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Lupus and Hives

Lupus is an autoimmune disorder that can affect all parts of the body including causing hives (also called urticaria). Hives are red, itchy, and swollen bumps that appear on the skin. 

Donald Thomas, MD author of The Lupus Encyclopedia for Gastrointestinal symptoms in lupus blog post

This blog on “Hives and Lupus” was edited and contributed to by Donald Thomas, MD; author of “The Lupus Encyclopedia.” Parts of this blog post come from “The Lupus Encyclopedia: A Comprehensive Guide for Patients and Health Care Providers, edition 2

Hives are most commonly due to an allergic reaction. However, systemic lupus erythematosus can also cause hives. In this article, we will discuss the connection between lupus and hives, the causes, and some recommendations to manage this condition.

Causes of Lupus and Hives

According to the Johns Hopkins Lupus Center hives are a common symptom of lupus, affecting around 10% of people with this condition. Hives can appear anywhere on the body, including the face, neck, arms, and legs. The severity of hives can vary from person to person, and they can come and go for no apparent reason.

The exact cause of hives in lupus patients is not clear, but it is believed to be related to the immune system. Lupus is an autoimmune disorder, meaning the body’s immune system attacks healthy tissues and organs. When the immune system mistakenly attacks the skin, it can cause hives.

Exposure to certain medications, foods, or environmental factors can also trigger hives in lupus patients. In some cases, hives can be a side effect of medications used to treat lupus, such as nonsteroidal anti-inflammatory drugs (NSAIDs), hydroxychloroquine, or methotrexate.


If you have lupus and hives, it is important to speak with your doctor to determine the underlying cause and develop a treatment plan. Here are some recommendations to help manage hives in lupus patients:

  • Hives due to lupus usually get better or go away when lupus is treated successfully. Hydroxychloroquine, methotrexate, mycophenolate, azathioprine, belimumab (Benlysta), anifrolumab (Saphnelo), and steroids can help. Make sure to follow all the advice in The Lupus Secrets to help your lupus get better to the best of your abilities.
  • Avoid triggers: If you notice that certain foods, medications, or environmental factors trigger your hives, try to avoid them. Common triggers include shellfish, nuts, antibiotics, pollen, and pet dander. Do not stop any prescribed medicines unless you talk to your doctor as discussed below.
  • Take medications as prescribed: If you are taking medications to manage your lupus symptoms, be sure to follow your doctor’s instructions. If you suspect that a medication is causing your hives, speak with your doctor about adjusting your dosage or switching to a different medication.
  • Apply cool compresses: To reduce itching and swelling caused by hives, apply a cool compress to the affected area. You can use a washcloth soaked in cold water or a bag of frozen vegetables wrapped in a towel.
  • Use over-the-counter antihistamines: Over-the-counter antihistamines, such as diphenhydramine or loratadine, can help reduce itching and swelling caused by hives. Be sure to follow the instructions on the package and speak with your doctor before taking any new medications. You want to make sure they are safe to take with your other medicines and medical conditions. These medicines can potentially cause drowsiness. Therefore do not take them before driving, climbing, or when using machinery.
  • Avoid hot baths and showers: Hot water can irritate the skin and make hives worse. Try taking lukewarm baths or showers instead.
  • Wear loose-fitting clothing: Tight clothing can irritate the skin and make hives worse. Wear loose-fitting clothing made from soft, breathable fabrics, such as cotton or silk.
  • Manage stress: Stress can trigger hives in some people. To help manage stress, try relaxation techniques such as deep breathing, meditation, or yoga.
  • You can also find out more about treating dry skin in the post Dry Skin in Lupus.

For more in-depth information on hives and other lupus skin problems in greater detail:

Read chapter 5 and 8 of The Lupus Encyclopedia, edition 2

Look up your symptoms, conditions, and medications in the Index of The Lupus Encyclopedia.

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If you have had hives, urticaria, or angioedema from lupus, what has your experience been? What do you recommend for other patients?

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Reviewed and edited by Donald Thomas, MD

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