It's rare for hives to cause any sort of scarring because hives don't typically lead to breaks in the skin, according the American Osteopathic College of Dermatology. Without this type of damage, the skin doesn't stimulate collagen production to repair the wound and thereby form scar tissue. However, hives can result in a condition known as post-inflammatory hyperpigmentation, which is often confused with scarring. Swelling left in the skin from the hives can encourage excess melanin to accumulate and result in small areas of discoloration thought to be a form of scar tissue.
Discuss your treatment options with a doctor or dermatologist. Medical professionals can assess the state of your skin to determine what needs to be done to remedy the condition.
Apply a thin layer of a topical corticosteroid to the areas of discoloration. This prescription medication reduces any residual swelling and stops the excess production of melanin. Spots eventually fade.
Cover the areas of discoloration with topical hydroquinone. This skin-bleaching agent is available in prescription and nonprescription strengths. It directly breaks up the clusters of melanin caused by the residual swelling, and spots eventually fade.
Rub a topical lightener containing either azelaic acid or glycolic acid over the areas of discoloration. Sometimes these over-the-counter creams can lighten the spots left on the skin from hives, so check your pharmacy, grocery or another store for purchase.
Undergo a skin rejuvenation procedure. Chemical peels, dermabrasion and even microdermabrasion can all help to eliminate the areas of discoloration by stripping away the surface skin cells, which causes new skin to form that doesn't contain the excess melanin.
Before using any one of these treatment options, make sure the hives have healed on your skin. Antihistamines, such as diphenhydramine, chlorpheniramine, desloratadine and hydroxyzine, or prescription corticosteroids are used to reduce inflammation, redness and itching associated with this skin condition.
Corticosteroids are sometimes combined with hydroquinone and retinoids to reduce the swelling and encourage cellular turnover, which can speed the fading process.