Hives can occur anywhere on the body, including the mouth and lips. They appear as raised lumps or welts that may itch. Usually, hives that only appear in one area are the result of contact with an irritating substance, such as a bee sting.

In rare cases, hives in or around the mouth can be an early sign of anaphylaxis, which is a severe and life threatening allergic reaction. Dial 911 or the number of the nearest emergency department if someone develops:

  • swelling of the lips, tongue, or throat
  • difficulty breathing
  • wheezing
  • nausea or vomiting
  • dizziness or feeling faint
  • loss of consciousness

This article will cover the causes, diagnosis, and treatment of hives of the mouth and lips.

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Yes. Hives, or urticaria, can develop around or inside the mouth. But it is also possible that this might be angioedema.

Angioedema is swelling beneath the surface of the skin. Similarly to hives, it can also develop as a result of exposure to an irritant or allergen, and can look similar.

A doctor can tell whether swelling around the mouth is the result of hives or angioedema.

Hives are usually not serious. Most cases are mild and resolve on their own. Each hive typically lasts less than 24 hours, although they may come and go over several days or weeks.

Acute cases of hives are short term, lasting 6 weeks or fewer. People can also develop chronic hives that last longer, but this is less common. Neither acute nor chronic hives are serious conditions, but they can be uncomfortable to live with.

Rarely, hives or mild swelling around the lips and mouth can be an early symptom of anaphylaxis, which is serious and requires immediate medical attention. If a person does have anaphylaxis, the symptoms will quickly change and get worse.

Both hives and angioedema on their own can also be severe, even if they are not related to anaphylaxis. If the swelling restricts airflow, or affects the throat and tongue, a person needs to seek urgent medical help.

There are several potential causes for hives on the lips or mouth, including:

Irritant exposure

Usually, localized hives that appear in one place are the result of the skin coming into contact with an irritant. This is not the same as an allergy. Instead, it is the result of the immune system identifying a substance as a potential threat.

Some common triggers include:

  • insect bites or stings
  • animal saliva
  • substances from plants, such as tree sap
  • certain foods

Babies can sometimes get oral hives if they eat a food they have never tried before, or if they drool after eating a new food.

Oral allergy syndrome

Hives or swelling around the mouth can also be a symptom of oral allergy syndrome (OAS). This group of symptoms affects people with hay fever when they eat certain foods.

Some foods contain proteins that are similar to proteins in pollens. For some, eating or touching these foods leads to an allergic reaction. The symptoms of OAS include:

  • rash
  • itching inside the mouth
  • swelling of the lips, mouth, or tongue

OAS is more likely to affect people with allergies to ragweed, birch, or grass pollen. The potential triggers of OAS are varied, but may include any of the following raw fruits or vegetables:

  • cherries
  • apples
  • kiwis
  • tomatoes
  • celery

Cooking these foods usually breaks down the proteins that cause the allergic reaction.

Cold hives

This type of hives develops when the skin comes into contact with something cold. People with this condition may have to avoid iced drinks, ice cream, and other cold foods, as these could cause hives inside the mouth.

Learn more about cold hives.

Other causes

The above causes may explain localized hives, but if someone has hives around the mouth as well as in other locations, there may be other factors involved. The hives could be the result of a:

People can also get hives in response to adrenalin, sunlight, water, vibration, or pressure on the skin. But over 30% of the time, the cause is not found.

Doctors can usually diagnose hives in the mouth by performing a physical examination. They may ask when the symptoms developed, whether a person has had hives in the past, or whether they have any allergies. Preexisting conditions or medications a person takes may also be relevant.

It may not be necessary to investigate the cause of mild, acute hives. But for recurring or chronic hives, a doctor may request additional tests. These could include allergy testing or blood tests to rule out underlying conditions.

Usually, hives only last a few hours and resolve without treatment. To alleviate symptoms, people can try:

  • anti-itch creams, such as calamine lotion
  • over-the-counter (OTC) nondrowsy antihistamines
  • cold compresses, which people can apply several times each day if they do not have cold hives

Chronic hives may require higher doses of antihistamines a person takes regularly. Severe chronic hives may require medications to lower inflammation, immune modulators, or immunosuppressants.

People who have serious allergic reactions must carry an epinephrine auto-injector with them at all times. Do not hesitate to use it if the hives or swelling come with rapidly worsening symptoms.

Several conditions cause lumps, swelling, or rashes around the lips and mouth. These include:

Because hives may resemble other conditions, it is advisable to speak with a doctor for a diagnosis if a person has a new or persistent rash around the mouth.

Hives are raised lumps or welts on the skin. They can occur around the lips and inside the mouth. When this happens, it is usually the result of an irritant. But hives in the mouth can also happen as a result of OAS, or rarer conditions, such as cold hives.

OTC antihistamines and anti-itch creams can reduce the symptoms of mouth hives, but a person should seek medical advice if the hives do not go away, or if they keep coming back.