The diagnosis of hives is visual. There are no specific diagnostic lab or x-ray tests required for the diagnosis. Since the physiologic cause of hives is due to histamine release, we use antihistamine medications in addition to topical or oral steroids as the mainstay of treatment. Applying a cool compress of the affected area can also be symptomatically helpful. If the hives are associated with tongue, lip or throat swelling and difficulty breathing you should seek medical attention immediately at a certified urgent care or emergency department. The vast majority of times, hives occur independent of these more significant symptoms. If you are able to identify the specific stimulus that may have caused hives, it should be eliminated. If you believe the hives are due to direct skin contact, the affected area should be washed to avoid continued exposure and ongoing symptoms.