What is Urticaria?

Urticaria is also known as hives, weals, welts or nettle rash in Singapore. It manifests as a raised, itchy and red rash that appears on the skin, either on one part of the body or across large areas. The rashes range in size – they can go from a few millimetres to being palm-sized.

What are the different types of Urticaria in Singapore?

  • Acute Urticaria - This type of rash will disappear within 6 weeks.
  • Chronic Urticaria - This type of rash is persistent and comes and goes for more than 6 weeks over many years.
  • Urticaria Vasculitis - This is a rare form of urticaria that causes inflammation of the blood vessels inside the skin. The weals in this case last longer than 24 hours and are much more painful, and can also cause bruising.

Common causes of Urticaria (Hives) in Singapore?

Urticaria is caused by high levels of histamine and other chemicals released in the skin when triggered. They cause blood vessels to dilate and become leaky, thereby causing the redness, swelling and itching.

The body may be triggered to release histamine due to a variety of factors, such as:

  • An allergic reaction – such as allergy to food, insect bites or stings
  • Cold or heat exposure
  • Infections – like flu infections and urinary tract infections
  • Certain medications – like non-steroidal anti-inflammatory drugs (NSAIDs) or antibiotics

That said, many cases of urticaria often happen without obvious reasons.

Some cases of chronic urticaria may be due to autoimmune conditions where your body’s own immune system attacks your healthy tissues. However, such cases are difficult to diagnose and there is no other special way to treat them. Certain triggers of urticaria include:

  • Alcohol or caffeine
  • Emotional stress
  • Warm temperatures
  • Prolonged pressure on the skin – often caused by tight clothing
  • Certain food additives – like salicylates

What are the symptoms of Urticaria?

Some symptoms of urticaria include:

  • Red, raised welts or bumps
  • Blanching – where the centre of the hive turns white when pressed
  • Itching
  • Swelling

What are the risk factors for Urticaria?

Some risk factors or urticaria include:

  • Personal history of allergies
  • Personal history of urticaria
  • Family history of urticaria
  • A known disorder associated with hives – such as urinary tract infections or strep throat infections
  • Frequent viral infections
  • Medications
  • Existing skin sensitivities or dermatitis (skin inflammation)
  • Existing sensitivities to disinfectants, dyes, chemicals or perfumes
  • Emotional triggers associated with stress and anxiety

What are the treatment options available for Urticaria in Singapore?

  • Allergy Medications - Medications such as antihistamines are able to block the effects of histamine such that you experience relief from the itching and control your allergic reactions.
  • Allergy Shots - For chronic hives which do not respond to medications, your doctor may recommend injection of a drug called omalizumab which blocks the body’s allergy antibody, immunoglobulin E (IgE), from causing allergic reactions. In severe allergies, there can be too much IgE that results in hives and asthma attacks.
  • At-Home Treatments - Taking a cold shower or bath may help to relieve the itching. You may wish to wear loose-fitting clothes and apply a cold compress.
    There are also over-the-counter options like hydrocortisone creams to soothe the itching and swelling.
  • Epinephrine - Severe allergic reactions may lead to something life-threatening – anaphylaxis. It can lead to shortness of breath and swollen airways, which require immediate injections of epinephrine to relieve symptoms.
  • Oral Steroids - Oral steroids such as corticosteroids can relieve hive symptoms if antihistamines don’t work.


What does a contact allergy look like?
Skin rashes, hives, itchiness, redness, burning, swelling, and tenderness could be symptoms of a contact allergy, especially after coming into contact with a particular substance.
How do you relieve contact allergies?
Applying anti-itch creams and taking anti-itch medications, cold compresses, cool baths, and avoiding the particular substance that causes the allergy can all provide relief for contact allergies.
How long does it take to treat contact allergies?
Upon avoiding the contact allergen, symptoms typically clear up in 2-4 weeks. However, it depends on the individual and treatment plan.
Are contact allergies contagious?
No, contact allergies are not contagious and will not spread to other people.



Dr Uma Alagappan is a MOH accredited consultant dermatologist in private with more than 15 years experience as a medical doctor. She sub-specialises in paediatric dermatology, women’s dermatology and general dermatology. Dr Uma’s interests include chronic eczema, food allergy and immunodermatology. She is also well versed with the use of lasers for treating paediatric and adult patients.
Dr Uma completed her dermatology training in Changi General Hospital and National Skin Centre in 2015. She joined KKH Dermatology Service to subspecialize in paediatric dermatology in 2017. She was awarded the Ministry of Health Manpower Development Plan Award in 2019 to pursue paediatric immunodermatology and allergo-dermatology in the renowned Boston Children’s Hospital, Massachusetts, USA. Upon her return, she spearheaded a number of clinics at KKH including the food allergy eczema clinic for the paediatric eczema patients, immunodermatology clinics and the psychology eczema multi-disciplinary clinics.
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