Urticaria

UrticariaUrticaria, or hives, are red, itchy, swollen areas of the skin that differ in size and appear anywhere on the body.

It rarely last in one area more than few hours, and typically leaves without a residual marks. Approximately 15% of the population will experience an episode of hives at least once in their lives (maybe as high as 20%).

They can be either acute (lasting less than 6 weeks), or chronic (lasting more than 6-8 weeks). In acute urticaria, the cause is usually identifiable and is often a viral infection, drug, food or latex. These hives usually go away spontaneously. Chronic urticaria is rarely associated with an identifiable etiology, although a thorough evaluation is warranted as some are associated with certain underlying diseases.

Angioedema, a swelling of the deeper layers of the skin, sometimes occurs with hives. Angioedema is not red or itchy, and most often occurs in soft tissue such as the eyelids, mouth, hands, feet, or genitals. Hives and angioedema may appear together or separately on the body.

Whenever there is an identifiable trigger of hives, it should be eliminated.

In adults, reactions to medicines are a common cause of acute hives. Medications known to cause hives or angioedema include aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, high blood pressure medicines known as ACE-inhibitors, or analgesics containing codeine or codeine-like drugs. Like all drug-induced hives, these reactions occur within only minutes to few hours of taking the drug. Adults can also develop hives after eating certain foods, including nuts, peanuts, eggs, fish, shellfish, soy, wheat or milk.

In children, food and viral infections are the most common causes of urticaria.

Physical urticaria are hives resulting from an outside source: rubbing of the skin, cold, heat, physical exertion or exercise, pressure or direct exposure to sunlight. Patients with chronic urticaria often report that at least one of these triggers induces their hives.

UrticariaQ: How can i treat my chronic urticaria?

A: If you experience chronic hives, the allergist will prescribe certain pills, and will combine medications and adjust your dosages as needed for your individual symptoms. If first line drugs do not provide appropriate comfort, further medication or combination of medications can be prescribed. With proper treatment, and compliance, your urticaria will be almost always controlled.

Q: Will my hives eventually go away?

A: In 50% of patients with chronic urticaria, the hives will clear in 3-12 months; 40% will clear in 1-5 years. About 1.5% of these patients may experience these hives for more than 20 years. However, 40% of patients with chronic hives, i.e: hives more than 6 weeks, will have at least one more episode of chronic hives in their lifetime. In general, patients with severe disease and longer lasting disease at the time of the first visit to an allergist have a worse prognosis than patients with milder disease.