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What is urticaria?

  • Urticaria or hives are raised area of the skin that itch intensely and are red in colour.
  • It is very common condition and about 20% of people have hives at some time during their lives.

How can one get urticaria?

  • Urticaria is caused by release of a chemical called histamine which causes itching, redness and swelling of the skin. In most cases, the lesion appear suddenly and disappear within several hours.
  • If the disease lasts less than 6 weeks, causes like infection, food allergy and drug allergy may be responsible. If it last for more than 6 weeks, other chronic causes need to be ruled out.

What are the type of urticaria?

Urticaria can be acute, chronic or physical. But when you first get urticaria, you cannot tell how long they will last, and so you cannot tell if you have acute or chronic lesions.
Although all type of urticarial lesions look similar, they often have different triggers. Learning what trigger your urticaria can help you to avoid trigger.

Acute urticaria:

  • Hives will not last beyond a few days or will last for a maximum of 6 weeks.
  • Triggers of acute hives include infections, drugs, insect stings (bees, wasp,ants), food allergies and physical contact with certain agents.
  • Food associated urticaria appears within 30 minutes of eating the food and the foods most likely to cause it include milk, eggs, peanuts, other nuts, soy, wheat, fish and shellfish. Physical contact with plants, raw fruits, vegetable and latex can cause urticaria in certain individuals.

Chronic uricaria:

  • Hives occurs almost daily and last longer than 6 weeks, sometimes for years. These hives come and go and can interfere with sleep, work or school.
  • In most cases of chronic hives, the cause is unknown. Problem in the immune system may play a role. It can be a sign of medical or autoimmune condition, including thyroid or liver diseases, chronic infection or lupus.
  • Food additives like colorants, preservatives and essence and NSAIDs are important trigger of both acute or chronic urticaria.

Physical urticaria:

  • Hives can be triggered by physical factor like exposure to cold, changes in temperature or sweating, vibration, pressure, exercise, sunlight or water.
  • Dermatographism is a type of physical urticaria in which red, raised lines develop if the skin is stroked firmly or scratched. Physical form of hives tend to be long lasting.

How does urticaria look? Can urticaria spread to other parts of the body?

  • Urticaria are raised red areas that itchy intensily. These raised areas may enlarge and merge together.
  • Itching is the most bothersome symptom. Rarely severe pain, purple spots, raised lesions spots, raised lesion along with fever and joint pains can oocur.
  • Urticaria can affect any area of the body, especially the trunk, thighs,upper arm and face.
  • Most individual lesion fade quickly, but new crops may appear every 24 to 72 hours if the person continues to be exposed to the environment or substance that triggered the hives.
  • In up to one-half of people with urticaria, a condition called angioedema also develops. Angioedema causes puffiness of the face, eyelids, ears, mouth, hands,feet, and genitalia. It may be associated with pain.
  • Hives can also occur as part of a serious allergic reaction. It can be associated with breathlessness, tightness in the throat, nausea, vomiting, cramping abdominal pain and giddiness. If these symptoms occur, get immediate medical attention. You could be developing anaphylaxis, a life threatening condition.

FAQ on Allergies Treatment

  • Recognizing and avoiding the triggers is most important.
  • In mild cases: consult a physician, an antihistaminic tablet and application of soothing calamine lotion will provide relief.
  • In recurrent episodes, or chronic cases, consult a dermatologist.
  • Consult a physician or go to a hospital immediately if one experiences angioedema or breathlessness, tightness in the throat , nausea, vomiting, cramping abdominal pain and giddiness.
  • Most people with urticaria do not need any testing. The diagnosis is usually based on the history and appearance of skin lesions.
  • However, tests may be recommended if lesions do not resolve within 6 weeks.
  • Skin testing for food and drug sensitivities may be done for people with acute urticarial, but may not yield satisfactory result.
  • Blood tests are done if urticaria continue for more than 6 weeks, to check for underlying diseases, such as liver or thyroid problem or an autoimmune disease.
  • A skin biopsy me help identify uncommen causes of urticaria (in case of persistent fever, painful hives, individual hives that last for days at a time, hives associated with bruising of the skin or abnormal blood test.
  • Urtcaria is treated with a combination of avoiding things that cause or worsen the hives and certain medications.
  • The first treatment for acute urticaria is to figure out what is triggering it and then avoid the trigger. Even if you cannot figure out the trigger, urticaria usually disappears over days or weeks.
  • Antihistamines are the mainstay medicines for urticaria that can relieve itching and most people respond to antihistamines. A relative high dose or more than one type of antihistamines may be needed to control symptoms.
  • Hives usually respond well to treatment, which includes medicines and avoiding whatever triggered the hives.
  • Most simple cases of urticaria fade quickly, and the affected skin returns to normal within hours.
  • Even when you have episodes that recur over several weeks, without a known cause, they often stop coming back after a few months.
  • Consult your doctor if hives persist for several days or if itching interferes with your ability to sleep or perform normal daily activities.
  • Chronic urticaria in a significant percent of patient are non-allergenic in origin. Hence unnecessary elimination of diet should not be done.
  • Second generation of antihistamines like fexofenadine, loratadine, cetrizine and levocetrizine are very safe on long term use for several months to several years at a stretch with proper monitoring.
  • Urticaria is non contagious.
  • They are rarely permanent: almost 50% of people are free of lesions within one year.
  • Chronic urticaria is rarely caused by allergies and is not life threatening. It is treatable in most people and may need few months to a few years of long term antihistamine therapy. This is very safe but regular monitoring is needed.