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What to know about hives and asthma

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Asthma and hives are inflammatory conditions caused by an exaggerated immune system response. The conditions may occur separately or together.

Asthma refers to a long-term lung condition that affects adults and children. It causes inflammation and narrowing of the bronchial tubes of the lungs. Hives, also called urticaria, describes a type of skin reaction that causes small blood vessels in the skin to leak, leading to raised bumps.

Both asthma and hives can occur due to an exaggerated immune system response that triggers the release of histamine. Although hives and asthma are two separate conditions, they may occur together.

This article discusses the connection between asthma and hives, as well as the symptoms, causes, and treatments for both.

A collage of hives and asthma-1.Share on Pinterest
Design by MNT; Photography by AndreyPopov/Getty Images & Grace Cary/Getty Images

Both asthma and hives can occur due to an allergic reaction. In people that have allergic asthma or hives, their immune system may overreact to a typically harmless substance. When the immune system becomes exposed to triggers, the body often responds by producing antibodies called immunoglobulin E (IgE).

When IgE binds to an allergen, it triggers the release of histamine from the mast cells. Typically, histamine can cause many of the symptoms of allergies, including hives and allergic asthma symptoms.

There is an association between elevated IgE levels and both asthma and hives. For example, 2021 research indicates that people with chronic or long-term hives often have elevated levels of serum IgE. Evidence also notes that people with asthma often have elevated IgE levels.

Incidence

About 20% of people develop hives at some point. However, not all hives occur due to an allergic reaction.

In the United States, over 25 million people have asthma. Although there are different types of asthma, allergic asthma is the most common form of the disease.

Current research has not determined the exact percentage of people that have both hives and asthma. However, a small 2016 study looked at the incidence of hives in people with asthma compared with those without asthma. The study indicated that 26 out of 110 individuals with asthma had episodes of hives compared to 2 out of 100 people without asthma.

Having asthma in itself does not typically result in hives. Asthma symptoms do not usually include hives. Although asthma may not cause hives, the conditions can occur together.

Asthma occurs more often in people that have other types of allergic conditions. Therefore, it is possible that people with asthma may have a higher risk of allergies, which can lead to hives.

Doctors do not fully know why some people develop asthma. Individuals with asthma have airways that are sensitive to various things that do not affect others. Common causes of asthma attacks include:

  • allergies
  • respiratory infections
  • air pollution
  • strong emotions
  • certain weather conditions

Various factors can trigger hives. In addition to allergies, infections are a common cause of hives. About 60% of hives occur due to an infection. Other causes of hives include:

The symptoms of both hives and asthma can vary in severity. In the case of asthma, symptoms can become life threatening.

Asthma symptoms may include:

Symptoms of hives include the following:

  • raised bumps on the skin, which may occur suddenly
  • itching
  • blanching — the center of the hives change color when pressed

A doctor can typically diagnose hives easily. Diagnosis usually involves an examination of the skin. Depending on how often hives occur, a doctor may want to order skin tests to determine the cause.

Doctors make a diagnosis of asthma based on a medical exam and symptoms history. Addition tests help confirm a diagnosis and may include:

Not everyone with hives requires treatment, especially if the condition occurs once or infrequently. However, asthma requires treatment to prevent serious breathing issues.

Treatment for asthma includes:

If necessary, treatment for hives may include the following:

  • avoiding known triggers
  • medications to stop itching
  • antihistamines to prevent hives due to allergies

Hives and asthma are two separate conditions. In some cases, asthma and hives develop due to an exaggerated response by the immune system that leads to inflammation. In asthma, the inflammation occurs in the lungs. With hives, the inflammation affects the skin.

Since both may occur due to a response by the immune system, asthma and hives may occur together.

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