General Dermatology
Hives & Urticaria Treatment in Tampa
Hives can appear suddenly, spread rapidly, and cause intense itching that disrupts daily life. Whether you're dealing with a single acute episode or recurring chronic urticaria, Dr. Sergay will identify triggers, provide relief, and prevent future flares.
Dr. Sergay's Approach
Understanding Hives & Urticaria
Urticaria — commonly called hives — are raised, itchy welts that appear when the body releases histamine in response to a trigger. They can be as small as a pencil eraser or as large as a dinner plate, often merging together into larger plaques. Most individual hives resolve within 24 hours, but new ones may keep appearing.
Acute urticaria lasts fewer than 6 weeks and is most often triggered by an infection, food, medication, or allergen. Chronic urticaria persists beyond 6 weeks — and in many cases, no specific trigger is ever found (idiopathic), making proper dermatologic management essential.
Dr. Sergay will take a careful history, evaluate for underlying causes, and build a step-wise treatment plan to control symptoms and improve quality of life — whether your hives are acute, chronic, or associated with angioedema.
Trigger Investigation
Identify root cause when possible
Rapid Relief
Same-appointment treatment options
Types & Patterns
Types of Urticaria
Urticaria is classified by duration and trigger. Identifying the type is the first step toward effective treatment.
Acute Urticaria
Less than 6 weeks
- Most common form — often a single episode
- Frequently triggered by infection, food, or medication
- Shellfish, nuts, eggs, and penicillin are common culprits
- Typically resolves once trigger is removed
- Angioedema (deeper swelling) may co-occur
Chronic Urticaria
More than 6 weeks
- Affects ~1% of the population at any given time
- No identifiable trigger found in majority of cases (idiopathic)
- Can be associated with autoimmune or thyroid conditions
- Significantly impacts sleep and quality of life
- Requires ongoing management strategy
Physical Urticaria
Triggered by physical stimuli
- Dermographism — hives from skin pressure or scratching
- Cold urticaria — triggered by cold air or water
- Cholinergic urticaria — triggered by sweating or heat
- Solar urticaria — triggered by sun/UV exposure
- Exercise-induced urticaria or anaphylaxis
Urticaria with Angioedema
Deeper tissue swelling
- Swelling in deeper layers of skin or mucous membranes
- Most commonly affects lips, eyelids, tongue, and throat
- Can accompany both acute and chronic urticaria
- Throat involvement requires emergency evaluation
- Hereditary angioedema is a separate, distinct condition
Treatment Options
How Dr. Sergay Treats Hives
Treatment is matched to your type of urticaria, severity, and how long you've been experiencing symptoms. Most patients can achieve excellent control with the right combination of therapies.
Non-Sedating Antihistamines
Second-generation H1 antihistamines (cetirizine, fexofenadine, loratadine) are the foundation of hives treatment. Safe for daily use, Dr. Sergay often recommends scheduled dosing rather than as-needed use for better control of chronic hives.
H2 Antihistamines
Adding an H2 blocker (famotidine, cimetidine) to an H1 antihistamine can improve response in patients whose hives haven't fully responded to H1 blockers alone. Works by blocking histamine receptors in the GI tract and blood vessels.
Omalizumab (Xolair)
FDA-approved monthly injectable biologic for chronic spontaneous urticaria not controlled by antihistamines. Targets IgE to reduce the allergic response cascade. Highly effective — approximately 60–70% of patients achieve complete response.
Systemic Corticosteroids
A short oral prednisone taper provides rapid relief during severe acute episodes. Not recommended for long-term use due to side effects. Useful as a bridge while initiating other therapies or while investigating triggers.
Trigger Workup
For chronic urticaria, Dr. Sergay may order lab work (CBC, thyroid antibodies, ANA) to screen for autoimmune or infectious causes. Allergy testing may be recommended when a specific food or environmental trigger is suspected.
Lifestyle & Trigger Avoidance
Identifying and avoiding known triggers is an important part of management. This includes dietary changes, medication review (NSAIDs and ACE inhibitors can worsen hives), stress reduction, and avoiding known physical triggers like extreme temperatures.
Common Questions
Hives FAQ
Get Relief
Stop Living with Unpredictable Hives
Whether you're dealing with a first outbreak or have struggled with chronic hives for years, Dr. Sergay can help. Book an appointment and get a personalized treatment plan.