Both bug bites and hives can cause red, itchy bumps on your skin. While it can be difficult to tell them apart, learning key features and characteristics of each can help.

Hives and bug bites are common causes of skin irritation. They often have similar symptoms, and it isn’t always easy to tell them apart.

For some people, bug bites can lead to hives, which may make it more challenging to determine what’s going on with your skin.

Bug bites

Bug bites are skin reactions that occur after a bug bites you.

The bite itself causes injury to your skin, which can lead to swelling, redness, and inflammation. The saliva from the bug can also trigger a localized allergic reaction.

An itchy, red bump or welt is often the result.

Many types of bugs bite humans. Common culprits include:

Bugs can bite multiple times in the same area, and it’s also possible to have more than one bug bite you at the same time.

Hives

Hives, also known as urticaria, are raised, skin-colored or red welts called “wheals” that appear suddenly. They can have a variety of triggers and often develop in clusters or groups.

Hives can appear anywhere on your body. They aren’t always caused by an allergic reaction, even though they’re usually itchy.

Common triggers of hives include:

  • certain foods
  • medications
  • physical pressure or temperature
  • latex
  • blood transfusions
  • infection
  • pet dander
  • pollen
  • allergens
  • hormone changes
  • intense emotions or stress

Why are hives and bug bites both itchy?

The itch from hives and bug bites comes from the reaction of your immune system to certain irritants, allergens, or injuries. Cells known as mast cells release histamine as part of this response. Histamine affects sensory nerve fibers in your skin and causes an “itch” sensation.

Not all immune reactions are itchy, however, and histamine isn’t always a primary part of the immune response. For example, infections, autoimmune reactions, or inflammatory conditions like arthritis can involve different primary chemical messengers.

Even though bug bites and hives often have different causes, this isn’t always a sure-fire way to tell them apart. For some people, bug bites can trigger a body-wide reaction to histamine that results in hives.

Even when the cause is the same, you can learn to tell hives and bug bites apart in other ways.

Bug bites

Bug bites typically:

  • develop at the site of the bite
  • produce a single spot of irritation for each bite (it can be large or small)
  • have a central dot or darker center where the bite happened
  • involve redness or discoloration
  • are more common in warmer months when bugs are active
  • worsen gradually after the bite and remain for several days

Bug bites can vary significantly in appearance. Some may cause red marks without any visible bumps, while others can lead to larger areas of swollen, raised skin.

Some types of insect bites, such as those from external parasites like scabies and lice, may have unique features, including scabbing or scaling.

In rare cases, bug bites can cause a serious allergic reaction called anaphylaxis. Anaphylaxis is a medical emergency, and features symptoms of:

  • trouble breathing
  • nausea or vomiting
  • hives
  • facial swelling
  • fainting
  • racing heartbeat
  • low blood pressure
  • diarrhea
  • tightness in the throat

Hives

Hives can:

  • develop in clusters or groups
  • appear suddenly and can disappear just as quickly
  • appear anywhere on the body, even distant sites from the initial trigger
  • change shape, move around, or disappear and reappear
  • be red or skin-colored
  • blanch or turn white in the center when pressed (depending on your skin tone)

Hives are not usually dangerous, but they can be a symptom of anaphylaxis (which can be life threatening) when caused by an allergen. It’s always OK to call your doctor or emergency services if you’re unsure.

Bug bites and hives have individual and shared treatment approaches, depending on your symptoms and the underlying causes.

Both hives and bug bites may be treated using:

  • antihistamines
  • topical corticosteroids
  • cold compresses
  • scratching avoidance

For bug bites, your doctor might also recommend topical antibiotics to prevent secondary infection.

Some hives require long-term management. Doctors consider systemic medications like steroids or biologics when hives are recurrent and persistent or don’t respond well to other standard treatments.

Trigger avoidance is also important in hive management. Avoiding triggers for hives might mean making significant lifestyle changes.

Bug bites and hives have similar symptoms, and sometimes they can even share an underlying cause. Both skin conditions can produce red, itchy bumps or welts.

Bug bite irritation develops at the site of the bite. It’s usually red or discolored and has a darker center where the bite occurred. Hives can appear anywhere on the body, even far away from the initial trigger exposure. They can also merge together or appear in clusters.