CONDITIONS
Urticaria (Hives)
Hives, also known as urticaria is a skin reaction resulting in swollen, pale red bumps, patches, or on the skin that appear suddenly. These may range in size from small spots to large blotches.
It is estimated that about 1 in 5 people will have urticaria once in their lifetime and the worldwide incidence is 0.1%–3% with women being twice more likely to be affected than men.
Chronic urticaria (CU) is urticaria if it lasts for more than 6 weeks. In India, CU is very common with most cases being without any allergic triggers or any known cause.
What are the symptoms of Urticaria?
The welts/rashes associated often have the following characteristics:
- Skin-coloured, reddish on white skin, or purplish on black and brown skin
- Itchy, ranging from mild to intense
- Round, oval or worm-shaped
- As small as a pea or as large as a dinner plate
Most hives are acute, meaning they appear quickly and go away within 24 hours. Chronic hives can last for months or years.
A reaction like hives but in deeper layers of skin is known as Angioedema.
What are the causes and risk factors of Urticaria?
Allergic reactions, certain chemicals in foods, insect stings or infections, sunlight, airborne allergens, and medicines may make the body release a chemical called histamine which causes hives or angioedema.
The most foods that may trigger reactions in people with sensitivities are shellfish, fish, peanuts, tree nuts, soy, eggs, and milk.
A person may be at increased risk of hives if:
- They have had hives or angioedema before
- They have had other allergic reactions.
- They have a family history of hives, angioedema, or hereditary angioedema.
How is Urticaria diagnosed?
For the diagnosis of hives or angioedema, the doctor examines the welts or areas of swelling and takes the medical history. Sometimes, a blood tests or an allergy skin test may be advised by the doctor.
What are the treatment options for Urticaria?
Symptoms that are mild may not need treatment and clear up on their own. Treatment may offer relief from intense itching, serious discomfort or any other persisting symptoms.
Some drugs prescribed by the doctor are:
- Anti-itch drugs.
- Drugs that suppress the immune system.
- Drugs for hereditary angioedema (to relieve symptoms and keep the levels of certain proteins in the blood to prevent symptoms occurrence).
- Anti-inflammatory drugs (to reduce swelling, inflammation and itching).
Emergency treatment:
A severe attack of hives or angioedema may require emergency treatment and an emergency injection of epinephrine (a type of adrenaline). If cases of recurring attacks despite treatment, the doctor may advise a penlike device to self-inject epinephrine in emergencies.
Can Urticaria be prevented?
To lower the chances of contacting hives, take the following precautions:
- Avoid known triggers.
- Bathe and change your clothes (in case of exposure to pollen or animals).
What care can be taken while dealing with urticaria:
- Use lukewarm water instead of hot water for baths.
- Use gentle, mild soap.
- Apply cool compresses or wet cloths to the affected areas.
- Stay in a cool room.
- Wear loose-fitting lightweight cotton clothes.
- Ask the doctor for an anti-itch medication that does not require prescription, such as calamine lotion.
- Apply a fragrance-free moisturizer several times a day to keep your skin from getting dry.
References
- Khan S, Maitra A, Hissaria P, Roy S, Padukudru Anand M, Nag N, Singh H. Chronic urticaria: Indian context-challenges and treatment options. Dermatol Res Pract. 2013;2013:651737.
- Mayo Clinic. April 2024. https://www.mayoclinic.org/diseases-conditions/hives-and-angioedema/diagnosis-treatment/drc-20354914
- WebMD. April 2024. https://www.webmd.com/allergies/hives-urticaria-angioedema#1-3
