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Difference Between Hives and Eczema

Hives vs Eczema

Hives and Eczema are both allergic skin conditions. The medical term for hives is Urticaria. Eczema is a term commonly used for a condition called atopic dermatitis though most often it is used for the chronic stage. Hives and Eczema both arise as a result of a heightened immune reaction of the body but there is a vast difference between the two.

Difference in causes:

Hives occur due to the release of histamine, a substance produced by the mast cells in the skin, when the skin is exposed to an allergen. This causes fluid to ooze out from the superficial blood vessels in the skin. The possible triggering factors for hives are pollens, animal dander, insect stings, sun exposure, fresh fruits, fish, shell fish, milk products and peanuts. Hives can also be triggered by exercise, bathing with hot or cold water, stress and in extreme cases, just by stroking or scratching the skin. Depending on the triggers, hives has been given different names.

Eczema is usually associated with other respiratory allergies and is common in people with a family history of asthma. It occurs as a result of an exaggerated response of the immune system and due to certain defects in the skin barrier. The exact cause of eczema is unknown but some common irritants to the skin could be soaps, detergents, shampoos and sometimes dust mites.

Difference in manifestations:

Hives present as pale red, raised eruptions over the skin characterized by severe itching and may occur in any age group. These lesions commonly called ‘wheals’, vary in size and shape, only to disappear and reappear within few hours. Hives is a self limiting condition and usually subsides within 24 – 48 hours. Hives of less than 6 weeks duration is termed acute and that continuing for more than 6 weeks is termed chronic. Sometimes a deep seated tissue swelling called angioedema may accompany hives which affects the lips, area around eyes, throat, tongue and lungs. Angioedema of the throat can obstruct breathing and always calls for emergency medical measures.

Eczema is characterized by skin lesions which are itchy, dry, reddish, crusting, blistering, cracking, oozing or bleeding. It usually starts in infancy and may continue well into adolescence while sometimes the onset may be in adulthood. It is a chronic condition which can affect any part of the body including the face, ears and scalp. The constant rubbing and scratching due to severe itching tends to cause bleeding from the rash which eventually makes the skin thicken and blacken.

Difference in treatment:

Hives is a self limiting condition and usually does not require treatment. However, when it becomes annoying it can be treated with antihistamines. Chronic hives require a little longer treatment but the best way to avoid hives is by avoiding the triggering factors.
Eczema has no cure and can only be managed symptomatically with moisturizers for dryness and antihistamines for itching. Often topical steroid applications are used.


Hives and Eczema are the result of a hypersensitive immune system to many stimulants and allergens which may or may not be identified even by skin tests. Both present as severe itching of the skin but the appearance of each is different. Apart from angioedema which is a medical emergency, hives and eczema per say never give rise to any life-threatening complications. Eczema calls for a long duration treatment during which it can subside only to reappear later. However, both are best treated by carefully noting the triggering factors and stringently avoiding them.

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  1. Thank you so much!!

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