Hives (Urticaria & Angioedema)

  • Medical Author:
    Gary W. Cole, MD, FAAD

    Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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What causes hives and angioedema?

Hives appear when histamine and other compounds are released from cells called mast cells, which are normally found in the skin. Histamine causes fluid to leak from the local blood vessels, leading to swelling in the skin.

Hives are very common. Although annoying, hives usually resolve on their own over a period of weeks and are rarely medically serious. Some hives may be caused by allergies to such things as foods, infections, medications, food colors, preservatives and insect stings, and contactants; but in the majority of cases, no specific cause for them is ever found. Although patients may find it frustrating not to know what has caused their hives, maneuvers like changing diet, soap, detergent, and makeup are rarely helpful in preventing hives unless there is an excellent temporal relationship.

Having hives may cause stress, but stress by itself does not cause hives.

What are the different kinds of hives?

Hives fall into two chronological categories: acute urticaria (ordinary hives which resolve after six to eight weeks) and chronic urticaria (which continue longer than six to eight weeks). Since hives are so common and acute urticaria by definition resolves spontaneously, physicians do not generally expend much time or expense to evaluate the cause of hives of less than eight weeks duration. Continue Reading

Reviewed on 2/22/2016
References
REFERENCES:

Bernstein, Jonathan A., et al. "The Diagnosis and Management of Acute and Chronic Urticaria: 2014 Update." J Allergy Clin Immunol 133.5 May 2014: 1270-1277.

Criado, Paulo Ricardo. "Chronic Urticaria in Adults: State-of-the-Art in the New Millennium." An Bras Dermatol 90.1 (2015): 74-89.

Fine, Lauren M., and Jonathan A. Bernstein. "Urticaria Guidelines: Consensus and Controversies in the European and American Guidelines." Curr Allergy Asthma Rep 15 (2015): 30.

Frigas, Evangelo, and Miguel A. Park. "Acute Urticaria and Angioedema." Am J Clin Dermatol 10.4 (2009): 239-250.

Langley, Emily W., and Joseph Gigante. "Anaphylaxis, Urticaria, and Angioedema." Pediatrics in Review 34 (2013): 247-258.

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