Treatment of hives is fairly standardized. The majority of hives are caused by supersensitivity to a chemical in the body called histamine. Histamine is known to cause the swelling, itching and pain in hives. Thus, the majority of drugs used today are anti histamines.
Antihistamines: There are a wide variety of antihistamines. The first generation antihistamines have been around for at least 50 years. They include diphenhydramine (Benadryl), hydroxyzine (Atarax) and chlorpheniramine (Chlor-Trimeton). The second-generation antihistamines include loratadine (Claritin) and cetirizine (Zyrtec). The first generation antihistamines are not much used today because they often cause sedation, dry mouth and dizziness. The second generation drugs cause less sedation and dizziness. Most individuals use these drugs to control not only hives but also allergies. The first generation antihistamines are also frequently used for sleep. They are much safer than the benzodiazepines, like valium.
Stop all offending medication. Anyone who is on penicillin or a related antibiotic should stop taking the medication and be reassessed by the physician to ensure that it is not the cause of hives.
Steroids: Sometimes hives may be multiple and also associated with other features such as skin rash, severe itching and difficulty breathing. In such cases, corticosteroids may be required. If the episodes are mild, one may take oral corticosteroids. If the symptoms are severe, then hospital admission may be required for IV corticosteroids.
Other medications: Sometimes an antidepressant may also help in the treatment of hives. The first generation of tricyclic antidepressants also have potent antihistamine effects and work well. For those who get repeated episodes of hives, an antiasthmatic drug called motelukast, also prevents the release and generation of histamine and is effective.
Lotions: When the itch is severe, a moisturizer can be applied. These lotions can help soothe the skin and reduce the itch.
Avoid: One should avoid aspirin and nonsteroidal anti-inflammatory medications (NSAIDs). The NSAIDs have ingredients in them which can cause hives.
Miscellaneous: One should avoid extremes of temperature, alcohol and all mental stress.
Of course, the best treatment for hives, whenever possible, is to remove and avoid whatever is triggering your hives.