Hives

Hives or urticaria is a skin condition that causes itchy welts to appear on the skin. The welts can be fresh colored, pink, or red. In most cases, hives occur due to allergic reactions. During an allergic reaction episode, the body triggers the release of chemicals known as histamines into the blood. Histamines are the body’s defense against infections and foreign intruders. For some people, this reaction can lead to itching and swelling. In rare cases, hives can occur due to factors other than allergies. For example, wearing tight clothes, stress, infection, and exercising can lead to a hives breakout. You can also get hives if exposed to cold and hot temperatures for long. 

The most noticeable hives are welts that may appear anywhere on the body. The welts can be small, ring-shaped, round or large, or random shapes. Hives are very itchy and appear in batches when you have an outbreak. They sometimes appear clear without requiring treatment. When they appear, they can last for a couple of hours to an entire day and tend to turn white when you press them. Some people experience hive breakouts all their lives. They are a medical emergency if they develop on the tongue or around the throat.

Types of Hives

There are several types of hives depending on how often they recur and the underlying cause. They include;

Acute Urticaria

These are hives that appear and disappear within six weeks. These types of hives occur because of allergic reactions. Diseases and insect bites can also cause them. Some common foods that may cause acute urticaria include fish, chocolate, nuts, eggs, and milk. In addition, some drugs like aspirin and nonsteroidal medications can lead to hives breakouts. 

Chronic Urticaria

Chronic urticaria lasts for more than six weeks, and the cause is usually hard to pinpoint. In rare cases, it can occur due to diseases such as cancer, hepatitis, and thyroid disease. Chronic hives affect organs like the lungs and gastrointestinal tract. Common symptoms may include muscle soreness, diarrhea, vomiting, and sudden shortness of breath. 

Physical Urticaria 

Physical urticaria occurs when something stimulates your skin. It can be heat, cold, pressure, sweating, exercise, or exposure to the sun. Such hives occur in areas exposed to these conditions an hour after exposure. 

Dermatographism

These are types of physical hives that form after you’ve scratched or stroked the skin. Such hives tend to occur together with other types of hives. 

Symptoms of Hives

Hives cause specific symptoms that include:

• Raised lesions on the skin that may appear anywhere on the body and in batches
• Welts that change shape, size and appear and disappear after less than 24 hours
• Sometimes the lesions may appear as blotches, tiny spots, or thin and raised lines
• Itching that is so severe
• Painful swellings inside the throat, on the eyelids and lips
• Symptoms that flare up when exposed to heat and other stressful situations

Diagnosis of Hives

In some cases, the trigger of hives is obvious. For example, eating certain foods like shrimp or peanuts can lead to an outbreak shortly after. Other cases need more medical tests to rule out underlying health issues. People who experience a single hives episode don’t need extensive testing. For instance, if a food allergy is a cause, you might want to track what you eat to identify the triggers. Hives that keep recurring, however, need evaluating by a specialist. The doctor will ask about your symptoms plus your family medical history. They will also ask about substances you may have been exposed to, pets, and medications you are on. 

The specialist will then order more tests to pinpoint the cause of the hives. These tests include urine, blood, and skin tests. For example, if a particular food caused the outbreak, the doctor would draw a little blood to confirm the diagnosis. After that, you will be advised on what foods you should avoid. Sometimes hives can occur due to conditions like vasculitis. In such a case, a skin biopsy can help confirm the diagnosis. 

How to Treat Hives

Mild cases of hives don’t need treatment and will usually go away on their own. At the same time, if you already know the trigger, avoiding that is treatment enough. Most treatment options are for chronic cases of hives. They include:

Allergy medications: Allergy medications block the effects of histamines in the body. Antihistamines help also relieve itching caused by hives. The medication prescribed will depend on how severe your symptoms are. The doctor will either prescribe prescription medications or over-the-counter allergy medications. 

Allergy shots: Some chronic hives are hard to treat with allergy medications. The doctor, in that case, will prescribe monthly allergy injections of omalizumab (Xolair®). 

Epinephrine: Sometimes, hives can lead to life-threatening complications like anaphylaxis. Symptoms will include;

• Shortness of breath
• Severe swelling
• Low blood pressure
• Wheezing 
• Vomiting

If you are experiencing anaphylaxis, an epinephrine injection or EpiPen® will help. 

Oral steroids: Oral steroids like corticosteroids are prescribed if antihistamines are not working. 

Home remedies: If your hives don’t cause any severe complications, home remedies like taking a shower or bath will help. Wearing loose-fitting clothes and applying cold presses might also help relieve inflammation. An over-the-counter cream called Cortizone® also helps relieve swelling and itching. 

How to Manage Hives

If you experience chronic hives, knowing how to manage the condition can ensure that the symptoms don’t worsen. Some of the best ways you can manage hives include;

• Understanding the triggers will help you avoid anything that may cause an outbreak
• If you develop hives, avoid scratching the area or exposing yourself to heat, cold, or sun 
• Apply wet cloths or cold presses to the affected area until the symptoms clear
• When it comes to sleep and working, do that in a cool room
• Wear lightweight, loose-fitting clothes

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FAQs

1. Are hives contagious? Hives cannot spread from one person to another. This is unless the cause of the hives is an infection like the flu, hepatitis B, mono, common cold, or glandular fever. 
2. What is the difference between angioedema and hives? Angioedema is often confused with hives since they both stem from allergic reactions. The condition, however, causes swelling underneath the skin surface. The common symptoms include swelling in the mouth, ears, eyes, throat, and nose. You may also have stomach pain, difficulties breathing, and eyelid swelling. 

Healthier Me Today is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Never ignore professional medical advice in seeking treatment, always consult with your healthcare professional. Stay healthy!