Hives: What Is It?
Itchy circumscribed swellings on the skin are called hives or urticaria. More often than not, a hive will appear on the skin as red or pink. This condition occurs when the cells in the skin (mast cells) release histamine, which is a chemical that causes tiny blood vessels to leak. As a result of leaking fluid accumulating in the skin, swellings (hives) form.
Generally speaking, hives are caused by 4 main factors. First, there are various physical factors, including heat, cold, exercise, sunlight, and stress, that triggers hives. Additionally, hives can be brought on by a sudden increase in body temperature or by applying an irritating chemical, cosmetic, or soap to the skin. Last but not least, hives can also be one symptom of a systemic (whole-body) allergic reaction if something was:
- Inhaled – This includes pollens, animal dander, molds
- Injected – For instance, insect stings or bites
- Ingested – Foods, food additives, and medications such as or aspirin
With hives affecting about 20% of the people in the United States, the greatest number of episodes will occur in people between ages 20 to 30. In the rarest of cases, an allergic reaction that triggers hives can create a domino effect in the body, resulting in a life-threatening condition known as anaphylaxis. If your hives last 6 weeks or more, it is called chronic urticaria, and while there is no found case of this chronic condition, it usually goes away on its own after several weeks.
What Are The Symptoms?
Sometimes red or pink and surrounded by a red blotch, hives typically appear as an itchy round or oval swelling on the skin. Varying in size, some hives may blend together to form larger areas of swelling. Hives are able to affect all areas of the skin, however, it is more common to see them appear on the thighs, upper arms, and face. If you do not remove yourself from the environment that triggered the hives, new crops may appear every 24 to 72 hours.
If you have reason to believe that your hives are an early sign of a systemic reaction, look for the following: swelling of the tongue, lips or face, dizziness, chest tightness, and breathing difficulties. If any of these symptoms occur, seek immediate medical attention as you could be developing anaphylaxis.
Diagnosing Hives
First, a doctor will look into your history of allergic reactions as well as your recent exposure to plants, medications, new foods, or pets. He or she will then conduct a physical examination, where they can distinguish if it’s hives or another type of skin rash. Additionally, your doctor will look for various other signs of an allergic reaction.
If you find yourself with hives frequently, your doctor might order blood testing or skin testing for allergies. If it is suspected that you are undergoing anaphylaxis, treatment will begin immediately and your blood pressure and breathing will be closely monitored.
How Long Do They Last?
Individual hives tend to last eight to 12 hours, however, recurrent hives can appear for weeks or months. In the case of chronic urticaria, the condition could last anywhere from 6 months and onwards.
How Can You Prevent Them?
If you are able to identify and avoid the environment or substance that triggered your skin reaction, you will be able to prevent hives. Furthermore, if you are allergic to insect venom, it is recommended that you keep an epinephrine kit for emergency injections. If you work outside or play a sport, keep your medication in a convenient place. Additionally, take your medication at the first sign of hives or itching. As always, check with your doctor before buying or taking antihistamines.
Treatment Options
To relieve hives, it is recommended that you apply calamine lotion and/or take a nonprescription antihistamine medication, such as Benadryl or Tavist. Scratching can stimulate more hives and itching, therefore it is important that you relieve the itching as soon as possible.
If these medications are not effective, alternatives have been available. If you have significant side effects from these medications, you may be given a non-sedating antihistamine such as Claritin and Allegra. In extreme cases where people are even more resistant to treatment, H2 receptor blockers may be added, such as Zantac, Pepcid or Tagamet.
When Should You Seek Professional Help?
If hives appear after you start taking new medication or after you have been stung by an insect, contact your doctor immediately. Seek emergency treatment if you have hives as well as wheezing, chest tightness, dizziness, breathing difficulties, or swelling of the face, lips or tongue.
Prognosis
Simple cases of hives will fade quite quickly, with the affected area of skin returning to normal within a few hours. If you have episodes that recur over several weeks, they often stop returning after a few months. If you have hives that persist for several days or if the itching interferes with your sleep or ability to perform, consult a doctor as soon as possible.
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