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What’s the Diff Between Eczema and Hives?

Eczema and hives can look a lot alike. Heck, they can even feel alike. So if your skin starts itching and new bumps are popping up left and right, how do you know which kind of scratch attack you’re dealing with?

Keep scrolling to learn the difference between two classic skin situations: eczema vs. hives.

  Hives Eczema
How it looks • raised spots
• round, oval, or squiggly shapes
• colors ranging from red (on light skin) to the same color as the surrounding skin (on black skin
• red on light skin tones
• purple, ashy, or dark brown on dark skin tones
• scaly or thickened skin
• crusty, fluid-filled bumps
• dry, cracked skin
How it feels warm, itchy, and tender dry, itchy, and painful when cracked or scaly
Why it happens foods, meds, allergies issues with your skin barrier, environmental factors, etc.
Treatments • avoiding triggers
• antihistamines (aka allergy meds)
• avoiding triggers
• moisturizer
• meds
• several natural remedies

The medical term for hives is “urticaria.” But no matter what you call those itchy, tender splotches, they’re no fun. 

eczema vs hives
Guille Faingold/Stocksy United

How to spot hives

Hives are raised, itchy bumps that are pink or the same color as your skin. They’re often tender to the touch. 

One indication of hives is “blanching,” which means the bumps briefly turn white when you press on them.

What causes hives?

Hives are usually triggered by an environmental irritant or allergy. Some common ones:

  • food allergies
  • certain meds
  • skin contact with an allergen like latex or nickel
  • pet dander or pollen
  • sky-high stress
  • some blood transfusions
  • infections (strep, a UTI, or even the common cold)
  • some plants

Oh, and to make things even more fun, research suggests that half of folks who get hives never figure out what caused it!

🚨 What about anaphylactic shock? 🚨

Anaphylaxis = a life threatening blood pressure drop that occurs in reaction to an allergen. We’re talking deadly peanut allergies, bee stings, etc.

Hives are one possible symptom of anaphylactic shock.

These other serious symptoms will also accompany anaphylaxis:

  • trouble breathing or swallowing
  • blue, white, or gray lips
  • faint, confused, or dizzy feeling
  • rapid heart rate

If you or someone you know has hives *and* other symptoms of anaphylactic shock, call 911 NOW.

How to treat hives

Good news: Most hives fade on their own after a few days.

These home remedies can soothe the itch while you wait:

  • a cold compress
  • calamine lotion
  • over-the-counter antihistamines
  • a cool bath
  • resisting the urge to scratch
  • staying out of the sun

If your hives get worse or don’t go away after a few days, contact a doctor for stronger treatments.

Eczema 101: Symptoms, causes, and treatment

Eczema” is actually a general term for seven types of itchy skin conditions. These scratch attacks affect roughly 31 million Americans, so chances are high that you or someone you know lives with some type of eczema.

How to spot it

Different types of eczema look different. Depending on the type, your skin might swell, blister, crust, ooze, or develop round lesions. Rather than individual spots, eczema usually develops in patches that turn pink, purple, brownish-red, or gray.

Some folks with severe, long-lasting eczema scratch their skin so much that it bleeds or toughens into leathery thickness.

Eczema can strike everywhere from your legs to your eyelids. It’s super common in sensitive areas like your fingers, feet, and inner elbows and the backs of your knees.

What causes it?

Sooooo many things. Anyone with eczema knows that IDing your triggers can be super frustrating. 

Causes can include:

How to treat it

The National Eczema Association’s hot take? “The first step to managing itchy skin is to reduce the risk of it happening in the first place.” So, goal #1 is to identify your triggers.

If the itch and irritation have already set in, you’ve got options:

If your eczema starts to interfere with daily life, it’s time to talk with a doctor or dermatologist. They can help you figure out your triggers and create a treatment plan customized for your skin.

Rashes 101: Symptoms, causes, treatment

Still not convinced you’ve got hives or eczema? There are other possibilities. 

rash is really any kind of blotchy breakout caused by environmental triggers. We’re talking athlete’s footjock itch, poison ivy, and contact dermatitis. (Though, fun fact: Eczema is considered a rash too.)

How to spot it

Any area of skin that’s red, darkened, irritated, or itchy can be traced to a rash. Some rashes, like ringworm, have a distinct shape. Others, like contact dermatitis or athlete’s foot, cover an entire area of skin that was exposed to irritants or fungus.

What causes it?

The reason for your rash depends on the type of rash. A few common types:

  • Contact dermatitis. This happens when any type of skin irritant (soap? chemicals? bleach on your undies?) leads to temporary itching and redness.
  • Fungal infection. Intense itching on your arms and legs or in your nether regions? Yeah, you might have a fungal skin infection like a yeastie, athlete’s foot, or jock itch. They’re all caused by an overgrowth of the fungus amongus
  • Prickly heat rash. Didn’t change out of your sweaty workout clothes today? Yep, that steamy moisture got trapped in your pores and burst forth as a rash.

How to treat it

Most rashes clear up on their own within a few days. If yours is sticking around, you need to pinpoint the type and cause. 

  • Got contact dermatitis? Avoid the offending irritant, keep your skin clean, and wear breathable fabrics until things calm down.
  • Got a fungal infection? Time to head to your drugstore for an antifungal cream.
  • Got prickly heat rash? Wear loose clothes, slather on some calamine lotion, and stay cool.

The takeaway

Eczema, hives, and rashes are all itchy and irritating. Sometimes they look alike, but treatment and triggers are different for each condition.

If you broke out in itchy, sensitive welts after consuming a new food or medication, you might have hives. Keep an eye on your skin and get to a doctor ASAP if you feel faint or have trouble breathing.

If you’ve got itchy, dry, scaly patches that just won’t quit, make an appointment with a dermatologist. They can help you figure out whether you have eczema, chronic hives, or some other rash that requires treatment.

Most scratch attacks go away with time. If yours doesn’t, contact a doctor. Identifying the problem will get you one step closer to relief.

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