Hives And Angioedema

1 What are Hives and Angioedema?

Hives or urticaria is a condition characterized by itchy spots or patches of raised bumps on skin. Hives may be small spots on the skin or large patches, often reddish and raised. It may be caused by an allergic reaction or by other conditions. They may appear anywhere in the body, but is usually seen on face, lips, tongue, throat, or ears. 

Angioedema, or giant hives, are similar to hives but form beneath the skin. It is characterized by swelling under the eyes and lips. These two conditions are often harmless and resolve without any specific treatment. Antihistamine medications are the common treatment for this skin condition. It may become potentially life-threatening if the swelling in throat or tongue obstruct the airway.

2 Symptoms

Smooth, raised, reddish colored bumps on the skin called wheals are the main symptoms of hives. They are itchy and cause a burning sensation. They first appear on trunk, upper arms, and legs. They may appear in batches and persist for few minutes or hours.

Hives appear as small patches which later join together to form big blotches covering a large part of the body. 

Angioedema are different from hive in appearance. It is characterized by swelling under the eyes and mouth. Swelling may also be found in throat, tongue, hands, and genitals. The swellings are not so itchy, but have a burning sensation. 

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3 Causes

Hives and angioedema are caused by a reaction of the body towards chemicals like histamine, bradykinin, leukotriene C4, and prostaglandin D2. It is most often caused by allergic reaction. 

Some of the most common triggers of hives are: 

  • Food allergy – certain kinds of food like shellfish, peanuts, tree nuts, eggs, and milk cause an allergic reaction that result in hives and angioedema. 
  • Certain medications – medications like penicillin, aspirin, ibuprofen, and naproxen often cause hives and angioedema. 
  • Allergens – common environmental allergens like pollen, animal dander, and insect stings cause skin irritation and hives.
  • Environmental factors – many environmental conditions, including cold, heat, sunlight, water, pressure, and stress, cause hives and angioedema. Strenuous physical activity also result in hives.
  • Certain medical conditions – immune system disorder like lupus, thyroid problems, certain cancers, and infections may lead to hives and angioedema. 
  • Genetics – one form of angioedema, called hereditary angioedema, is inherited. 

The major risk factors of hives and angioedema include history of hives, allergic reactions, and immune system disorders like lupus. 

4 Making a Diagnosis

Hives are diagnosed by a review of medical history and symptoms. Timing of symptoms after exposure to any of the triggers indicate chances of hives. Further tests are recommended on the basis of medical history and physical examination. 

Allergy test helps to identify the trigger. Blood tests help to rule out chances of other medical conditions that cause similar responses.

5 Treatment

Mild symptoms of hives and angioedema resolve on their own without any specific treatment. Medications are used to alleviate discomfort and specific symptoms of hives. 

  • Antihistamines are used to reduce swelling, itching, and other symptoms of allergy. 
  • Corticosteroids are suggested for severe symptoms of hives, and helps to control swelling, itching, and redness of skin. 
  • Autoimmune drugs help to control exaggerated response of the immune system to an allergen. It is prescribed when the patient does not respond to antihistamines or corticosteroids. 
  • Blood protein controllers are used to control symptoms of hereditary angioedema. 
  • Severe symptoms of hives or angioedema requires immediate medical attention. Emergency epinephrine shots are given to control the severe symptoms. 

6 Prevention

Avoiding triggers of allergic reactions and hives is the best way to prevent hives and angioedema. Keeping a food and symptoms diary helps to identify the food allergen that result in hives.

7 Alternative and Homeopathic Remedies

A few alternative and homeopathic remedies exist for hives.

Vitamin D3 and quercetin supplementation help in controlling hives. Guided imagery and hypnotherapy are also tried in the treatment of this skin condition.

8 Lifestyle and Coping

Lifestyle modifications are necessary in order to cope with hives.

Avoid triggers of hives like foods, medicines, or other chemicals.

Cool compress and baths also provide relief from the symptoms.

Avoiding direct sun lights and strenuous physical activity also help to control hives.

Irritation can be avoided by wearing loose fitting, cotton clothes.

9 Risks and Complications

There are several risks and complications associated with angioedema.

Severe symptoms of angioedema are potentially life-threatening and require immediate medical attention.

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