What is the Difference Between Hives and Angioedema

Hives and angioedema are two skin conditions. Both these conditions are mainly caused by allergic reactions. They are usually treated with antihistamine medications. However, angioedema can be life-threatening if swelling of the tongue or throat blocks the airways.

The key difference between hives and angioedema is that hives are itchy, raised welts that are found on the skin any area of the body while angioedema is the swelling in the deeper layers of skin that appears often around the face and lips. 

CONTENTS

1. Overview and Key Difference
2. What are Hives 
3. What is Angioedema
4. Similarities – Hives and Angioedema
5. Hives vs Angioedema in Tabular Form
6. Summary – Hives vs Angioedema
7. FAQ – Hives and Angioedema

What are Hives?

Hives are also known as urticaria. It is a skin reaction that causes itchy welts anywhere on the body. These welts range in size from small spots to large blotches. The signs and symptoms of hives are skin-colored, reddish welts on white skin, purplish welts on black and brown skin, mild to intense itchiness, round, oval, worm-shaped welts, and welts that are as small as a pea or as large as a dinner plate. Hives are usually caused by an allergic reaction to food, drink, medication, or something that people touch, infections from bacteria or viruses, or as a result of other medical conditions such as lupus.

Figure 01: Hives

Hives are diagnosed through physical examination, allergy test, skin test, and blood test. Furthermore, hives are treated through allergy medications, applying over-the-counter (OTC) hydrocortisone or antihistamine cream, taking oral steroids, and epinephrine injections for chronic severe reactions.

What is Angioedema?

Angioedema is swelling under the skin that appears mainly on the face and lips. Angioedema is caused by animal dander, exposure to water, sunlight, cold or heat, food, insect bites, medicines such as antibiotics, NSAIDs, ACE inhibitors, pollen, autoimmune diseases such as lupus, and acquired C1 inhibitor deficiency (hereditary). The symptoms of angioedema include swelling below the skin surface, abdominal cramping, breathing difficulty, swollen eyes and mouth, and swollen lines of the eyes.

Figure 02: Angioedema

Angioedema is diagnosed through physical examination, blood test or allergy testing, and genetic testing. Furthermore, angioedema can be treated by avoiding allergy triggers, cold compresses to relieve the pain, taking antihistamines and corticosteroids, and giving epinephrine shots and inhaler medicines that help open up the airways.

Similarities Between Hives and Angioedema

1. Hives and Angioedema are two skin conditions.
2. Both conditions are a result of allergic reactions.
3. These conditions cause swelling.
4. Both these conditions are usually treated with antihistamine medications.

Difference Between Hives and Angioedema

Definition

1. Hives are raised red bumps, welts, or splotches on the skin.
2. Angioedema is swelling under the skin instead of on the surface.

Swelling Type

1. Hives cause swelling in the skin surface or surface swelling.
2. Angioedema causes swelling under the skin or deeper layers of the skin.

Causes

1. Hives are caused by foods, plants, animals, chemicals and latex, cold water or wind, a reaction to a medicine, insect bite or sting, scratching or pressing on the skin, an infection, immune system problems, water or sunlight.
2. Angioedema is caused by food allergies, medication allergies, venom, natural rubber latex, and hereditary.

Signs and Symptoms

1. Signs and symptoms of hives include raised bumps or patches in different shapes and sizes, welts appear anywhere on the body, feel itchy, sting or burn, look pink or red when affecting someone with white skin, and look purplish when affecting someone with brown or black skin.
2. Signs and symptoms of hives include puffy swollen face, eyes, mouth, lips, tongue, swollen hands, feet, genitals, dizziness or fainting due to blood pressure changes and swelling in the mouth, throat, or airway that may make it harder to breathe and talk.

Diagnosis

1. Hives can be diagnosed by physical examination, allergy test, skin test, and blood test.
2. Angioedema can be diagnosed by physical examination, blood test or allergy testing, and genetic testing.

Treatment

1. Hives can be treated by taking prescribed menthol cream, antihistamines, steroid tablets, and epinephrine shots.
2. Angioedema can be treated by taking a combination of antihistamines and corticosteroids, taking alternative medicines for drugs that do trigger angioedema, and giving an adrenaline auto-injector pen for anaphylaxis.

The following table summarizes the difference between hives and angioedema.

Summary – Hives vs Angioedema

Hives and angioedema are two conditions that cause skin swelling and are mainly triggered by allergic reactions. Hives are itchy, raised, reddish areas on the skin while angioedema is swelling below the surface of the skin and fatty tissue. Moreover, hives can appear anywhere on the body whereas angioedema mainly occurs on the face, lips, throat, larynx, Uvula, arms, hands, legs or feet. This is the summary of the difference between hives and angioedema.

FAQ: Hives and Angioedema

1. What causes sudden hives?

• Hives or urticaria cause pale, red bumps or welts on the skin that appear suddenly. Hives are caused by allergic reactions, chemicals in certain foods, insect stings, sunlight, and medications.

2. What are the main characters in the hive?

• The main characteristics of hives are itchy welts that may change shape, move around, disappear, and reappear over short periods of time, bumps or red or skin-colored wheels with clear edges, and pressing the center of a red hive makes hives turn white.

3. What is the treatment of hives?

• Treatments for hives include applying an over-the-counter hydrocortisone or antihistamine cream for relieving itching and swelling, taking oral steroids to relieve hive symptoms that don’t respond to antihistamines or topical steroids.

4. What is the most common cause of angioedema?

• Angioedema is caused by certain types of food such as nuts, shellfish, milk and eggs, some types of medication like penicillin, aspirin and non-steroidal anti-inflammatory drugs (NSAIDs), insect bites and stings and acquired C1 inhibitor deficiency (hereditary).

5. What is the first line of treatment for angioedema?

• Angioedema is caused by antihistamines like cetirizine, desloratadine, fexofenadine, levocetirizine, and loratadine, changing medications that do trigger angioedema, and giving adrenaline auto-injector pen for severe anaphylaxis.

Reference:

1. “Hives.” NHS Choices, NHS.
2. “Angioedema: Symptoms, Causes, Treatment, Types.” WebMD.

Image Courtesy:

1. “Urticaria” By BruceBlaus – Own work (CC BY-SA 4.0) via Commons Wikimedia
2. “Blausen 0023 Angioedema” Blausen.com staff (2014). “Medical gallery of Blausen Medical 2014”. WikiJournal of Medicine 1 (2). DOI:10.15347/wjm/2014.010. ISSN 2002-4436. – Own work (CC BY 3.0) via Commons Wikimedia

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