What Is Urticaria?
Urticaria, also known as hives, is a skin reaction that causes itchy welts. It usually occurs alone but sometimes may appear along with swelling of the eyes, lips, and face (angioedema).
Urticaria usually happens when the body has an allergic reaction to an allergen. But can also occur in autoimmune or systemic conditions. Urticaria may be itchy or give a burning sensation. Sometimes, the urticaria welts merge into larger areas called plaques.
What Is the Difference Between Hives and a Rash?
The rash is a skin problem that involves something that looks like spots, swelling, redness, or itchiness. Hives are a form of rash, but not all rashes are hives.
What Are the Types of Urticaria?
There are two main types of urticaria according to the time scale-
Acute Urticaria - Urticaria that lasts for less than six months is called acute urticaria. This form of urticaria occurs due to allergic reactions to certain foods or medications.
Chronic Urticaria - When urticaria is present for more than six months, it is called chronic urticaria. In most chronic conditions, the cause is unknown, though it is believed to be an autoimmune condition.
Physical Urticaria - This often develops within an hour after exposure.
Some individuals may develop hives and swelling in specific situations like cold, heat, sun, vibrations, pressure, exercise, or sweating.
What Causes Urticaria?
The itchy welts that come with urticaria are mainly caused by releasing immune system chemicals, such as histamine, into the bloodstream. However, it is still unknown why chronic urticaria happens or why short-term urticaria sometimes turns into a long-term condition.
The skin reaction may be triggered by:
1. Airborne allergens, such as tree and grass pollen.
2. Heat or cold.
3. Sunlight.
4. Vibrations.
5. Allergies from medications, such as codeine, ACE inhibitors, and non-steroidal anti-inflammatory drugs (NSAIDs).
6. Bacterial infections, like urinary tract infections and strep throat.
7. Pressure on the skin, like from a tight waistband.
8. Medical conditions include infection, thyroid disease, allergy, and cancer.
9. Allergies to certain materials, like detergents and latex.
10. Insect bites.
What Are the Symptoms of Urticaria?
Symptoms of urticaria include:
1. Batches of welts or wheals that can appear anywhere on the body.
2. Welts that vary in size and shape.
3. Red, purple, or skin-colored welts, depending on the skin color.
4. Intense itching.
5. Painful swelling around the eyes, cheeks, or lips.
6. Flares that get triggered by heat, cold, exercise, or stress.
7. Symptoms last for more than six weeks and may recur anytime, sometimes for months or years.
8. Allergies to certain food items, such as milk, peanuts, eggs, fish, and shellfish.
How Is Urticaria Diagnosed?
The doctor can diagnose urticaria and swelling simply by looking at the affected skin. In addition, the provider may perform allergy tests to help determine what triggers a reaction. An accurate diagnosis helps the doctor with treatment options.
The tests include:
Skin Tests - Healthcare providers may test different allergens on the skin during this test. If the skin turns red or swells, the person is allergic to that substance. This allergy test is also called a skin prick or scratch test. However, skin testing is not done for chronic urticaria.
Blood Tests - A blood test helps look for specific antibodies in the blood.
How Is Urticaria Treated?
Treatment for urticaria usually starts with non-prescription anti-itch drugs (antihistamines). If these do not help, the healthcare professional may prescribe one or more of the following treatments:
Prescription Anti-Itch Drugs - The mainstay of treatment for chronic urticaria is prescription antihistamine pills. These drugs soothe itching, swelling, and other allergy symptoms. In addition, daily use of antihistamines helps block the release of histamine. Examples of antihistamines include:
1. Desloratadine.
2. Cetirizine.
3. Fexofenadine.
These medications may cause side effects.
Always consult a doctor before taking these medications if someone is pregnant or breastfeeding, has a chronic medical condition or takes other drugs.
Other Medications:
If the first line of drugs does not ease the symptoms, other drugs may help, including:
1. Famotidine.
2. Cimetidine.
3. Montelukast.
4. Doxepin.
5. Ranitidine.
6. Omalizumab.
7. Nizatidine.
Oral Steroids - Corticosteroids, including Prednisone, can reduce urticaria symptoms that are unresponsive to antihistamines.
At-Home Treatments - People with urticaria can take a cool bath or shower, wear loose-fitting clothing, and apply cold packs or compresses to relieve urticaria. Over-the-counter Hydrocortisone cream can ease itching and swelling.
What Are the Complications of Hives Urticaria?
Chronic urticaria does not lead to a sudden risk of a serious allergic reaction (anaphylaxis). However, this condition can potentially block the airways, resulting in death. Anaphylaxis symptoms include trouble breathing, dizziness, tongue, lips, mouth, and swelling. Seek emergency care if someone gets urticaria as part of a severe allergic reaction. People with anaphylaxis need an immediate shot of Epinephrine, like injectable Epinephrine.
What Is the Outlook for People With Urticaria?
For most people, urticaria does not cause serious problems. Most of the time, the symptoms disappear in a day or two. In addition, children usually outgrow allergic reactions that cause urticaria. For some people, urticaria can cause anaphylaxis that can potentially block the airways, resulting in death. People with anaphylaxis should always carry injectable Epinephrine to manage severe allergic reactions.
How Is Urticaria Prevented?
Allergy tests can help the healthcare professional determine which substances are causing urticaria and swelling. Once the triggers are known, they can be avoided. The following things may help:
1. Exclude certain foods or liquids from the diet that may cause allergies.
2. Choose detergents and soaps without scents or dyes.
3. Reduce exposure to airborne allergens.
4. Avoid extreme temperature changes.
5. Relax when feeling stressed or overworked.
6. Wear loose-fitting and lightweight clothing.
7. Avoid known triggers. If someone knows what has triggered their urticaria, try to avoid that allergen.
8. If grass pollen, mold spores, or animal contact has triggered urticaria in the past, take a bath or shower and change the clothes if exposed to pollen or animals.
When to Consult a Doctor?
The person should consult a doctor if
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If hives last more than a week.
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Infection resembles bumps.
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Swollen lips or face
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Severe itching.
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Signs of wheezing, shortness of breath, or vomiting.
Conclusion
Urticaria is the body's way of responding to a substance or allergen. These allergic reactions are uncomfortable and annoying but are not always serious. Most of the time, the symptoms disappear in a day or two. However, if someone is prone to urticaria, see a healthcare professional and get an allergy test. Knowing the triggers can help to avoid allergens and take the necessary steps to avoid the triggers.