started, how long episodes last, what makes them better or worse, your diet, medications, and any associated swelling. This clinical picture guides targeted allergy and immune testing.

Personalized Hives Treatment Plans

Every patient receives a customized urticaria treatment plan from our board-certified allergists and immunologists, built around your specific trigger (or lack of identifiable trigger), hives type, severity, and lifestyle, designed to reduce breakouts and improve quality of life.

Long-Term Chronic Urticaria Management

For patients with chronic or recurrent hives, we provide ongoing monitoring and medication management at our Alexandria, VA, K Street, DC, Foxhall, DC, and Frederick, MD locations, adjusting the plan as your condition evolves.

All Ages Welcome

From children with stress-triggered hives or food allergy-related urticaria to adults managing chronic spontaneous urticaria, our allergists and immunologists provide age-appropriate hives evaluation and care at every stage of life, no referral required.

Hives (Urticaria) Testing & Diagnosis

Diagnosing the cause of hives, especially chronic urticaria, requires a structured allergy and immune evaluation. Our board-certified hives specialists use a targeted combination of testing to determine whether your urticaria is allergen-driven, immune-mediated, or idiopathic, and to rule out underlying conditions.

Skin Prick Testing

For patients whose hives may be triggered by environmental allergens, foods, or insect venoms, skin prick testing identifies specific IgE-mediated sensitivities quickly, with actionable results in approximately 20 minutes. Particularly helpful for acute urticaria with a suspected allergen trigger.

Blood Testing & Allergen Panels

Blood tests measuring allergen-specific IgE levels, total IgE, CBC, thyroid antibodies, and inflammatory markers help us evaluate immune system involvement in chronic urticaria, particularly useful for identifying autoimmune-driven chronic spontaneous urticaria and ruling out systemic conditions.

Allergy & Immune Evaluation

A comprehensive clinical evaluation combining your detailed hives history, symptom pattern analysis, physical examination, and diagnostic test results, giving our allergists the complete picture needed to distinguish between acute, chronic spontaneous, chronic inducible, and autoimmune urticaria.

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When Should You See a Hives Specialist?

While a single brief episode of hives may resolve on its own, certain situations clearly call for evaluation by a specialist. See one of our hives specialists if:
  • Your hives have lasted more than 6 weeks or keep coming back (chronic urticaria)
  • Over-the-counter antihistamines provide little or no lasting relief
  • Your hives appear without an obvious trigger or the trigger is unclear
  • You are experiencing angioedema, swelling of the lips, eyelids, hands, or throat, alongside hives
  • Your hives are disrupting your sleep, work, or daily activities
  • You have had a severe allergic reaction or anaphylaxis associated with a hives outbreak
  • Hives appear consistently after eating specific foods or taking certain medications
  • Your child has recurring or unexplained hives that won't resolve
Call 911 or go to the nearest ER immediately if hives are accompanied by throat swelling, difficulty breathing, dizziness, or loss of consciousness.
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Skin Prick Testing

Quick, accurate results in about 20 minutes

Hives (Urticaria) Treatment Options

We treat the full spectrum of urticaria, acute, chronic spontaneous, chronic inducible, and hives with angioedema, using an evidence-based, stepwise approach tailored to each patient's condition and severity.

Antihistamines (First-Line Treatment)

Second-generation, non-drowsy antihistamines are the first-line treatment for both acute and chronic hives. We prescribe the right antihistamine type, dose, and combination for your specific urticaria pattern, going beyond over-the-counter options when standard doses are insufficient for symptom control.

Advanced Prescription Medications

For patients whose chronic hives do not respond to standard antihistamines, our allergists and immunologists prescribe escalated prescription-strength options, including higher-dose antihistamines, leukotriene antagonists (such as montelukast), and anti-inflammatory agents, to bring persistent urticaria under control while minimizing long-term steroid use.

Oral Medications & Anti-Inflammatory Agents

For moderate-to-severe or antihistamine-resistant hives, we may prescribe short courses of oral corticosteroids, leukotriene antagonists (montelukast), or immunomodulatory agents, used strategically to reduce inflammation, control flare-ups, and bridge to long-term biologic management when appropriate.

Trigger Identification & Avoidance Strategies

When a specific trigger is identified, whether a food, medication, physical stimulus, or environmental allergen, we provide clear, practical guidance on avoidance strategies, safe substitutions, and protective measures to reduce the frequency and severity of future hives outbreaks.

Why Choose DMV Allergy & Asthma Center for Hives Treatment?

For over 20 years, DMV Allergy & Asthma Center has helped thousands of patients across Virginia, DC, and Maryland find lasting relief from acute and chronic hives.

4 convenient locations — Alexandria, VA, K Street, DC, Foxhall, DC, Frederick, MD

Board-certified allergists and immunologists with 20+ years of clinical experience in urticaria management

Full spectrum of hives treatment, from acute urticaria to chronic spontaneous urticaria and hives with angioedema

Most insurance plans accepted

Trusted by 15,000+ patients across the DMV region

Patient Satisfaction

98%
of patients recommend us

Patient Stories

Real Results from Real Patients

Don’t just take our word for it. Hear from patients who found lasting relief from their allergy symptoms.

Rashid Zaheer
Rashid Zaheer
September 1, 2026
★★★★★

DMV Allergy and Asthma Center - Alexandria
Jen Butler
Jen Butler
August 29, 2026
★★★★★

DMV Allergy and Asthma Center - Foxhall
Juliana Isaac
Juliana Isaac
August 28, 2026
★★★★★

DMV Allergy and Asthma Center - Alexandria
Juliana Aquino Isaac
Juliana Aquino Isaac
August 28, 2026
★★★★★

DMV Allergy and Asthma Center - Alexandria
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Stop Living With Hives - Get Lasting Relief Today

Recurring hives and chronic urticaria don’t have to control your life. Our hives specialists at Alexandria, VA, K Street, DC, Foxhall, DC, and Frederick, MD are ready to identify your trigger, treat your urticaria, and build a plan that keeps hives from coming back.
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(202) 833 - 3500

Same-day appointments available • Most insurance accepted

Frequently Asked Questions About hives (urticaria)

Hives, medically known as urticaria, are raised, red or skin-colored welts that appear on the surface of the skin and are typically very itchy. They can range from a small spot to a large patch, often shift locations within hours, and may merge into a larger rash. Hives are caused by the release of histamine in the skin in response to a trigger, which may be an allergen, infection, medication, physical stimulus, or in many chronic cases, an immune system reaction with no identifiable cause.
Acute urticaria lasts less than 6 weeks and is often linked to a specific trigger such as a food, medication, or infection, and typically resolves once that trigger is removed. Chronic urticaria lasts more than 6 weeks, recurs frequently, and is often driven by an immune or autoimmune process. When no trigger can be found in chronic cases, the condition is called chronic spontaneous urticaria (CSU), which requires ongoing specialist management rather than simple trigger avoidance.
Individual hive welts usually fade within 24 hours, but new ones can continue to appear. Acute hives often resolve within a few days to a few weeks once the trigger is removed. Chronic hives can persist for months or years without proper treatment. If your hives have lasted more than 6 weeks, are recurring, or are not responding to over-the-counter antihistamines, an evaluation by a hives specialist is strongly recommended.
For chronic urticaria, our allergists and immunologists follow an evidence-based stepwise approach, starting with prescription-strength second-generation antihistamines, then escalating to leukotriene antagonists or anti-inflammatory agents if needed. The right treatment plan depends on the type, severity, and duration of your hives, and is fully personalized for each patient at our Alexandria, VA, Washington DC, and Frederick, MD locations.
Yes, allergens are one of the most common causes of acute hives. Foods (peanuts, shellfish, eggs, nuts), medications (antibiotics, aspirin, ibuprofen), insect stings, latex, and environmental allergens such as pollen and pet dander can all trigger an allergic hives response. Allergy skin testing or blood testing can identify whether a specific allergen is responsible for your hives, allowing for targeted avoidance and treatment.
Both can treat hives, but allergists and immunologists are specifically trained in the immune mechanisms behind urticaria, including chronic spontaneous urticaria, autoimmune hives, and hives with angioedema, and have access to comprehensive allergy testing and advanced prescription treatment plans. If your hives are recurring, linked to allergic triggers, or have not responded to standard over-the-counter treatment, an allergist is the most appropriate specialist to see.