What are hives?
Hives (or urticaria) are characterized by itchy welts on the skin in response to many triggers. While uncomfortable, hives are usually harmless and clear up even without treatment. Hives can appear as small spots or larger blotches on the skin.
If hives occur due to an allergic reaction, they can be accompanied by angioedema, or swelling in the lower layers of the skin. This type of swelling, while common and typically harmless, can be dangerous if around the neck and mouth.
Symptoms of hives
- Raised and red swellings (welts)
- Lone welts or connecting over a large area in groups
- Itching, sometimes stinging
- Pressing the center of a hive causes it to turn white (blanching)
Due to their mild symptoms, hives are easy and quick to treat. Alleviating hives simply involves reducing the itching and swelling.
Causes of hives
Hives typically fall into three different categories: acute, chronic, or physical.
- Acute: these hives last less than six weeks, come about suddenly, and are typically caused by an allergic reaction to food or medication.
- Chronic: these hives last for longer than six weeks and have no discernible cause, but usually believed to be autoimmune in nature.
- Physical: physical hives occur due to environmental factors. Extreme temperatures, pressure, sunlight, exercise, and sweating can lead to hives.
Hives are the skin’s reaction to irritation, an allergic reaction, or emotional stress. Alternatively, hives can develop with no apparent cause. Some of the more common causes are:
Who can develop hives?
Any person of any age can develop hives. In fact, one in five people will have hives during their lives, and only 1 in 100 have severe (chronic) cases that last more than six weeks.
Your physician can perform a physical exam to diagnose hives. If an allergic reaction is suspected, either by encountering a new stimulus or from past experience, they may perform urine, blood, or skin tests to determine if you experienced an allergic reaction and what may have caused it.
If you experience hives for a long time or frequently, keep a log of the scenarios and possible triggers for the hives. This can help you and a physician determine if your hives have a trigger or if they are chronic.
If the hives are mild, treatment may not be necessary. While uncomfortable, hives are typically harmless and will recover on their own. Most available treatments reduce itching and swelling.
Medications and drugs
For mild cases of hives, over-the-counter hydrocortisone cream can be used to alleviate itching and discomfort. However, over-the-counter antihistamines, such as diphenhydramine, can quickly alleviate itching. Antihistamines can also prevent further allergic reactions. Physicians may recommend daily over-the-counter or prescription allergy medications, such as loratadine, fexofenadine, or cetirizine if you might be frequently exposed to your triggers.
Chronic hives require more intense treatments. Physicians may call for regular injections of omalizumab, which blocks the body’s allergy antibody. Your body may produce too much immunoglobulin E (IgE), causing more severe allergic reactions.
Avoiding potential hive triggers is the biggest preventative measure you can take at home. If a medication is causing the outbreak, stop using it and contact your physician.
Along with hydrocortisone creams, keeping the affected area cool can relieve itching and swelling:
- Apply a cold cloth to soothe the skin.
- Take a cool bath or shower.
- Wear loose, soft clothing to avoid skin irritation.
These everyday remedies combined with suggested medications will promote a quick and comfortable healing process.
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Since hives usually come about due to an allergic reaction, the risk of anaphylaxis is a severe complication that can accompany hives. Additionally, hives around your throat can cause swelling and create a life-threatening blockage in your airway. Otherwise, hives are harmless and will typically disappear over time.
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American Academy of Family Physicians: “Hives (Urticaria).”
American Academy of Family Physicians: “Hives: What You Should Know.”
American College of Allergy, Asthma & Immunology: “Hives (Urticaria).”
Cleveland Clinic: “Hives (Urticaria) and Swelling (Angioedema): Management and Treatment.”
Mount Sinai: “Hives.”
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