Dr. Zain Husain, MD with Heather and Courtney, breaks down hives (urticaria) from “inside and out,” explaining that hives are a common inflammatory skin reaction driven by histamine release that causes leaky blood vessels, swelling, and itch. They review typical features (raised pink welts that move and usually resolve within 24 hours) and less common presentations like bullous urticaria and urticarial vasculitis, noting they saw unusual hives during COVID. The episode covers triggers including foods (shellfish, nuts), medications (including NSAIDs like ibuprofen/naproxen), and infections (viral, bacterial, sometimes parasitic), and clarifies hives are not always allergic or contagious. They discuss when hives become serious (angioedema/airway symptoms, systemic concerns), first-line treatment with antihistamines (including higher dosing), limited steroid benefit, and newer options like Xolair, Dupixent, and the BTK inhibitor Rapsodo, plus EpiPen use for anaphylaxis risk and practical tips like photos, symptom diaries, trigger avoidance, and gentle skincare.

00:00 COVID Hives Surprise

00:14 Show Intro And Setup

00:40 What Are Hives

01:26 Urticaria Types And Clues

02:56 Common Triggers Explained

05:08 When Hives Are Serious

07:11 First Line Treatments

09:29 Biologics and EpiPen

11:40 Skincare And Tracking Flares

15:31 Myths And When To See Derm

17:27 Wrap Up And Takeaways