What do we mean by Hives or Urticaria?

Red, raised and itchy rashes on the skin surface are called Hives, which are mostly triggered by allergens. Anything which produces an allergic reaction is called an allergen.

It is also called by other names including weals, welts, Urticaria or nettle rashes.

An allergic reaction is always followed by the release of a protein by a body called histamine. As soon as histamine is released, the small blood vessels i.e capillaries leak fluid. This fluid accumulation in the skin is the main cause of rashes.

At least 20 percent of people are affected at some point in their lives by Hives.

These rashes are not contagious.

Causes

The body releases Histamine and other chemicals, from the inner surface of the skin, as a result of reactions by allergens, which give rise to hives.

The histamine and other chemicals cause fluid accumulation and inflammation under the skin, which leads to wheals.

The following are the known triggers of hives:

  • Medications, such as selective antibiotics and NSAIDs ( i.e nonsteroid anti-inflammatory drugs ), for instance, aspirin and ACE inhibitors, which are used in high blood pressure.
  • Foods which include nuts, shellfish, additives, strawberries, wheat, and egg products.
  • Various infectious diseases e.g influenza, glandular fever, hepatitis B, and the common cold
  • Urinary tract and strep throat bacterial infections
  • Various Intestinal parasites
  • Extreme hot and cold or extreme temperature changes
  • Higher than normal body temperature
  • Pet dander shed by cats, dogs, horses, etc
  • Dust mites
  • Cockroaches and their waste materials
  • Latex
  • Pollen
  • Some plant species including nettles, poisonous ivy, and oak
  • Insect stings or bites
  • Few Chemicals
  • Chronic diseases, for instance, lupus or disease of the thyroid gland
  • Exposure to sunlight
  • Exercise
  • Intense scratching
  • Water on the skin surface

But patients fail to figure out the cause in almost 50% cases.

Chronic Urticaria is an autoimmune disorder, but the reason for this is not yet discovered.

Treatment

The regular consumption of non-sedating antihistamines for several weeks treat acute Urticaria.

Antihistamines, including fexofenadine and cetirizine, blocks the adverse effects of histamines thus inhibiting rashes and itchiness

Most antihistamines are available online and in pharmacies.

Antihistamines can cause drowsiness, especially in alcohol addicts. Some are prohibited for consumption in pregnancy, except when prescribed by a doctor.

Patients suffering from angioedema should see an allergist, an immunologist or a dermatologist. Serious breathing difficulties can result from angioedema.

In case of swelling of tongue or lips and breathing difficulties doctors usually prescribe an epinephrine auto-injector, for instance, EpiPen is prescribed in emergency conditions.

Patients should try to avoid triggers.

Chronic Urticaria

Chronic Urticaria can lead to long term discomfort and complications.

Its treatment is different from that of acute urticaria

Antibiotics, e.g Dapsone are used to reduce swelling and redness.

An injectable drug called Xolair, or Omalizumab functions to block immunoglobin E, a substance that helps in allergic reactions. This drug inhibits the symptoms of chronic idiopathic urticaria, another type of hives that has an unknown origin, lasting for months or years.

Patients experiencing severe symptoms should see a specialist.

A special treatment method called acupuncture can treat hives, a systematic review was published in 2016 that stated, ” Acupuncture may prove effective and safe for relieving symptoms of chronic urticaria, which was based on low-grade evidence”. However, the authors demanded to confirm findings.

Severe distress, discomfort can be caused by chronic hives, which can increase the possibility of depression. Stress can worsen hives, thus starting a vicious cycle. It is better for those patients who are experiencing depression to consult a doctor.

Symptoms:

Various rashes appear on the skin in the form of swellings or wheals. These swellings appear as round to oval bumps, which are either red or pink. Their size varies from few millimeters to several inches. A red flare circles these itchy rashes.

The wheels are mostly present in batches, most frequently they appear on the face or upper or lower extremities e.g arms, legs, hands and feet.

Welts do not last longer than 24 hours but expect the appearance of new ones. Either their occurrence is limited to one part or they scattered in different parts of the body.

Symptoms do not last longer than 24 hours, but in some cases, a new weal follows the last one.

Sometimes, hives can last longer than several days. People suffering from chronic hives continue to exhibit symptoms from days to months.

Anaphylaxis

Severe allergic reactions that can affect the entire body is called Anaphylaxis.

Breathing difficulties and general loss of consciousness are one of the leading causes of anaphylaxis. It must be treated right away as it is fatal. Anaphylaxis is a major medical emergency.

If the patient encounters the following symptoms then immediate treatment is necessary.

  • Nausea plus vomiting
  • Breathing difficulties as an outcome of swelling in the floor of mouth, lips, tongue or throat
  • Cold and clammy skin
  • Increased heart rate
  • Faintness and dizziness
  • Anxiety attacks

Patients with hives can experience other symptoms which are an indication of anaphylactic reactions.

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