Urticaria (also called hives) are flat red patches that can appear anywhere on the skin and are often itchy. Hives usually occur as an allergic reaction to something eaten or swallowed, or something that comes into contact with the skin. They can also occur due to stress or autoimmune diseases. You can find more information below.
What is urticaria (hives)?
Hives , or urticaria , are flat red patches that can appear anywhere on the skin and are often itchy. Hives usually occur as an allergic reaction to something that is eaten or comes into contact with the skin. Foods, medicines, and herbs are common causes. However, sun exposure, stress, infections and autoimmune diseases are also known to cause hives.
Symptoms of urticaria include an itchy, stinging pink/red rash on slightly swollen skin. The severity of the rash may increase and decrease. Acute hives typically resolve within six weeks, but chronic hives may persist for months or years.
Hives usually resolve spontaneously, especially in children. Otherwise, treatment for acute hives includes oral antihistamines to help relieve itching and stinging. Chronic hives that do not improve with antihistamines can also be treated with corticosteroids, antibiotics, and other potent medications.
As long as you are not having difficulty breathing, you can safely treat this condition on your own, in consultation with your doctor or pharmacist, with antihistamines.
What causes urticaria (hives)?
Urticaria, or urticaria, is caused by immune cells. Mast cells and basophils are two types of immune cells that play an important role in fighting foreign substances (such as infection and cancer), regulating blood flow to damaged tissue, and wound healing. These cells also secrete substances into the skin that cause the blood vessels to dilate.
Blood vessel dilation and white blood cell responses cause the swelling of the skin experienced with hives. These released substances include histamine, bradykinin, and kallikrein. Mast cell activation can be caused by:
- Immune-mediated activation: IgE antibodies bind to mast cells due to an allergy (i.e. hypersensitivity reaction) or autoimmune disorder.
- Non-immune-mediated activation: Drugs can directly activate mast cells or act on other chemical signals that subsequently lead to mast cell activation. Physical or emotional stress can also lead to the release of chemical signals that then activate mast cells.
Common triggers of allergic hives that cause most acute cases include:
- Certain foods, including fruit, milk, eggs, nuts, soybeans, and shellfish
- Medications such as aspirin , NSAIDs, opioids, antibiotics, some blood pressure medications
- blood transfusions
- Insect bites and stings
- animal saliva and dander
- Irritants such as pollen, dust and mold
Other triggers that can also cause hives include:
- Infections (such as viruses, parasites, bacteria, and fungi)
- Autoimmune diseases ( such as lupus disease , inflammation of blood vessels, Sjogren’s syndrome , and thyroid diseases )
- Certain cancers (such as gastrointestinal cancer, lung cancer, and lymphoma)
- Sunlight (a condition known as solar urticaria)
- Extremely hot or cold temperatures
- To exercise
- Pressure (for example, from sitting for a long time or wearing a tight wristband)
- scratching the skin
What are the symptoms of urticaria (hives)?
Although hives are usually manifested by redness and itching on the body, they can have a variety of symptoms such as:
The main symptoms of hives can be described in the following details:
- The rash may be slightly higher than the skin.
- The fried patches can be tied together.
- The rash usually resolves at some point within 24 hours, but then appears elsewhere.
- The rash can circulate throughout the body.
- The spill can be as small as a pencil tip or as large as a dinner plate.
- It may itch, sting or hurt.
- Hives may appear within moments of a trigger or begin a few hours later.
- The acute form of urticaria occurs in 70 percent of cases and lasts less than six weeks. It is usually due to allergies.
- The chronic form of urticaria occurs in the remaining 30 percent of cases. It lasts for more than six weeks and is usually caused by unidentified or autoimmune causes.
Hives are sometimes associated with angioedema, a potentially dangerous condition that requires immediate medical attention. Symptoms include:
- lip swelling
- eyelid swelling
- Throat and tongue swelling (this can cause difficulty breathing, which is a medical emergency)
- Abdominal pain (cramps may come and go due to intermittent swelling in the intestines)
- genital swelling
When should you see a doctor?
Difficulty breathing and facial swelling may be the first signs of a severe reaction that can progress rapidly if not treated promptly. If you have symptoms of hives and develop any respiratory distress, call 911 immediately.
If hives are bothersome enough to interfere with your daily life, seek medical attention to learn how to better control your symptoms.
Most cases of hives resolve within 48 hours. If it persists, medical attention is needed to evaluate for deeper underlying medical problems.
How is urticaria (hives) diagnosed?
Your doctor can detect hives and related complications by looking at your skin. Allergy tests can help determine what triggers a reaction. Knowing the cause can help you avoid allergens, hives, and swelling.
Allergy tests include:
- Skin tests: During this test, a nurse tests your skin for different allergens. If your skin is red or swollen, it means you are allergic to this substance. If the hives are chronic in nature, skin testing is not commonly performed.
- Blood tests: A blood test checks for certain antibodies in your blood. Your body produces antibodies to fight allergens. This process is part of your immune system, but if your body makes too many antibodies, it can cause hives.
How is urticaria (hives) treated?
If you’ve had hives after starting a new medication, eating a food you don’t usually eat, or being exposed to an animal or environment that is unusual for you, avoid future exposure to these potential triggers. There are also a number of treatments that can be effective, such as over-the-counter medications, prescription medications, and home treatment , in consultation with your doctor, to relieve the symptoms of hives for which you have not yet determined the cause.
Antihistamine medications are usually effective at reducing itching and swelling. They work best when taken regularly, not just when needed.
- Newer antihistamines: These are H1 receptor blocking options such as cetirizine, fexofenadine, and desloratadine that can be taken daily and have minimal side effects.
- Older antihistamines: Diphenhydramine is effective, but older antihistamines often have side effects such as fatigue. These can be most helpful when taken at bedtime.
Topical antihistamines and steroids are not effective for hives .
If hives persist for more than two days and are not responding to over-the-counter medications, your doctor may recommend additional treatments such as:
- Additional H1-blocking antihistamines: Your doctor may recommend higher doses, combination therapy with older and newer antihistamines, or prescription antihistamines such as hydroxyzine.
- H2-blocking antihistamines: These famotidine and ranitidine may help.
- Leukotriene receptor antagonists: Montelukast and zafirlukast, for example, may be helpful in certain situations.
- Tricyclic antidepressants: In addition to their mood-related effects, these drugs, such as doxepin, also have highly potent antihistamine activity.
- Immunomodulatory therapies: These may be recommended by allergists and immunologists in severe cases that do not improve with the treatments listed above. Immunosuppressive treatments sometimes used for hives include omalizumab, an injection of antibodies, as well as cyclosporine and tacrolimus.
What is good for urticaria (hives)?
If you are experiencing mild hives, the following tips may help relieve your symptoms:
- Avoid triggers: These can include food, medications, pollen, pet dander, latex, and insect stings. If you think a medicine is causing the rash, stop using it and contact your doctor.
- Consult your pharmacist or doctor and use an over-the-counter anti-itch medicine: An over-the-counter oral antihistamine such as loratadine, cetirizine, or diphenhydramine can help relieve itching. You can talk to your pharmacist about options.
- Apply a cold washcloth: Covering the affected area with a cold cloth can help soothe the skin and prevent itching.
- Take a comfortable and cool bath: A cold shower can be good. Some people may also benefit from bathing in cold water sprinkled with baking soda or oatmeal powder. However, this is not a solution for long-term control of chronic itching.
- Wear loose , smooth-textured cotton clothing: Avoid wearing tight, tight, itchy or woolen clothing. This will help you avoid skin irritation.
- Avoid the sun: When outside, take care to get up in the shade to alleviate discomfort.
- Wash your clothes: Wash all the clothes you used before you got sick. Allergens may still be on what you’re wearing.
Remember, your doctor will decide which medicine to take and how.