What Are Hives?
Hives, also known as urticaria, nettle rash, or welts, refer to a skin condition characterized by raised itchy rashes. These rashes may develop suddenly, and can be localized or spread over a large surface of the skin. They vary in size and shape and are more commonly found in women than men.
The rashes may disappear within a few hours and then recur later on a different part of the body. If the swelling arises below the skin surface, this skin condition is called angioedema.
Hives or urticaria is a red colored circular rash on the skin which causes intense itching. At times, this rash can swell to dangerous degrees. It is caused by an allergic reaction and often the result of food allergies.
Angioedema is categorized by profound inflammation around the lips and eyes. Sometimes, angioedema can also cause inflammation of the hands, genitals, and feet. The swelling caused by angioedema often takes longer than hives to subside; however, it generally goes away in less than 24 hours.
Hives can form in various sizes. They can be as small as the tip of a pen or as large as a dinner plate. At times, hives can even connect to each other to form even larger welts.
What Causes Hives?
Both hives and angioedema are caused by a rise in histamine levels and other chemical messengers. Histamine and other emissaries cause the blood plasma to leak out from blood vessels, resulting in hives.
Common Causes of Hives
Some of the common causes of hives include:
- Exposure to sunlight
- Certain medications
- Insect stings
- Preservatives and other chemicals used in food
- Allergic reactions
Different Types of Hives
There are different types of hives. These include:
- Acute hives or urticaria – These hives persist on the skin for less than six weeks. They are often caused by chemicals in food, infections, or certain medications. Chocolates, tomatoes, fresh berries, eggs, milk, and fish may cause an acute form of hives on the skin. Fresh food generally poses a higher risk of causing hives than cooked food. Even some preservatives or additives in foods can be responsible for hives. Non-steroidal anti-inflammatory drugs, medications given for hypertension, and pain killers like codeine can also cause hives.
- Chronic hives or urticaria – This type may remain for more than six weeks. The exact cause of this skin condition is still unknown. The chronic form of hives and angioedema may affect internal organs such as the lungs, muscles, and gut. In some cases, these hives can be caused by thyroid disease, hepatitis, cancer, or other infections.
- Physical hives or urticaria – These hives are the result of increased stress on the skin like exposure to sun, vibration, sweating, pressure, cold, heat, and even exercise. In this case, the hives will form only in stimulated regions. In most cases, hives may resolve within 1-2 hours.
- Pseudo-allergic hives or urticaria – Some substances labelled as non-specific histamine liberators can cause hives. Several antibiotics and products used in radiology may also cause urticaria or hives.
- Secondary hives or urticaria – At times the hives are related to an auto-immune disease, thyroid disease, cancer, or infections. For these hives or urticaria to subside, the root causes must first be eradicated.
- Dermatographism – Stroking and scratching of the skin results in the dermatographism form of hives. It is the most common form of physical hives or urticaria. These hives may rise along with other forms of urticaria.
Diagnosis of Hives
Your medical service provider or dermatologist may conduct several physical tests to better understand the condition. The doctor may also ask questions to help determine the key triggers of your condition. There are no specific tests to diagnose hives directly; however, there are skin tests that may be performed to identify triggers of your condition. Routine blood check-ups may also be conducted to determine if internal illness is the cause behind the hives.
Some tests may include:
- Allergy tests
- Skin biopsy
- Blood work
Treatment of Hives or Urticaria
The best way to treat hives or urticaria and angioedema is to find the root cause behind the hives and remove it. Antihistamine medicines are also prescribed by the physician or dermatologist to help relieve pain and itching. These medications perform well if taken regularly. If the Hives are caused by food allergies, it is recommended to remove those foods from your diet. Similarly, if the hives are a side-effect of a specific medicine, that medicine is to be removed from your treatment indefinitely. In short, the best way to stop the Hives is to remove the root cause of the allergy.
Chronic urticarial or hives may be treated with antihistamine medications or with a combination of other medicines. It antihistamines fail to provide relief; oral corticosteroids can be prescribed by your medical service provider. For individuals over 12 years of age, a biologic drug called omalizumab may be prescribed to treat chronic hives or urticaria.
For serious angioedema or hives, an injection of epinephrine (adrenaline) is prescribed. This injection is used if a hives outbreak occurs. If the hives occur around the eyelids and lips, causing them to swell, the person needs immediate emergency medical treatment.
If all the previously mentioned conventional treatments fail to cure the hives, the dermatologist may prescribe less traditional medications.
An antibiotic called Dapsone may be prescribed to provide relief from redness and swelling. All medicines can have potential side effects; therefore, it is important to always check with your doctor about possible side effects of the medications that you are prescribed.
Some researches show that up to 50% of persons with chronic hives continue to have hives even after treatment with antihistamines.
For many patients, hives are not that serious. Some patients living with chronic hives have noted that their condition vanished on its own, without treatment, within a year. However, for many patients, hives can come and go for several months to several years. If the hives remain for an extended period or become serious, you need to seek immediate medical assistance. Sometimes hives can be an indication of internal illness too. If you begin to experience hives, it is recommended that you consult a doctor to ensure that your hives are not caused by something serious.
How to Manage Hives
While you undergo medical treatment for Hives, you may also use some home remedies to manage hives and get some relief.
- Applying cold compresses or wet clothes on the affected area may give you relief from the itching and burning sensation.
- Try to avoid hot atmospheres.
- Wear loose fitting and lightweight clothes.
- You can also apply apple cider vinegar mixed with bath water for instant relief from the itching, burning, and uneasiness of hives.
- Applying fresh Aloe Vera gel on the hives will soothe the burning sensation, irritation, and itch that occurs with hives.
- Increase the amount of vitamin C in your diet.
These home remedies can help provide temporary relief from the discomfort caused by hives; however, you need to see the doctor if any of the following symptoms occur.
- Drowsiness or dizziness
- Shortness of breath
- Shallow breathing or difficulty in breathing
- Chest tightness
- Swelling on face, tongue, or lips.