Tips to Avoid Chronic Physical Hives

Reviewed by: HU Medical Review Board

For people with physical hives, a specific physical trigger directly causes symptoms. Symptoms vary for each person and each type of hives. For example, people may experience urticaria (hives) or angioedema (swelling), or both.1

An important part of managing physical hives is to reduce your exposure to triggers. It is not always practical or possible to completely avoid exposure. However, a combination of medicines and lifestyle changes may help to reduce symptoms.

It can be especially difficult to avoid exposure to triggers in the workplace. If you notice that physical triggers are causing symptoms at work, talk to your employer. They must provide reasonable accommodations to make sure you can do your job safely.


People with dermographism (dermatographism) develop hives after scratching, rubbing, or adding pressure to the skin. It is the most common type of physical hives. It is also known as "skin writing." Tips to prevent hives caused by dermographism include:1,2

  • Avoid using harsh soaps on your skin
  • Wear clothing made from softer fabrics
  • Avoid hot showers and baths
  • Avoid scratching your skin
  • Keep your skin moisturized using lotions and creams

Delayed-pressure hives

In delayed-pressure hives, symptoms happen 4 to 6 hours after sustained pressure to the skin. Common daily activities can put constant pressure on your skin. Tips to reduce exposure to pressure include:1,3

  • Wear looser clothing
  • Take breaks in between long periods of sitting
  • Try to sit on softer surfaces
  • Use carts instead of carrying heavy items
  • Choose bags with larger handles or straps to spread weight over a larger area

Cholinergic hives

For people with cholinergic hives, symptoms happen when your body heat rises. Any trigger that causes your body temperature to increase can cause cholinergic hives. Examples include exercise, stress, strong emotions, and hot water.1,4,5

Tips to prevent triggers of cholinergic hives include:1,4,5

  • Minimize exercise in hot and humid temperatures
  • Keep your home relatively cool
  • Avoid saunas and other warm rooms
  • Take lukewarm or cool baths and showers
  • Reduce stress and anxiety using meditation, yoga, and other techniques
  • Avoid eating spicy or hot foods
  • Dress in lightweight clothing during the summer
  • Dress in layers during the winter so you can remove clothing when you go inside
  • Take steps to prevent and treat fevers
  • Use cool compresses or ice packs to cool your skin in hot weather
  • Avoid alcohol, especially in hot weather

Aquagenic hives

In aquagenic hives, symptoms happen after direct skin contact with water. This is a very rare type of chronic hives. It is especially hard to reduce exposure to triggers with this type of hives. Any source and temperature of water can cause hives, including tears and sweat.1,6

It is not practical or possible to avoid exposure to water. There may be some ways to reduce the risk of water-causing symptoms. Tips include:6

  • Use creams, such as petroleum jelly, before bathing
  • Apply skin creams with antihistamines before exposure to water
  • Take brief, infrequent showers
  • Wear clothes that move moisture away from your skin (moisture-wicking)
  • Watch the weather to avoid exposure to rain

Solar hives

For people with solar hives, symptoms happen after exposure to sunlight. Symptoms are worse when the sun is more intense or direct. Exposure to sunlight through glass or thin clothing can also cause symptoms. Some ways to do reduce exposure to sunlight include:1,4,5

  • Wear loose, dark clothing that covers as much skin as possible
  • Wear hats with wide brims
  • Carry an umbrella
  • Sit in the shade
  • Avoid going outside when sunlight is most direct

Cold contact hives

In cold contact hives, symptoms are caused by cold exposure of the skin. Cold objects, liquids, and air can all trigger symptoms.7

Avoiding cold temperatures is not always possible. However, knowing your exact temperature threshold can help you avoid exposures that are cold for you.7

Tips for avoiding cold exposure include:8

  • Avoid or reduce time spent swimming, especially in colder water
  • If you do swim, expose a small area of the body first to see if symptoms appear
  • Try wearing a wetsuit while swimming
  • Avoid consuming cold foods and drinks
  • Tell doctors about your cold contact hives, as some procedures can trigger symptoms (such as surgery and intravenous fluids)
  • Dress in layers to protect yourself from sudden changes in temperature

Vibratory hives

For people with vibratory hives, symptoms happen after applying vibrations to the skin. Common daily activities cause exposure to vibrations, so it is not always practical or possible to avoid triggers. Some activities to avoid include:1,4,5

  • Mowing the lawn
  • Riding a motorcycle
  • Horseback riding
  • Mountain biking
  • Long car or bus rides

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