An overview of Hives

Hives, also known as urticaria, are itchy, raised welts that are found on the skin. They are usually red, pink, or flesh-colored, and sometimes they sting or hurt.

In many cases, hives are an acute (temporary) problem that may be alleviated with allergy medications. Most rashes go away on their own. However, chronic (ongoing) cases, as well as hives accompanied by a severe allergic reaction, are larger medical concerns.

Acute urticaria : hives that don’t last very long (less than six weeks).

Chronic urticaria : hives that happen at least twice a week for more than six weeks.

Chronic, spontaneous urticaria or chronic idiopathic urticaria : chronic hives that don’t have an obvious cause.

Acute hives are often an allergic reaction to something you put into your body, like food, drink or medication, or something that you touch. The skin has immune cells called mast cells. When these cells go into action, they release chemicals, including one called histamine. Histamine is the reason that hives form.

You can also get hives for a variety of other reasons. Some of these include having an infection, stress or physical pressure on your skin.

The skin reaction may be triggered by:

1. Heat or cold

2. Sunlight

3. Vibration, such as caused by jogging or using lawnmowers

4. Pressure on the skin, as from a tight waistband

5. Medical conditions, such as thyroid disease, infection, allergy and cancer

Symptoms of chronic hives include:

1. Batches of welts (wheals) that can arise anywhere on the body

2. Welts that might be red, purple or skin-colored, depending on your skin color

3. Flares triggered by heat, exercise or stress

4. Painful swelling (angioedema) around the eyes, cheeks or lips

5. Itchiness (pruritus), which can be intense

6. Welts that vary in size, change shape, and appear and fade repeatedly

Tips for preventing hives may include:

1. Choosing mild or fragrance-free soaps, skin creams, and detergents

2. taking over-the-counter antihistamines when the pollen count is high, if pollen may be a trigger

3. keeping a record of any possible triggers, such as a food diary

4. talking to a doctor about whether medications may be responsible

5. using meditation and other relaxation techniques to manage stress

Almost any food can cause an allergic reaction. Some common triggers include: milk, eggs, nuts, soy, wheat, seafood

Your healthcare provider can diagnose hives and angioedema by looking at your skin. Allergy tests can help identify what’s triggering a reaction, but this is true primarily for acute hives. Knowing the cause can help you avoid allergens and the hives that come with them. Allergy tests to diagnose hives include:

Skin tests: During this test, healthcare providers test different allergens on your skin. If your skin turns red or swells, it means you’re allergic to that substance. This type of allergy test is also called a skin prick or scratch test. Skin testing usually isn’t done for chronic hives.

Blood tests: A blood test checks for specific antibodies in your blood. Your body makes antibodies to fight off allergens. If your body makes too many antibodies, you can develop hives and swelling.

The best approach to treatment depends on the cause and whether the issue is acute or chronic.

Acute urticaria

If symptoms are mild and occur after exposure to an allergen or irritant, home remedies can usually soothe the itchiness until the rash disappears.

Options that a doctor may recommend include :

1. non-sedating antihistamines, such as cetirizine (Zyrtec) or fexofenadine (Allegra)

2. short-term use of topical steroids

3. antiseptic creams to prevent a secondary infection

4. soothing creams to reduce itchiness

If there are signs of allergy, and the person has swelling in their lips, face, or tongue, the doctor may prescribe an epinephrine auto-injector to carry for use in emergencies.

Chronic urticaria

A person with chronic urticaria may need to take antihistamines regularly until their symptoms resolve.

Omalizumab (Xolair) is an injectable drug that blocksTrusted Source immunoglobulin E, a substance that plays a role in allergic responses. It can reduce symptoms of chronic spontaneous urticaria, a type of hives with an unknown origin.

Chronic hives can lead to severe discomfort, distress, and possibly depression. Stress, too, can aggravate hives. And having hives can worsen stress. Anyone who feels that hives is affecting their quality of life or mental well-being should speak with a doctor.

If tests reveal an underlying disease, such as lupus, the doctor will recommend treatment for this.

Tips for reducing hives symptoms include:

1. using a soothing lotion or cool compresses to ease the itchiness.

2. wearing loose, light, cotton clothing.

3. avoiding scratching.

4. choosing soaps, moisturizers, and other cosmetics for sensitive skin.

5. avoiding overheating by taking cold showers and using a fan.

6. avoiding sun exposure.

7. avoiding exposure to known triggers