"The groundwork of all happiness is health." - Leigh Hunt

hives

What are hives?

Hives, also often called hives, are swellings on the skin which are often itchy. Often they’re pink or red, but they don't need to be. Hives occur when skin cells called mast cells release histamine, a chemical that causes small blood vessels (capillaries) to leak fluid. When this exudative fluid accumulates within the skin, it forms a swelling often called a hive.

Hives might be triggered by physical aspects corresponding to heat, cold, exercise, sunlight, stress, constant pressure on an area of ​​skin (corresponding to from a belt or shoulder strap), a sudden increase in body temperature (from a fever or a hot bath). can or shower) or from irritating chemicals, cosmetics or soaps applied to the skin. Hives may also be an indication of a whole-body allergic response to something that was:

  • breathed – Pollen, animal dander, molds
  • injection – Insect stings or bites, especially bee stings, or injection medication
  • ate – Foods (tree nuts; fish and shellfish; dairy products; legumes, especially peanuts), foods, drugs corresponding to penicillin or aspirin.

Hives likely affect about 20% of individuals within the United States in some unspecified time in the future of their lives, with the best variety of episodes occurring in people between the ages of 20 and 30. In rare cases, allergic reactions that trigger hives can trigger a series response throughout the body, resulting in a life-threatening condition called anaphylaxis. Sometimes, hives last for six weeks or longer, a condition called chronic (or idiopathic) urticaria. Often, there isn’t any known cause for this chronic condition, and it often goes away by itself after several weeks.

Symptoms of hives

Hives appear as “whales” (swellings) on the skin, sometimes pink or red and surrounded by a red rash. Usually round or oval, hives are sometimes itchy. Hives vary in size, and a few may mix to form large areas of swelling. Hives can affect the skin on any a part of the body, especially on the trunk, thighs, upper arms and face. Most individual hives disappear quickly, but recent crops may appear every 24 to 72 hours if the person continues to be exposed to the environment or a substance that triggers hives.

If hives are an early sign of a systemic response, other symptoms include swelling of the tongue, lips or face. wheezing dizziness chest tightness; and difficulty respiratory. If these symptoms appear, seek immediate medical attention. You can develop anaphylaxis, a life-threatening condition.

Diagnosis of hives

Your doctor will ask about your history of allergic reactions, and your recent exposure to pets, plants, insects, or recent foods or medications. During a physical exam, your doctor can often distinguish between hives and other skin conditions. In addition, he’ll check for other signs of a serious allergic response.

If this condition occurs ceaselessly, your doctor may order a blood test or skin test for allergies. If your doctor suspects you're having anaphylaxis, he or she is going to start treatment immediately and closely monitor your blood pressure and respiratory.

Expected duration of the hive

Individual hives often go away inside eight to 12 hours, but recurrent hives may keep reappearing for weeks or months. In cases of chronic urticaria (hives), the condition may last for six months or more.

Prevention of hives

You can prevent hives by identifying and avoiding certain situations or substances that trigger your skin's response. If your doctor determines that you may have an allergy to insect venom, it’s possible you’ll be advised to have an epinephrine kit for emergency injections to stop anaphylaxis. If you’re employed outside or play a sport, keep the drugs in an appropriate place. Keep an antihistamine in your medicine cabinet and take it at the primary sign of hives or itching. Older adults and folks with heart disease should double check with their doctor before taking an antihistamine.

Treatment of hives

To relieve probably the most severe episodes of hives, your doctor may prescribe a topical lotion or an antihistamine, corresponding to cetirizine (Zyrtec, others) or loratadine (Claritin, others). Many over-the-counter antihistamines can be found. Generic versions work in addition to brand-name drugs. It is significant to remove the itch because the itch can trigger more hives and itching.

If these medications are usually not effective, it’s possible you’ll be given prescription medications corresponding to cyproheptadine (Periactin), hydroxyzine (Atarix or Vestaril), or desloratadine (Clarinex).

In cases which are more immune to treatment, H2 receptor blockers could also be added. These include nizatidine (Axid), famotidine (Pepcid) or cimetidine (Tagamet). Doxepin (Adapin, Sinequan) at bedtime is very helpful for individuals who have trouble sleeping due to itching.

When other options fail, drugs that suppress or alter the immune system could also be prescribed. These include omalizumab (Xolair), montelukast (Singulair), zafirlukast (Accolate) or corticosteroids (corresponding to prednisone).

When to Call a Professional

Call your doctor immediately should you've began taking a brand new medication or have been bitten by an insect. Get emergency treatment should you experience wheezing, dizziness, chest tightness, difficulty respiratory, or hives with swelling of the tongue, lips, or face.

Assessment

Most easy cases of hives go away quickly, and the affected skin returns to normal inside hours. Even when you may have episodes that repeat for several weeks, for no apparent reason, they often stop coming back after just a few months. Consult your doctor if the hives persist for several days or if the itching interferes together with your ability to sleep or perform normal every day activities.

Additional information

American Academy of Allergy, Asthma and Immunology (AAAAI)

https://www.aaai.org/

American Academy of Dermatology

https://www.aad.org/