Disease and Condition

Urticaria Also known as: Hives

What is it?
Urticaria, also called hives, is a skin condition characterized by intensely itching welts, also called wheals. Wheals are small, either pale or reddened swellings.

Who gets it?
Adults and children can get urticaria, but it is more likely in those with allergies or sensitivities to heat or cold.

What causes it?
Urticaria is usually triggered by allergens, such as drugs, foods, insect bites, inhaled substances, or latex. Some people develop hives in response to sunlight, cold, heat, stress, exercise, or a viral infection. An allergic reaction occurs when the immune system produces antibodies and other disease fighting cells in response to an allergen. The antibodies release chemicals that actually injure the surrounding cells and cause physical symptoms. Certain antibodies release histamines, which affect the skin and mucous membranes.

What are the symptoms?
Urticaria symptoms include itching, followed by swelling and redness. Hives usually remain for anywhere from several hours to 24 hours, then go away, leaving the skin looking normal again. They may, however, clear up in one area only to appear in another. This pattern can continue for as long as the allergen remains. When larger areas of the skin are involved, the condition is called angioedema, and may include severe swelling that interferes with breathing.

How is it diagnosed?
To diagnose urticaria, your doctor will take a complete medical history and perform a physical examination. In many cases, hives clear up on their own and don’t require diagnosis or treatment. However, a patient with frequent flare-ups of urticaria may need to see a specialist called an allergist to determine what is causing the reaction.

What is the treatment?
Urticaria is treated with antihistamines to relieve swelling and itching. An oatmeal bath product, available over the counter, may also help relieve itching. Taking a bath or shower can make hives go away if they have been caused by skin contact with an allergen, such as pollen or animal dander. If your condition is caused by a certain allergen, your doctor will tell you to avoid that allergen as much as possible. If swelling is severe, your doctor may prescribe a corticosteroid, which is taken orally for the best results. When swelling affects your ability to breathe, you need emergency treatment, which includes antihistamines and an injection of epinephrine to open the airways.

Self-care tips
Many people are sensitive to certain foods, such as nuts, strawberries, shellfish, additives or preservatives. Drugs in the penicillin family, as well as bites from bees, wasps, or mosquitoes, are also common causes of hives. You can prevent hives by avoiding allergens that trigger this condition.

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