Urticaria or Hives
(Common name: Hives)
It is skin condition in which usually there is sudden outbreak of pinkish bumps of various shapes and sizes in one or more areas.
- The hives or urticaria is confined to the upper layers of skin tissues only but at times may be associated with a variant called angioedema which characteristically involves deeper layers of skin. The lesions in hives typically fade within 24 hours
- Itching is the most prominent feature of hives while some patients might complain of burning or stinging
- Common causes for hives include allergies, insect bites, medicines (codeine, aspirin), and In a significant proportion of cases, no cause for urticaria can be ascertained despite investigations.
- It is more helpful to elicit the cause by history and examination rather than the extensive laboratory testing.
- The hives that form on stroking the skin are a physiological response seen in many normal people. This condition is called dermatographism.
How to Deal with Urticaria
An encounter with urticaria or should be dealt with patience and appropriate treatment. Most cases should respond well to treatment. However, in certain situations like those mentioned hereunder, a physician opinion is called for:
- Difficult breathing
- Chest complaints
- Swollen tongue and lips
Certain substances and article of use need to be avoided in this condition. These are:
Foods like eggs, soya products, milk, fish, nuts, chocolate, preservative containing food items, spices, and caffeinated drinks
Medicines like pain killers e.g. Aspirin, Codeine, and Ibuprofen
Harsh soaps like washing soap
Exposure to extremes of temperature and sudden variations in the ambient temperature
Avoid stress, alcohol, and stimulants
In Chronic Urticaria, the skin swelling lasts for more than six weeks. The cause of this variety is generally a tougher challenge than in the acute type of urticaria. The causes for this variant can be similar to acute type and in addition might have components of autoimmunity, chronic infections, hormonal disorders, and malignancy.
Certain individuals develop hives as a response to firm stroking of the skin. This condition is called Dermographism and it is known to occur even in otherwise normal individuals. It may or may not accompany urticaria.
The drug treatment for hives is usually in the form of antihistamines, H1 and or H2 antagonists. If there is no response, steroids may be given over a period of few days but not extending to several weeks. Angioedema requires to be treated with subcutaneous injection of adrenaline.
Omalizumab is a biological compound that may be required for severe cases. However, there is a risk of anaphylaxis or immediate and severe form of reaction to this compound.
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Dr Vinay Kumar
Senior Consultant Dermatologist
+91-93 199 299 00
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