Hives (Urticaria)

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Urticaria is a medical name for hives which are described as pink-colored welts that manifest on any part of the skin. These rashes are itchy and can last a few hours before fading away, thus leaving no trace at all. New hives appear as old areas fade. They are pea-sized or connect in order to cover a wide area in the body. Even though the itchiness can be intense, the skin is not usually scabbed or broken. In some individuals, the hives sting or burn.

Hives are quite common with some individuals experiencing at least one episode in their lifetime. Hives can oftentimes occur in the deeper tissues of the eyes, hands, mouth or genitals. Take note that these areas can develop swelling that can be undesirable in appearance but typically vanishes in less than 24 hours.

In most cases, a single attack of hives is due to a virus or infection and typically vanishes within a few days to a few weeks. Some experience repeated attacks that occur as an allergic reaction to various triggers. In such cases, the hives usually break out within a few hours of exposure.

Physical urticaria

Some individuals can develop recurrent hives from cold, sunlight, pressure, exercise or vibration which are called physical urticarias. In case hives develop from scratching or firm rubbing of the skin, it is called dermatographism. This is the most prevalent form of physical urticaria and it does not always itch.

Some individuals can develop recurrent hives from cold, sunlight, pressure, exercise or vibration which are called physical urticarias.

Cholinergic urticaria

In some individuals, they react to anything that makes them sweaty or hot such as exercise, sunlight, hot baths as well as anger or blushing. This leads to the manifestation of tiny severely itchy hives with a big red blotch around them and known as cholinergic urticaria.

Pressure urticaria

It is important to note that pressure urticaria develops as a deep welt in an area that was subjected to prolonged pressure.

Chronic hives

Occasionally, an individual will continue to experience hives for many years which is called as chronic hives. The hives last longer than 6 weeks. In most cases of chronic hives, they are considered idiopathic or there is no known cause. Only a small percentage of cases have a cause thus it is best to consult a doctor to determine if there is any underlying disease present or if there is an allergic cause.

The doctor will gather a complete history along with a physical exam, blood and urine tests and oftentimes, a skin biopsy. Some individuals with chronic hives with elevated anti-thyroid antibodies in the blood improve once given thyroid supplements.

Treatment of hives

The main treatment of hives involves antihistamines that are effective if they are used properly. The common reasons for lack of effectiveness of these medications include the following:

  • Antihistamine used is not strong enough
  • Antihistamine is not used in a high dose
  • The prescribed antihistamine was not continued based on the given time frame

In case antihistamines do not work, the doctor might recommend a short course of cortisone shots to clear the hives completely. After the treatment, the individual can maintain the effect with safer antihistamines.

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