Urticaria or hives are short -lasting raised areas of the skin that are intensely itchy and red in colour, It is a very common condition and about 20% of the people have hives sometime during their lives.
Urticaria is caused by release of a chemical called histamine, which causes itching,redness and swelling of the skin. In most cases, the lesions appear suddenly disappear within several hours
If the disease last for less than six weeks, causes like infection(usually upper respiratory tract infections), food allergy and drug allergy may be responsible.
When hives last for more than six weeks, other chronic causes need to be ruled out.
Urticaria can be acute, chronic or physical, but when you first get Urticaria, you cannot tell how long it will last, so you cannot tell if you have acute or chronic lesions
Although all the types of relations looks similar,they often have different triggers. Learning what triggers your Urticaria may help you avoid the triggers
Hives will not last beyond a few days and will last for a maximum of six weeks.
Triggers of acute hives include infections, drugs, insect stings (bees, wasps, ants) and food allergy and physical contact with certain agents.
Food associated urticaria appears within 30 minutes of eating the food and the foods most likely to cause it include milk, cake, other nuts, soy wheat, fish, and shellfish, Physical contact with certain plans of fruits, vegetables and can also cause Urticaria in certain individuals.
The list is not all inclusive.
Hives occur almost daily last longer than six weeks, sometimes for years. In Chronic Urticaria also, the individual lesions disappear in 24 hours, while new ones may keep coming up.
These hives come and go and can interfere with sleep or school.
In most cases of chronic hives, the cause is unknown. Problems in the immune system may play a role. It can be a sign of medical or auto immune diseases, including thyroid, liver, disease, disease, chronic infection, allergic conditions such as allergic rhinitis, asthma or lupus.
The list of causes is not all inclusive, some times a cause cannot be found.
Food additives like colour, preservatives and essence, and NSAIDs are important triggers of both acute and chronic Urticaria
Hives can be triggered by physical factors like exposure to cold, changes in temperature, sweating, vibration, pressure, exercise, sunlight, or water
Dermographism is a type of physical Urticaria in which red lines are developed if the skin is stroked. Physical forms of tend to be long lasting
Urticaria are red raised areas that are intensely itchy. These raised areas may large and merge together. Itching is the most bothersome symptom. Rarely severe pain, purple spots, raised lesions along with fever or joint pain can occur.
Urticaria can affect any part of the body, specially trunk, thighs, arms, and face.
Most individual lesions fade quickly, but some new crops may appear for 24 to 72 hours if the person continues to be exposed to the environment or substance that triggered the hives.
In up to half of the patients with Urticaria, a condition called angioedema also develops. Angioedema causes puffiness of the face, eyelids, ears, mouth, hands, feet and genital area. It may be associated with pain.
Hives can also occur as part of a serious allergic reaction can be associated with breathlessness, tightness in the throat, nausea, vomiting, cramping, abdominal pain, and giddiness. If these symptoms occur, get immediate medical attention. You could be developing anaphylaxis, a life threatening condition.
Recognising and avoiding the trigger, if identified, is the most important step.
In mild cases, consult a physician and antihistaminic tablet will provide relief.
Application of soothing calamine lotion will provide relief.
In recurrent episodes or chronic cases, consult a dermatologist.
Go to hospital immediately if experiencing angioedema as described above, breathlessness, tightness in the throat, nausea, vomiting, cramping, abdominal pain, or giddiness.
Most of the people with Urticaria do not need any test. The diagnosis based on history and appearance of the skin lesions.
However, test may be recommended if lesions don’t resolve within six weeks.
Skin testing for food and drug sensitivities may be done for people with acute urticaria, but may not yield satisfactory results.
Blood test are done if Urticaria continues for more than six weeks, to check for underlying diseases such as liver and thyroid problems and immune disease.
Skin biopsy may help identify uncommon causes of Urticaria (in cases of persistent fever, painful hives, individual hives that last for days at a time or associated with bruising of the skin or abnormal blood tests).
Urticaria is treated with a combination of avoiding things that cause worsen hives and certain medications.
The first treatment for acute urticaria is to figure out what is triggering it and then avoid the trigger. Even if you cannot figure out the trigger, acute urticaria tends disappear over days or weeks.
Antihistamines are the main step for the treatment of Urticaria. They help relieve the itching and most patients do respond to antihistamines. Relatively high doses and more than one type of antihistamine may be needed for the control of symptoms.
There are two types of antihistamines. They differ in the type of side-effects, cost, duration of medication and need for a prescription.
The older antihistamines start to work quickly and work well to relieve the symptoms.
The problem with these antihistamines are that the dose is 3 to 4 times per day. The other bothersome side-effects such as drowsiness, dry mouth , double vision, difficulty in urinating can occur. It can interfere with driving and task requiring quick reactions, similar to the effects of drinking alcohol. These medicines are therefore not recommended people who plan to drive, pilot aircraft or boat, or operate heavy machinery or those people who job performance maybe otherwise affected. The side-effects usually get better if you take the medicine regularly over a period of time
Newer antihistamines have few side-effects than older antihistamines. They need to be taken less often, usually one to twice per day. A high dose of antihistamines are recommended before trying other treatments.
It is always advised that Urticaria patients should keep an antihistamine with them so they can take it at the first signs of Urticaria or hives
In unresponsive patients, oral steroids or other treatments like immunomodulator medications or biologicals may also be recommended by the dermatologist.
Hives usually respond well to treatment- which include medicines and avoiding whatever triggered the hives.
More simple cases of Urticaria fade quickly, affected skin returns to normal within hours.
Even if you have episodes that trigger over several weeks,without a known cause, hives often stop coming back after a few months.
Consult your dermatologist, if hives persist for several days or if interferes with your efforts to sleep or perform a daily activities.
Chronic urticaria in a significant percentage of patients is non-allergic in origin. So unnecessary elimination of diet should not be done.
Second generation antihistamines are very safe and long-term for several months to years at a time without with proper monitoring
Urticaria is not contagious.
It is rarely permanent and 50 percent of the people are free of the lesions within a year.
Chronic urticaria is rarely caused by allergies and is not life threatening.
It is treatable in most patients and may need a few months to a few years of long-term antihistamine therapy. They are very safe when taken under supervision.
Disclaimer: This article is only for general patient information and is not intended for self medication. There is no legal liability of IADVL arising out of any adverse consequence to the patient. Subsequent to its use for self treatment of the disease images adjust for the depiction of the condition and is not to be used for any other purpose.
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