Hives (urticaria) treatment in Dubai — acute vs chronic hives and when it is an emergency

Key facts

• Individual wheals fade within 24 hours
• Chronic hives last six weeks or more
• Regular non-sedating antihistamines are first-line
• Biologic options exist for resistant chronic hives
• Throat swelling or breathing difficulty: call 998

What hives are

Hives are caused by mast cells in the skin releasing histamine and other chemicals, which make small blood vessels leak fluid into the skin. This produces raised, itchy, pink or red welts, called wheals, that can be small spots or large patches, often with pale centres. A typical feature is that individual wheals fade within 24 hours, even though new ones may appear elsewhere. Some people also develop angioedema, a deeper swelling of the lips, eyelids, hands or feet that can last a few days. On darker skin, hives may look less red and more skin-coloured or slightly darker.

Acute versus chronic hives

Acute urticaria lasts less than six weeks. It is often triggered by viral infections, especially in children, but can also follow certain foods, medicines such as antibiotics or anti-inflammatory painkillers, insect stings or contact with latex. Often no trigger is found, and the hives settle on their own. Chronic urticaria lasts six weeks or more, with hives appearing most days. In most cases it is chronic spontaneous urticaria, where the immune system is overactive without an external allergy. Inducible urticaria is triggered by physical factors such as pressure, scratching, heat, cold, sun or sweating, which can be relevant in the UAE climate.

Finding triggers and appropriate tests

Dr. Abdullah Anis takes a detailed history, including the timing of hives, recent infections, medicines, foods, physical triggers and other symptoms. For acute hives with a clear trigger, extensive tests are rarely needed. In chronic hives, food allergy is an uncommon cause, so restrictive diets are generally not recommended without clear evidence. Limited blood tests may be advised to look for inflammation, thyroid problems or other associated conditions. Physical urticarias can sometimes be confirmed with simple challenge tests. Keeping a diary of hives, photos and possible triggers is helpful, because the rash may have faded by the time you see the doctor.

Antihistamine plans and advanced treatments

Non-sedating antihistamines, taken regularly rather than only when hives appear, are the main treatment for both acute and chronic urticaria. If symptoms continue, a dermatologist may increase the dose within accepted guidelines. Short courses of oral steroids are occasionally used for severe flares but are not suitable for long-term control. For chronic urticaria that does not respond to high-dose antihistamines, advanced options include biologic treatment with omalizumab, and in some cases other immune-modulating medicines, which need specialist assessment and monitoring. Avoiding known triggers such as anti-inflammatory painkillers, alcohol or tight clothing can reduce flares.

When hives are an emergency

Call emergency services (998 in the UAE) or go to the nearest emergency department immediately if hives come with swelling of the tongue, lips or throat, difficulty breathing or swallowing, wheezing, hoarse voice, dizziness, fainting, vomiting or a feeling of collapse, especially soon after a food, medicine or insect sting. These can be signs of anaphylaxis, a severe allergic reaction that needs adrenaline. If you have been prescribed an adrenaline auto-injector, use it as instructed. For non-urgent hives that are persistent or recurrent, book a review with Dr. Abdullah Anis, a specialist dermatologist with more than 25 years of experience.

Eczema and psoriasis are chronic inflammatory skin conditions. Good control comes from an accurate diagnosis, a clear plan for flares, and daily skin care that suits the UAE climate.

Prepared by the Manhal Medical Center editorial team · Updated: 2026-10-18 · Treating specialist: Dr. Abdullah Anis

This page is general information and does not replace a consultation. Suitability, risks and results vary between patients.