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Hives

By Megann Sauer, M.D.

Hives, also known as urticaria, affect about 20 percent of people during their lives. The outbreak tends to appear suddenly on the skin from the body’s reaction to certain substances or situations. While the exact cause is still unknown, common symptoms, triggers, and types of hives are known.

Symptoms of hives:

Symptoms can last anywhere from minutes to months or even years and often resemble bug bites.

  • Itchy bumps that are red or skin-colored with a clear center
  • Appear on any area of the body
  • Vary in size and may form together to form large affected areas
  • Change shape, move, disappear, and reappear over short periods of time or may last hours before fading

Triggers of hives:

  • Foods (most common are nuts, dairy and seafood)
  • Chemicals in certain foods
  • Medications, such as (penicillin, sulfa, aspirin, and ibuprofen)
  • Insects bites and stings
  • Infections
  • Physical stimuli, such as pressure, cold, heat, exercise, or sun exposure
  • Blood transfusions
  • Sunlight exposure
  • Pet dander
  • Allergies, such as pollen
  • Plants, such as poison oak and poison ivy

Common types of hives:

Acute are short-lived and last less than six weeks. The most common causes are certain foods, medication, infections, and insect bites. Fresh foods may cause hives more often than cooked foods. Certain food additives and preservatives may also be to blame.

Physical are a result of direct physical stimulation of the skin such as, cold, heat, sun exposure, vibration, pressure, sweating, and exercise. The hives usually occur right where the skin was stimulated and rarely appear elsewhere. Most appear within one hour after exposure.

Angioedema occurs beneath the skin instead of on the surface and is characterized by deep swelling around the eyes and lips and sometimes of the genitals, hands and feet. It generally lasts longer than hives, but the swelling usually goes away in less than 24 hours. Rarely, angioedema may cause swelling in the throat, tongue or lungs and may block the airways, causing difficulty breathing.

Chronic are long-term and last more than six weeks. The cause of this type of hives is usually more difficult to identify and sometimes impossible to determine. In some cases, the cause may be thyroid disease, hepatitis, infection or cancer. Chronic hives can affect other internal organs such as the lungs, muscles, and gastrointestinal tract. Symptoms typically include muscle soreness, shortness of breath, vomiting and diarrhea.

How to manage hives:

Waiting for hives to stop swelling and disappear may take some time. Here are some tips that may help:

  • Apply cool or wet cloths to affected areas
  • Try to work and sleep in a cool room
  • Wear loose-fitting lightweight clothes

The best treatment is to identify and remove the trigger, but this is not an easy task. Your doctor will need to ask many questions to find possible triggers including your family medical history. Your doctor may prescribe:

  • Antihistamines to provide relief from symptoms. Antihistamines work best if taken on a regular schedule to prevent hives from forming in the first place.
  • Oral corticosteroids may also be prescribed when antihistamines don't provide relief.

While hives are typically not life-threatening, if drastic swelling occurs that affects breathing, seek immediate emergency care with your physician.