Hives on Black Skin: Appearance, Symptoms, and More

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Hives are a common condition that causes itchy, raised welts on the skin. The medical name for hives is urticaria. They are most often caused by an allergic reaction or an irritant in your environment.

When you search for images of hives, you’ll often see pictures of hives on white or light skin. In this case, the hives typically appear pink or red in color.

However, if you have brown or Black skin, hives can look very different from that. For example, the skin will appear inflamed but may not be red. Rather, the hives may be the same color as the surrounding skin.

Also, brown and Black skin can vary in pigmentation, and so too can the appearance of hives and other rashes. How hives appear on Black and brown skin can vary from person-to-person.

Sometimes, hives are often mistaken for other rashes. That’s why it is important to see a board-certified dermatologist to help clarify what type of rash you have.

Continue reading as we discuss the appearance of hives on brown and Black skin, other symptoms to look out for, and potential treatment options.

Most available images of hives show the condition as it appears on white skin. In this case, the inflamed pink or red-colored patches of skin are often visible.

However, hives on Black and brown skin may not look exactly like that. Though the skin is still irritated and inflamed, skin reddening, or erythema, isn’t always visible.

Instead, skin welts from hives are often similar in color to your skin tone. In some cases, they may be slightly lighter or darker, depending on what’s causing them. Because of this, hives on Black skin can be more difficult to identify.

In fact, a 2020 study examined the ability of 177 medical students to accurately identify dermatologic conditions in white skin and skin of color. Researchers found that only 57.5 percent of the students correctly identified hives in skin of color.

You may be wondering how you can tell if you have hives. Look for skin welts that:

  • have a round, oval, or worm-like shape
  • are raised
  • are very itchy
  • occur in an isolated group or are connected over a large area of skin

Angioedema is a condition similar to hives. It involves a reaction in the deeper layers of your skin and can appear by itself or along with hives. Some symptoms include:

  • swelling, particularly around your eyes, lips, and cheeks
  • skin that feels warm to the touch
  • pain or tenderness in the affected area

Anaphylaxis: A medical emergency

In addition to hives, some of the other symptoms of anaphylaxis are:

Anaphylaxis can be life-threatening. If you or someone else has symptoms of anaphylaxis, call 911.

Though it’s possible for hives to appear for no identifiable reason, many times, they can occur following a trigger. We’ll go into specific triggers next, but generally, you may develop hives shortly after:

  • eating a specific food
  • taking a medication
  • coming into contact with a particular thing, such as latex or a cosmetic product
  • exercising
  • experiencing a high level of stress

It’s important to note that in 50 percent of patients with hives, the cause is not known.

One common cause of hives is an allergic reaction. This is when your immune system overreacts to something that’s typically harmless.

Allergic triggers

Some examples of things that can trigger allergies include:

  • Foods, particularly:
  • Insect stings or bites
  • Certain types of medications, particularly:
    • antibiotics like penicillin and sulfonamides
    • nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin
    • blood pressure medications like ACE inhibitors
    • opioids like morphine and codeine
  • Contact allergies, such as those to latex
  • Airborne allergens, such as:

Non-allergic triggers

There are also other causes of hives that aren’t related to allergies. These are:

It’s also possible that hives can have no known cause. When this happens, the condition is referred to as idiopathic.

In many cases, hives will go away on their own in a day or so, but chronic hives last longer. Various treatments can help to reduce itching and swelling. Some potential treatment options include:

Home remedies

You can try some of the following things at home to get symptom relief.

  • Apply a cool compress: Placing a cool compress onto the affected area can help soothe itching or irritation.
  • Take a cool bath or shower: If hives affect a large area, consider taking a cool bath or shower to help ease your symptoms.
  • Avoid triggers: If certain things trigger your hives, try to avoid further exposure to them.
  • Wear loose, comfortable clothing: Tight-fitting or constrictive clothing may further irritate your skin.
  • Don’t scratch: It may be tempting, but try to avoid scratching. This can cause additional skin irritation and also raises the risk of pigmentation changes.
  • Stay out of the sun: Being out in the sun can make hyperpigmentation worse. If you’re going to be outside, be sure to apply sunscreen.

Medications

There are several types of medications to treat hives. These are:

  • Antihistamines: Antihistamines block production of histamine, a compound associated with allergic reactions, and can ease itching and swelling. They’re available over-the-counter (OTC) or by prescription.
  • Oral corticosteroids: For severe hives, your doctor may prescribe a course of oral corticosteroids. These medications work to reduce levels of inflammation in the body and can help with itching and swelling.
  • Cyclosporine: Cyclosporine may be prescribed for chronic hives. Cyclosporine is a type of drug called an immunosuppressant, which works to inhibit the activity of your immune system.
  • Omalizumab: Omalizumab is an injectable medication that may be used for chronic hives. It works by binding to and neutralizing IgE, an immune protein associated with allergies.
  • Epinephrine: In cases where hives are happening with symptoms of anaphylaxis, you may be given a shot of epinephrine to help stop the reaction.

Post-inflammatory hyperpigmentation is a condition that can impact skin of color. It involves the affected area of skin becoming darker than the surrounding skin.

These pigmentation changes are caused by skin damage or irritation due to a variety of things, including allergic reactions, eczema, and acne.

The effects of post-inflammatory hyperpigmentation are often temporary but can take from months to years to clear. The condition can be made worse by scratching and sun exposure.

Hives will often go away through using home remedies and OTC antihistamines. However, speak with your doctor if:

  • Hives last longer than a few days.
  • Hives are severe or cover a large area of your body.
  • You believe your hives are caused by an allergy.

Anaphylaxis is a medical emergency. If you or someone else is experiencing symptoms like shortness of breath and swelling of the face, throat, or mouth, call 911.

Hives on Black and brown skin can be more difficult to recognize. If you have concerns about this, there are a couple of resources you can use to help find a dermatologist who focuses on skin of color.

The American Academy of Dermatology website is a good place to start. It has a search tool to help you find a dermatologist who’s close to you. Be sure to use the filters under “Practice Focus” to find a provider with a focus on skin of color.

Another potential resource is the Skin of Color Society (SOCS), which aims to increase awareness of dermatologic conditions in skin of color. Its website has a large searchable list of dermatologists.

Hives are a skin reaction that causes raised, itchy welts to appear on the skin. They’re often caused by allergies, but can also be due to infections, underlying health conditions, and environmental factors. In some cases, the cause of hives may be unknown.

Hives in Black and brown skin may look different compared with other skin types. While welts are still raised and itchy, they may not appear red. In many cases, welts may be similar in color to the surrounding skin. This can make them harder to recognize.

Most of the time, hives will go away on their own. In the meantime, you can use home remedies and OTC medications to soothe your symptoms.

Talk with your doctor if hives don’t go away after a few days, are severe, or cover a large area of your body. Call 911 if you’re experiencing hives that occur with symptoms of anaphylaxis.

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