Identify and avoid potential triggers (new foods, medicines, supplements, detergents, heat, cold, alcohol, stress)
Stop the suspected medication and contact a clinician for guidance (especially if the hives started after a new drug)
Take an over-the-counter non-drowsy antihistamine:
Cetirizine
Loratadine
Fexofenadine
If needed, use an antihistamine as directed on the label for symptom control
Consider a short course of an H2 blocker (famotidine) as advised by a clinician
Use cool compresses on affected areas
Use fragrance-free, gentle skin care; avoid hot showers and scratching
Wear loose, breathable clothing
Avoid triggers such as heat, intense exercise, and alcohol until improved
Use topical anti-itch options if helpful:
Pramoxine lotion
Calamine lotion
Seek urgent care or call emergency services if any of the following occur:
Trouble breathing, wheezing, or throat tightness
Swelling of lips, tongue, face, or around the eyes
Dizziness, fainting, or feeling of impending doom
Rapidly worsening symptoms
For recurrent or persistent hives (lasting more than a few days, or coming back often), arrange medical evaluation
Ask a clinician about prescription options if OTC treatment is not enough (e.g., higher-dose antihistamines under supervision, or other therapies for chronic hives)
If hives are associated with a known allergy and you have an epinephrine auto-injector, use it immediately if anaphylaxis symptoms occur and seek emergency care afterward