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Hives Details

Hives (Urticaria & Angioedema)

Understand The - Symptoms, Causes, Tests & Treatment

Hives (medically known as urticaria) appear on the skin as wheals that are red, very itchy, smoothly elevated areas of skin often with a blanched center. They appear in varying shapes and sizes, from a few millimeters to several centimeters in diameter anywhere on the body.

It is estimated that 20% of all people will develop urticaria at some point in their lives. Hives are more common in women than in men. One hallmark of hives are their tendency to change size rapidly and to move around, disappearing in one place and reappearing in other places, often in a matter of hours. An individual hive usually lasts no longer than 24 hours. An outbreak that looks impressive, even alarming, first thing in the morning can be completely gone by noon, only to be back in full force later in the day. Very few skin diseases occur and then resolve so rapidly. Therefore, even if you have no evidence of hives to show the doctor when you get to the office for examination, the diagnosis can be established based upon the accurate recounting of your symptoms and signs. Because hives fluctuate so much and so fast, it is helpful to bring along a photograph of what the outbreak looked like at its most severe point.

Swelling deeper in the skin that may accompany hives is called angioedema. This swelling of the hands and feet, as well as the face (lips or eyelids), can be as dramatic as it is brief.

The common symptoms include a raised, bumpy red rash, with the bumps often looking more like normal skin colour, that is often quite itchy. The raised areas of skin are known as weals, which often fade after a few hours but can sometimes reappear elsewhere on the body.

Causes Hives(Urticaria & 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 and are not considered contagious.

Some hives may be caused by allergies to such things as foods, infections by different organisms, medications, food coloring, preservatives and insect stings or bites, and chemicals; but in the majority of cases, no specific cause is ever found.

Although people 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.

Different Types Of Hives

Acute Urticaria (Hives)

Hives lasting less than six weeks. The most common causes are certain foods, medications, or infections. Insect bites and internal disease may also be responsible.

Common Signs & Symptoms:

The most common foods that cause hives are nuts, chocolate, fish, tomatoes, eggs, fresh berries, and milk.

Fresh foods cause hives more often than cooked foods. Certain food additives and preservatives may also be to blame.

Chronic Urticaria (Hives) & Angioedema

Hives lasting more than six weeks. The cause of this type of hives is usually more difficult to identify than those causing acute urticaria. For most people with chronic urticaria, the cause is impossible to determine. In some cases, though, the cause may be thyroid disease, hepatitis, infection, or cancer.

Common Signs & Symptoms:

Chronic urticaria and angioedema can affect other internal organs such as the lungs, muscles, and gastrointestinal tract.

Symptoms include muscle soreness, shortness of breath, vomiting, and diarrhea.

Physical urticaria (Hives)

Hives caused by direct physical stimulation of the skin -- for example, cold, heat, sun exposure, vibration, pressure, sweating, and exercise. The hives usually occur right where the skin was stimulated and rarely appear elsewhere. Most of the hives appear within one hour after exposure.

Dermatographism:

This is a common form of physical urticaria where hives form after firmly stroking or scratching the skin. These hives can also occur along with other forms of urticaria.

Diagnosing Hives & Angioedema

Diagnosing Acute urticaria (Hives)

A health professional can diagnose acute urticaria by examining the rash on the skin & Pinpointing the trigger.

The doctor will probably ask about:

When and where the episode began

Whether there has been an insect bite

Whether the patient lives or works in a place where potential triggers may exist, such as latex gloves, chemicals, or animals

Whether Any medications taken, including herbal supplements

The patient's medical history

Any family history of urticaria

Often, the trigger is unclear, but if there appears to be a specific trigger, the doctor may refer the patient to an allergy clinic. Allergy clinics test the patient's blood and skin to find out whether there is an allergy to specific substances, such as chemicals, dust mites, or some food.

Diagnosing Chronic urticaria (Hives)

If the urticaria continues for more than 6 weeks, the trigger is probably not external, so experts do not recommend allergy tests at this point.

The following tests can check for underlying health conditions:

Blood test to check for anemia

Stool sample to identify any parasites

Erythrocyte sedimentation rate (ESR) test, to identify problems with the immune system

Thyroid function test to assess for an overactive thyroid, known as hyperthyroidism, or hypothyroidism, an underactive thyroid

Liver function tests, in case there are liver problems

Factors that may worsen the existing urticaria include:

Alcohol

Caffeine intake

Mental health issues, such as stress

Viral infections

Treatments Options For Hives

The best treatment for hives and angiodema is to identify and remove the trigger, but this is not an easy task. Antihistamines are usually prescribed by your doctor to provide relief from symptoms.

The first step in getting treatment is to figure out if you actually have hives. In most cases, your doctor will be able to determine if you have hives from a physical exam. Your skin will show signs of the welts that are associated with hives. Your doctor may also perform blood tests or skin tests to determine what may have caused your hives — especially if they were the result of an allergic reaction.

Chronic hives may be treated with antihistamines or a combination of medications. When antihistamines don't provide relief, oral corticosteroids may be prescribed. A biologic drug, omalizumab (Xolair), is also approved to treat chronic hives in those at least 12 years of age.

You may not need prescription treatment if you’re experiencing a mild case of hives not related to allergies or other health conditions. In these circumstances, your doctor might suggest that you seek temporary relief by:

Taking antihistamines, such as diphenhydramine or cetirizine
Avoiding irritating the area
Avoiding hot water, which may aggravate the hives
Taking a cool or lukewarm bath with colloidal oatmeal or baking soda

How Is Hives Prevented ?

If you have allergies and you know which substances are likely to cause an allergic reaction, your doctor will suggest that you avoid any possible exposure to these factors.

Allergy shots are another option that may help you reduce the risk of experiencing hives again.

Avoid being in high-humidity areas or wearing tight clothing if you have recently had a hives outbreak.

Diet Recommendations For People With Hives

Food can’t cure or even treat Hives, but eating better might reduce your symptoms. These five lifestyle changes may help ease symptoms of Hives and reduce flare-ups:

Lose weight

If you’re overweight, losing weight may reduce the condition’s severity. It may also make treatments more effective. It’s unclear how weight interacts with Hives, so even if your symptoms remain unchanged, losing weight is still good for your overall health.

Eat a heart-healthy diet

Reduce your intake of saturated fats. These are found in animal products like meats and dairy. Increase your intake of lean proteins that contain omega-3 fatty acids, such as salmon, sardines, and shrimp. Plant sources of omega-3s include walnuts, flax seeds, and soybeans.

Consider taking vitamins

Some doctors prefer a vitamin-rich diet to vitamins in pill form. However, even the healthiest eater may need help getting adequate nutrients. Ask your doctor if you should be taking any vitamins as a supplement to your diet & try to getting adequate nutrients

Avoid trigger foods

Hives causes inflammation. Certain foods cause inflammation, too. Avoiding those foods might improve symptoms. These foods include:red meat, refined sugar, processed foods, dairy products etc.

Drink less alcohol

Alcohol consumption can increase your risks of a flare-up. Cut back or quit entirely. If you have a problem with your alcohol use, your doctor can help you form a treatment plan.

Foods that may reduce inflammation include:

fatty fish, such as salmon and tuna, seeds, such as flax seeds and pumpkin seeds, nuts, especially walnuts and almonds, green leafy vegetables, such as spinach and kale. So these food are must be a healthy side