What is Urticaria?
Urticaria or hives are a skin rash that is typically red or white in colored, raised and usually itchy. The location and the size of the individual hives or welts can change from day to day. For some patients, the skin rash is associated with swelling also called angioedema. Urticaria can be short lived, also called ACUTE, or longer lasting, also called CHRONIC. Generally, daily or near-daily hives for more than 6 weeks are considered chronic. This separation is important in that most instances of ACUTE hives will resolve and will not return. Chronic Urticaria or Hives are likely to persist for months and possibly years. There is also a higher likelihood that Chronic Urticaria may be associated with another underlying disease or disorder. Based on the specifics of your symptoms, your doctor may recommend additional testing.
What causes Urticaria?
Some triggers or causes of Urticaria are obvious such as contact with an allergen such as pet dander or grass pollen or ingestion of a food allergen such as peanuts or shellfish. Other common causes of hives include medications or antibiotics, insect stings or bites, or occasionally a lotion or detergent. Viral and other infections have also been linked to acute cases of hives, especially in children. In most instances, to link a trigger as the cause of hives, the hives should occur immediately or quickly after exposure or ingestion. Medications like aspirin and ibuprofen can trigger hives in some patients, but may not always be reproducible which can be confusing. Sometimes, temperature changes (cold and heat) and pressure on skin (tight belts or tight socks) can trigger hives.
We always attempt to identify the cause of urticaria in patients, but the underlying cause is not always found.
How do you diagnosis Urticaria?
We diagnose Urticaria or hives by physical exam and history. In order to determine the cause of urticaria or hives testing may be recommended. Testing may include skin testing, patch testing, blood work or even a skin biopsy. Your doctor will recommend the appropriate testing based on your symptoms and history.
How do you treat Urticaria?
The main medications used to treat Urticaria are anti-histamines. There are a number of different anti-histamines available which are both over-the-counter and prescription. For some patients, short courses of oral steroids can be helpful as well. For chronic urticaria, some patients will need additional therapies which your doctor can discuss if necessary.