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Urticaria results from the release of histamine, bradykinin, kallikrein, and other vasoactive substances from mast cells and basophils in the superficial dermis, resulting in intradermal edema caused by capillary and venous vasodilation and occasionally caused by leukocyte infiltration.
Some patients can have both urticaria and angioedema, occurring simultaneously or separately. Approximately 50% of patients have both urticaria and angioedema, whereas 40% have urticaria alone, and 10% have angioedema alone. [24] Hereditary angioedema (C1 inhibitor deficiency) accounts for only 0.4% of cases of angioedema but is associated with a high mortality rate.
Quercetin and evening primrose are two supplements for hives that will calm and get rid of your hives faster. (19) Quercetin is a natural antihistamine and an anti-inflammatory. Test tube studies have revealed that quercetin prevents immune cells from releasing histamines, which cause allergic reactions like hives. (20) Other studies have also shown that quercetin, a natural medicine and phytochemical, is as effective at fighting allergies as some prescription medications, all with little to no side effects. (21) Other supplement recommendations include vitamin B12, vitamin C, vitamin D and fish oil. (22)
Allergic reactions to foods such as nuts, seafood (including fish), chocolate, berries and milk common causes of ordinary hives. Viral infections, insect bites and medications can also cause ordinary hives.
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Urticaria due to the direct effects of physical forces on the skin. Cold temperature (cold urticaria), pressure (pressure urticaria), ultraviolet radiation (solar urticaria), and scratching (dermographism) are some causes of physical urticaria.
I have had urticaria for 7 years, and in that time I’ve made some discoveries. First, upon the first sensations of an itch, DO NOT SCRATCH IT; slap it instead. If that doesn’t work, I’ve found that a bath in the hottest water possible really helps to releive my discomfort/itch, then put on a long-sleeved cotton shirt that is relatively form-fitting (but not constrictive) and cotton yoga pants. I’ve noticed a link between my consumption of peanuts/peanut butter, coffee, and, yes, even chocolate to uriticaria outbreaks. Since I’ve eliminated peanuts/peanut butter from my diet entirely, I almost never get outbreaks (except the rare days that I have a cup of coffee as a special treat–then I know what I’m in for). Try experimenting with your diet, but I know the above mentioned foods are known to be common allergy-producing foods, so this could be a good starting (and perhaps ending) point… Good luck!
To treat a type of chronic hives called CIU, which can last for 6 weeks or longer and sometimes years, the U.S. Food and Drug Administration has approved 2 medications — antihistamines and omalizumab.
Past medical history should include a detailed allergy history, including known atopic conditions (eg, allergies, asthma, eczema) and known possible causes (eg, autoimmune disorders, cancer). All drug use should be reviewed, including OTC drugs and herbal products, specifically any agents particularly associated with urticaria (see Table: Some Causes of Urticaria). Family history should elicit any history of rheumatoid disease, autoimmune disorders, or cancer. Social history should cover any recent travel and any risk factors for transmission of infectious disease (eg, hepatitis, HIV).
Getting to the bottom of what caused your hives is not easy and it’s possible that you may never know. However, it’s also likely that you can check many of these known causes off your list of potential triggers. Since most cases have no known cause, what is important is properly treating hives, which is typically done with done with antihistamines.
28. Federman DG, Kirsner RS, Moriarty JP, Concato J. The effect of antibiotic therapy for patients infected with Helicobacter pylori who have chronic urticaria. J Am Acad Dermatol. 2003;49:861–4. [PubMed]
The main symptom of urticaria is a red, raised skin rash. They can appear anywhere on the body, including the face, hands, lips, tongue, throat or ears. Hives vary in size (from a pencil rubber to a dinner plate), and may join together to form larger areas known as plaques.
She’ll also ask about the foods you eat and if you have pets, to see if an allergy is to blame. She may check for other illnesses or conditions that could be causing the hives, like an overactive or underactive thyroid.
What do bed bug bites look like? See spider bite pictures and learn how to identify bug bites from mosquitos, bees, bed bugs, wasps, and more. See what their bites & stings look like and how to treat bug bites.
The majority of stinging insects in the United States are from bees, yellow jackets, hornets, wasps, and fire ants. Severity of reactions to stings varies greatly. Avoidance and prompt treatment are essential. In selected cases, allergy injection therapy is highly effective.
Urticaria (hives) is a vascular reaction of the skin marked by the transient appearance of smooth, slightly elevated papules or plaques (wheals) that are erythematous and that are often attended by severe pruritus. Individual lesions resolve without scarring in several hours. Most cases of urticaria are self-limited and of short duration; the eruption rarely lasts more than several days, it but may be recurrent over weeks. Chronic urticaria is defined as urticaria with recurrent episodes lasting longer than 6 weeks).
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Fueyo-Casado A, Campos-Muñoz L, González-Guerra E, Pedraz-Muñoz J, Cortés-Toro JA, López-Bran E. Effectiveness of omalizumab in a case of urticarial vasculitis. Clin Exp Dermatol. 2017 Mar 1. [View Abstract]
What we are referring to is allergens, or substances that cause the body to react in the form of an allergic reaction. This reaction can take many forms from fever, to swelling, stuffy nose, and depending on the severity of the allergy, possible even death. However, for this purpose of this article, we are going to focus on one of the most common reactions to allergens, and that is hives.
Methods of stress relief may include taking a much-deserved vacation, starting a hobby as a distraction from stress, practicing meditation and mindfulness, and exercising. If stress-relieving activities don’t help to reduce your hives, treatment with oral antihistamines will likely help. You can also work with your doctor or a psychologist to address specific causes of stress and develop coping mechanisms.
Asthma triggers are substances, conditions or activities that lead to symptoms of asthma.Asthma symptoms include difficulty breathing, coughing, wheezing and shortness of breath. These symptoms can…
If Aspirin & Salicylate intolerance is suspected then all forms of Salicylate including toothpaste, muscle rubs and peppermints should also be avoided. Aspirin sensitive individuals tolerate the newer Cyclo-oxygenase-2 selective inhibitors or COX-2 anti-inflammatory (NSAI) medications such as Celecoxib and Meloxicam.
Acute urticaria, which is an allergic (IgE-mediated) reaction, is common in both children and adults. This type of urticaria is a self-limiting process that occurs when mast cells in the skin are activated, degranulate, and secrete histamine, leukotrienes, platelet activating factor (PAF), enzymes such as tryptase and chymase, cytokines, and chemotactic cytokines (chemokines). When an allergen (for example, a food) to which the person is allergic arrives via the bloodstream to mast cells in the skin, it binds to the IgE, and the mast become activated, and degranulate. Allergens that can result in acute urticaria include foods, drugs (particularly antibiotics such as penicillin), and venoms from bee, wasp, yellow jacket, hornet, or fire ants. Virtually any allergen that can be disseminated throughout the body, and to which there is an IgE response, has the potential to cause generalized urticaria.
Chronic hives don’t put you at any sudden risk of a serious allergic reaction (anaphylaxis). If you do experience hives as part of a serious allergic reaction, seek emergency care. Signs and symptoms of anaphylaxis include dizziness, trouble breathing, and swelling of your lips, eyelids and tongue.
Practice positive affirmations. Positive affirmations are phrases you say to yourself to help reduce your stress and bring up your mood. When saying these, use the present tense and repeat as often as you can. Examples of positive affirmations are:
The reported adverse effects related to biological agents used for the treatment of rheumatic diseases in Turkey / Romatizmal Hastaliklarin Tedavisinde Biyolojik Ajanlarin Kullanimina Bagli Turkiye’de Bildirilmis Yan Etkiler
Kevin P Connelly, DO Clinical Assistant Professor, Department of Pediatrics, Division of General Pediatrics and Emergency Care, Virginia Commonwealth University School of Medicine; Medical Director, Paws for Health Pet Visitation Program of the Richmond SPCA; Pediatric Emergency Physician, Emergency Consultants Inc, Chippenham Medical Center
Understand what causes the hives. Anyone can get hives. About 20% of the population have experienced them at some point in their lives.[2] During an allergic reaction, certain skin cells, such as the mast cells that contain histamine and other chemical messengers like cytokines, are stimulated to release the histamine and other cytokines. These increase the amount of leakage from the tiny blood vessels in the skin and cause the swelling and itching that is so characteristic of hives.[3]
Angioedema is similar to hives, but the swelling occurs beneath the skin instead of on the surface. Angioedema 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.
The most popular treatment for relief from hives is an over-the-counter medication that contains antihistamine. These drugs help fight against an attack of hives and counter the release of histamine from the skin cells that causes the rash. However, antihistamines tend to have side effects such as drowsiness, especially in children. If you prefer an alternative hives treatment, there are several home remedies for hives that are not only effective but safe as well. Do keep in mind that not all home remedies are subjected to scientific testing and results can therefore vary considerably. Some popular methods of home treatment for relief include:
Hives, also known as urticaria, is a kind of skin rash with red, raised, itchy bumps.[1] They may also burn or sting.[2] Often the patches of rash move around.[2] Typically they last a few days and do not leave any long-lasting skin changes.[2] Fewer than 5% of cases last for more than six weeks.[2] The condition frequently recurs.[2]
It was during the promotion of Veni Vidi Vicious and Your New Favourite Band that the Hives signed a record deal with Universal Music, reportedly worth $50 million. This led to a dispute between the Hives and Burning Heart, who claimed that the Hives were still contracted to them for one more album.
Urticaria, also known as hives, is an outbreak of swollen, pale red bumps or plaques (wheals) on the skin that appear suddenly — either as a result of the body’s reaction to certain allergens, or for unknown reasons.
Steroid-sparing options:  The older tricyclic antidepressant Doxepin (10 to 50mg daily) has histamine blocking properties and is useful as an adjunct especially if there is co-existent depression with the urticaria.  Leukotriene Receptor antagonists, Singulair or Montelukast (10mg at night) has been used with variable success, and is most effective when used in combination with non-sedating anti-histamines.  Montelukast is very useful in aspirin sensitive individuals (who are prone to urticaria, nasal polyps and asthma).

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When my son came in contact with caterpillars he would break out in giant hives all over his body. THANK GOD FOR THE SASAFRASS TREE!!! I would make him a cup of tea and within 30 minutes the hives disappeared completely when Benadryl never did. Can be bought at your local grocers.
In many cases, mild hives won’t need treatment and will go away on their own. If a definite trigger is found, avoiding it is part of the treatment. If the hives feel itchy, the doctor may recommend an antihistamine medicine to block the release of histamine in the bloodstream and prevent breakouts.
Urticarial vasculitis is a form of vasculitis that affects the skin, causing wheals or hives and/or red patches due to swelling of the small blood vessels. It has two forms: One with normal levels of proteins called complements; the other with low levels of complements; it’s called hypocomplementemic vasculitis.
The most prominent symptom of urticaria is swelling of the surface of the skin. The pattern of the hives may get larger, spread out, or join together to alter the pattern as the condition progresses and spreads over a larger surface area. They may also disappear and reappear within a few minutes or within hours. If you press the center of a hive, it affects the entire hive, and it will turn white. An outbreak of hives generally escalates very rapidly and it is possible for the bumps to appear and spread over your skin within 30 minutes. This rapidity is considered to be one of the most characteristic of all urticaria symptoms. The raised patches of skin will be extremely itchy while the rest of your skin may be very sensitive. The welts caused by urticaria may be either pin point, or patch size in area and in some cases it can cause a secondary skin condition known as Angioedema. Single hives that cause much pain will last more than a day and leave bruise marks as they are likely to be a more serious condition known as urticarial vasculitis. Hives that are caused by friction will be linear in appearance and are of a benign condition and require little or no urticaria treatment apart from eliminating the source of friction.
Angioedema is a reaction similar to hives that affects deeper layers of your skin. It most commonly appears around your eyes, cheeks or lips. Angioedema and hives can occur separately or at the same time.
Asthma drugs with antihistamines. Medications that interfere with the action of leukotriene modifiers may be helpful when used with antihistamines. Examples are montelukast (Singulair) and zafirlukast (Accolate).
Examination of bedding and the children’s play areas for insects may provide a clue to the cause. If insects are found, they must be eliminated by insect repellant or fumigation, and pets should be washed. These bugs are usually not visible to the naked eye. Hanging the bedding in the hot sun may rid these of the bedbugs.
Q. I was diagnosed with chronic urticaria. What is the reason for this condition? I was diagnosed with chronic urticaria last week after more than two months of urticaria (I have more than twenty 1 dollar coin area no my trunk that are red swollen and itchy). when I was younger I had a similar reaction too a bee sting and I was treated with an adrenalin shoot. Since that one time I never suffered from this kind of symptoms till two months ago. What can be the reason for this condition?
Hives treatment may not be needed if hives are mild. If you wait a short time, they can disappear on their own without any intervention. If you want to do something to help them go away faster and to reduce itching and swelling, make sure that you do not take any hot baths or showers while you have hives. Also, avoid wearing any tight-fitting clothing because this can further irritate the area where you have hives. (14) This all applies to babies or toddlers with hives as well. Make sure you don’t bathe a child with hives in water that is too hot and keep their clothing loose-fitting and breathable.
The majority of the time, a doctor will know that you have hives just by looking at your skin. To get to the root of your hives, a doctor also, hopefully, will  ask you about any recent life stressors, or exposure to possible or known allergens.  If a patient complains of itchiness, he or she will often recommend diphenhydramine. Common side effects of antihistamines include drowsiness, dizziness, dry mouth/nose/throat, upset stomach, increased appetite and weight gain, thickening of mucus, vision changes and feeling nervous, excited or irritable. (12)
In a very small number of patients, severe, debilitating urticaria, associated possibly with airway angioedema, bronchospasm and hypotension, persists despite treatment with high-dose H1 anti-histamines; H2 anti-histamines and/or LTRA; corticosteroids; and, perhaps, dietary interventions. These patients usually have autoimmune urticaria and cyclosporin treatment has proved effective in about 65% of such patients in a randomized double-blind study [58]. Longer courses of cyclosporin may give a lengthier clinical response [59]; however, the optimum dose and length of treatment have not yet been established. Tacrolimus [60] and mycophenolate mofetil [61] have also been effective in open-label studies. Results of intravenous immunoglobulin treatment in small numbers of patients have been variable [62,63]. The current recommendation from the clinical guidelines for the use of intravenous immunoglobulin [64] is that intravenous immunoglobulin should not be used unless all other therapies have failed. If patients require immunomodulating therapies, referral to a specialist centre is recommended.
Unfortunately there are no known specific therapies for HUV. The regime of prescription steroids and other immunosuppressive drugs aims to dampen the body’s production of anti-C1q antibodies.[3] However, this again renders the individual immunocompromised.
An unusual, but well-recognized non-IgE-mediated, food-related cause of urticaria is histamine poisoning, which occurs if food containing very high content of histamine is eaten. The best-known example is ‘scombroid poisoning’ which is due to ingestion of scombroid fish (spiny-finned fish of the mackerel genus), such as tuna, mackerel and swordfish, which has not been stored properly and in which bacteria have decarboxylated histidine to produce histamine. (Ingestion of spoiled non-scombroid fish including herring, sardines and anchovies may also cause histamine poisoning.) Symptoms usually begin within 1 h of ingestion of the fish and patients develop urticaria and gastrointestinal symptoms. In severe cases there may be bronchospasm and hypotension [12,13].
HUV is diagnosed where the patient has the main symptoms of Urticarial Vasculitis combined with lower than normal levels of C1q complements and raised levels of anti-C1q antibodies (antibodies that attack the C1q complements). HUV is a more severe form of Urticarial Vasculitis and is likely to include symptoms such as purple or dark red spots or rash on the skin (a typical vasculitic rash); arthritic joint pain; breathing difficulties such as asthma, and stomach pains. Some regard HUV as a form of SLE (Lupus), although HUV patients usually test Anti-Nuclear Antibody (ANA) negative instead of the normal positive result for Lupus patients.
Vital signs should note the presence of bradycardia or tachycardia and tachypnea. General examination should immediately seek any signs of respiratory distress and also note cachexia, jaundice, or agitation.
Diseases such as systemic lupus erythematosus (SLE) and Sjögren’s syndrome may be associated with chronic urticaria, a cryoglobulin-related urticaria or urticarial vasculitis (see below). There is an increased incidence of autoimmune thyroid disease in patients with chronic urticaria, particularly those with histamine-releasing autoantibodies –‘autoimmune urticaria’ (see below) [29,30]. Patients are usually clinically euthyroid, but both hypothyroidism and hyperthyroidism [31] may present with urticaria. Although there are case reports of urticaria associated with malignancy, a study of more than 1000 patients showed no association between chronic urticaria and malignancy [32]. In contrast, urticarial vasculitis may sometimes occur in patients with lymphoproliferative disease (see below).
If hives occur with swelling of the tongue or throat, difficulty breathing or low blood pressure, anaphylaxis should be suspected. Urgent administration of adrenaline and medical assessment is required. Information about anaphylaxis is available on the ASCIA website www.allergy.org.au/anaphylaxis
The diagnosis is usually made clinically and on history – particularly in acute ordinary urticaria – and no investigations are needed. It can be established once it has been shown that individual lesions only last a few hours. A detailed history may point to a trigger in some cases.
Research shows that up to 50% of people with CIU continue to have hives after treatment with antihistamines. Omalizumab, which is injected under the skin, has been shown to relieve the itch and clear hives in some people with CIU. In one research study, 36% of patients treated with omalizumab reported no itch and no hives after treatment.
Occasionally women notice that their urticaria seems to fluctuate in severity in relation to their menstrual cycle, and there is a rare cyclical form of urticaria, known as autoimmune progesterone urticaria, which occurs 7–10 days premenstrually [33]. In pregnancy urticaria will often improve, but there is a distinct clinical condition known as polymorphic eruption of pregnancy or ‘pruritic urticarial papules and plaques of pregnancy’ (PUPPP) [34], in which the rash starts as itchy, urticarial papules and plaques in striae on the abdomen and thighs and then spreads to affect the whole trunk and limbs. It usually begins in the third trimester and is most common in first pregnancies or the first multiple pregnancy. In vitro fertilization, with the increased chance of multiple pregnancies, has increased the incidence of this condition. Treatment is with emollients, anti-histamines, topical steroids and occasionally, in severe cases, oral steroids. The rash usually resolves within days of delivery and generally does not recur. There is no adverse effect on the fetus. Urticaria occurring only during pregnancy and recurring during subsequent pregnancies has been reported [35].
The cold type of urticaria is caused by exposure of the skin to extreme cold, damp and windy conditions; it occurs in two forms. The rare form is hereditary and becomes evident as hives all over the body 9 to 18 hours after cold exposure. The common form of cold urticaria demonstrates itself with the rapid onset of hives on the face, neck, or hands after exposure to cold. Cold urticaria is common and lasts for an average of five to six years. The population most affected is young adults, between 18 and 25 years old. Many people with the condition also suffer from dermographism and cholinergic hives.[citation needed]
The most common symptoms are hives that cause itching, pain and a burning feeling. Skin patches often are red-rimmed with white centers, and unlike common hives may have petechia, or bleeding under the skin. The patches can be present for days and result in skin discoloration as they heal. Some patients may also have fevers, joint and abdominal pain, shortness of breath and swollen lymph glands. Sometimes urticarial vasculitis even causes injury to vital organs including the gut, lungs and kidneys.
urticaria pigmento´sa  the most common form of mastocytosis, characterized by small, reddish brown macules or papules that occur mainly on the trunk and tend to urtication upon mild mechanical trauma or chemical irritation.
Angiotensin converting enzyme inhibitors (ACE inhibitor) anti-hypertensives release Bradykinin and are a common trigger for angioedema and urticaria, especially Lisinopril, Perindopril and Enalapril.  ACE inhibitors may trigger angioedema even after many years of use.  The Angiotensin-II receptor anatagonists (ACE 2) such as Valsartan and Candesartan are less likely to induce angioedema and urticaria.
Antihistamines should be avoided where possible in pregnancy. There are no systematic studies of safety in pregnancy, and chlorphenamine is often the first choice if an antihistamine is required in this situation. Loratadine or cetirizine are preferred in women who are breast-feeding.
Serhat Inaloz H, Ozturk S, Akcali C, Kirtak N, Tarakcioglu M. Low-dose and short-term cyclosporine treatment in patients with chronic idiopathic urticaria: a clinical and immunological evaluation. J Dermatol. 2008 May. 35(5):276-82. [Medline].
Acute urticaria may be, in a short time, associated with life-threatening angioedema and/or anaphylactic shock, although it usually presents as rapid-onset shock without urticaria or angioedema. (See Emergency Care and Complications.)
The important thing is that the patient is given enough medication (antihistamines, perhaps in conjunction with other drugs) to suppress the hives. Whatever it is that controls a patients hives, should be the daily regimen, taking the drugs every day, whether or not they have the hives on any given day. The idea is that one is preventing the hives from breaking out.
An eruption of itching wheals, collquially called hives, usually of systemic origin; it may be due to a state of hypersensitivity to foods or drugs, foci of infection, physical agents (heat, cold, light, friction), or psychic stimuli.
If the disease is very severe large doses of Methylprednisolone or Plasmapheresis (plasma exchange) may also be given. When the disease becomes quiet less toxic drugs are used to keep control and these include: Azathioprine, Methotrexate and Mycophenolate Mofetil usually in combination with low dose prednisolone.

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Prevention is by avoiding whatever it is that causes the condition.[2] Treatment is typically with antihistamines such as diphenhydramine and ranitidine.[2] In severe cases, corticosteroids or leukotriene inhibitors may also be used.[2] Keeping the environmental temperature cool is also useful.[2] For cases that last more than six weeks immunosuppressants such as ciclosporin may be used.[2]
Chronic urticaria and angioedema: Hives lasting more than six weeks. The cause of this type of hives is usually more difficult to identify than those causing acute urticaria. For most people with chronic urticaria, the cause is impossible to determine. In some cases, though, the cause may be thyroid disease, hepatitis, infection, or cancer.
Dermatographism: This is the ability to ‘write on the skin’. If the skin is stroked firmly with a solid object a characteristic wheal and flare reaction occurs. You would be able to read what was “written” on the skin for a prolonged period of time.
cold urticaria urticaria precipitated by cold air, water, or objects, occurring in two forms: In the autosomal dominant form, which is associated with fever, arthralgias, and leukocytosis, the lesions occur as erythematous, burning papules and macules. The more common acquired form is usually idiopathic and self-limited.
Many different drugs may cause urticaria. The cyclo-oxygenase (COX)-inhibitor drugs such as aspirin [22] and NSAIDs [23] are a common cause. Opiates, including codeine, may trigger direct histamine release from mast cells [24]. Many different over-the-counter analgesics contain aspirin, NSAIDs and/or codeine and it is therefore important to be specific as to exactly which painkillers patients may or may not be able to take. These reactions are not IgE-mediated and specific IgE testing for aspirin, NSAIDs and opiates is not indicated. Evidence of oxidative damage, as shown by increased protein carbonylation and lipid peroxidation, and of increased anti-oxidant enzyme activity has been found in patients who develop non-IgE-mediated drug-related urticaria [25]; however, it is not known if this oxidative stress is the cause or the effect of the reaction. [Drugs such as angiotensin converting enzyme inhibitors (ACEI) and statins cause isolated angioedema much more commonly than urticaria]. Radio-contrast media and plasma substitutes may also cause urticarial reactions.
Question on Papular Urticaria: Is Urticaria & Papuller Urticaria the same? My 15 yr old sis is suffering from Papullar Urticaria since 2 yrs. We tried all medication including Allopathic (also Steroids), homeopathy. But no improvement. Pls suggest a remed
If you have chronic hives, or urticaria, you probably already know that when you are under stress, your symptoms either appear or worsen. Doctors have increasingly looked to study the relationship between emotional stress and skin conditions. One study, which appeared in Dermatology Times, examined the relationship between stress and chronic hives. Josie Howard, M.D., a psychiatrist in private practice and clinical instructor of psychiatry and dermatology at the University of California, stated that, “external stressors plus cognitive, behavioral and social stressors have been shown to play a significant role in the intensity of itch.” She also explains that it is not unusual for hives to appear after a major life stressor and that those with chronic hives have “limited stress management skills.”
In some cases, the trigger is obvious – a person eats peanuts or shrimp, and then breaks out within a short time. Other cases require detective work by both the patient and the physician because there are many possible causes. In a few cases, the cause cannot be identified.
[Guideline] Zuberbier T, Asero R, Bindslev-Jensen C, Walter Canonica G, Church MK, Giménez-Arnau AM, et al. EAACI/GA(2)LEN/EDF/WAO guideline: management of urticaria. Allergy. 2009 Oct. 64(10):1427-43. [Medline]. [Full Text].
Hives usually appear suddenly, sometimes because of an allergic reaction or being stung by a nettle. They form in response to histamine, which causes surrounding tissues to swell and become red. Histamine and other chemicals cause blood vessels to dilate and become leaky allowing fluid from the blood to leak out of the blood vessels causing itchiness and swelling.
Hives are very common with 10-20 percent of the population having at least one episode in their lifetime. Hives can sometimes occur in deeper tissues of the eyes, mouth, hands or genitals. These areas may develop a swelling that is frightening in appearance, but usually goes away in less than 24 hours. This swelling is called angioedema.
Davis MD, Daoud MS, Kirby B, Gibson LE, Rogers RS 3rd. Clinicopathologic correlation of hypocomplementemic and normocomplementemic urticarial vasculitis. J Am Acad Dermatol. 1998 Jun. 38(6 Pt 1):899-905. [View Abstract]
Skin biopsy may be performed to confirm urticarial vasculitis. Microscopic findings of early lesions include a neutrophil leukocytoclastic vasculitis, in which there is damage to small vessels in the middle layers of the skin (dermis). In later lesions, a lymphocytic vasculitis may be seen.
Jump up ^ Engin, B; Uguz, F; Yilmaz, E; Ozdemir, M; Mevlitoglu, I (2007). “The levels of depression, anxiety and quality of life in patients with chronic idiopathic urticaria”. Journal of the European Academy of Dermatology and Venereology. 22 (1): 36–40. doi:10.1111/j.1468-3083.2007.02324.x. PMID 18181971.
A highly effective (but expensive) treatment now recommended by the American FDA and British NICE guidelines for use as the preferred third line add-on treatment of Chronic Urticaria unresponsive to high dose antihistamines, includes subcutaneous injections of 300mg Omalizumab (Xolair) once a month for 6 months.  Recent studies on this monoclonal antibody (previously only used in asthma) show that once initial control is gained (after one month), the dose may be halved to maintain control for the 6 month induction period which can result in total remission of the Urticaria. However at least 40% will relapse after withdrawal of Omalizumab.  (Zuberbier et al, EAACI Guidelines urticaria, Allergy 69(7) 2014)
Urticaria is a common condition – it is estimated that lifetime incidence of urticaria is approximately 15%, with females being affected more often than males. Both children and adults may develop urticaria, with the peak age of onset in adults being between 20 and 40 years. Urticaria is defined as ‘acute’ if it lasts for less than 6 weeks and ‘chronic’ if it lasts for more than 6 weeks. ‘Episodic’ urticaria, which occurs intermittently, but recurrently over months or years, is also recognized. Most urticarial reactions are acute and self-limiting; however, patients referred to allergy clinics usually have chronic urticaria or episodic urticaria. Histology shows oedema of the upper dermis, dilatation of blood vessels and lymphatics and a cellular infiltrate in the dermis. The nature of this cell infiltrate varies depending on the type of urticaria and the duration of the weal.
Stress rash often takes the form of hives, or welts. Hives can appear anywhere on the body. Areas affected by hives are generally red, raised, and swollen. These blotchy areas can be as small as a pencil tip or as large as a dinner plate.
A much rarer type of urticaria, known as urticaria vasculitis, can cause blood vessels inside the skin to become inflamed. In these cases, the weals last longer than 24 hours, are more painful, and can leave a bruise.
Avoid anything you think might have caused the hives. For hives triggered by pollen or animal contact, take a cool shower or bath. For localized hives, wash the allergic substance of the skin with soap and water. Localized hives usually disappear in a few hours and don’t need Benadryl. Avoid heat or rubbing, which makes hives worse.
Another common form of physically induced hives is called cholinergic urticaria. This produces hundreds of small, itchy bumps. These occur within 15 minutes of exercise or physical exertion and are usually gone before a doctor can examine them. This form of hives happens more often in young people.
Saigal K, Valencia IC, Cohen J, Kerdel FA. Hypocomplementemic urticarial vasculitis with angioedema, a rare presentation of systemic lupus erythematosus: rapid response to rituximab. J Am Acad Dermatol. 2003 Nov. 49(5 Suppl):S283-5. [View Abstract]
According to the American Osteopathic College of Dermatology, about half the cases of chronic idiopathic hives are due to immune systems that attack the body’s own tissues (also known as autoimmunity). Thyroid disease is the most commonly reported autoimmune condition in people with chronic hives, followed by rheumatoid arthritis and type 1 diabetes. A study published in September 2013 in the European Journal of Dermatology found that celiac disease is also associated with chronic hives.
The main treatment for acute urticaria in adults and in children is with an oral second-generation antihistamine chosen from the list below. If the standard dose (eg 10 mg for cetirizine) is not effective, the dose can be increased fourfold (eg 40 mg cetirizine daily). They are best taken continuously rather than on demand. They are stopped when the acute urticaria has settled down. There is not thought to be any benefit from adding a second antihistamine.
Research shows that up to 50% of people with CIU continue to have hives after treatment with antihistamines. Omalizumab, which is injected under the skin, has been shown to relieve the itch and clear hives in some people with CIU. In one research study, 36% of patients treated with omalizumab reported no itch and no hives after treatment.
There are other rashes that may look like hives, but the fact that they remain stable and do not resolve within 24 hours is helpful in distinguishing them from hives. Such rashes may need to have a small specimen of skin removed and examined under the microscope (biopsy) to accurately determine the nature of the skin disease.
Chronic hives can lead to severe discomfort, distress, and possibly depression. Stress, too, aggravate hives, creating a vicious cycle. Patients who experience symptoms of depression should speak to a doctor.
Skin prick testing may be helpful to determine if an individual is atopic and if there are any specific contact antigens, such as foods or latex, which are likely to be triggers for the urticaria. Patients often expect ‘allergy testing’ and, once again, may be reassured by negative skin test results. However, there are two potential problems when skin prick testing patients with urticaria. First, patients need to stop anti-histamine treatment (usually for 3 days) prior to having the skin testing and during this time urticarial symptoms may become very severe and may even progress to systemic reactions requiring hospital treatment. Secondly, patients with urticaria may exhibit some degree of dermographism, which can make interpretation of skin tests very difficult. SIgE testing is the alternative to skin prick testing, although it is much more costly [46].
Exercise-induced anaphylaxis was first described in a series of patients in whom combinations of pruritus, urticaria, angioedema, wheezing, and hypotension occurred as a result of exercise. The hives seen with exercise-induced anaphylaxis are large (10-15 mm), in contrast to the small punctate lesions characteristic of cholinergic urticaria. Subtypes of exercise-induced anaphylaxis have been described that are food-related. In one of these hives is seen only if exercise takes place within 5 hours after eating a food to which the patient is allergic. In a second subtype, hives occurs if exercise is within 5 hours of having eaten but the identity of the food is irrelevant.
Some doctors suggest that medications should be continued for long periods – perhaps even a month after the hives have disappeared. Again, the exception to this is the cortisone/steroid-type medications, which should only be used for short periods initially to quiet down the urticaria. Remember that one must work closely with their doctor to find a medication regimen that suppresses the hives until they resolve on their own.
Sulfone antibiotics are used for infectious diseases (eg, leprosy); however, sulfones are effective in inflammatory diseases. The mechanism of action may involve inhibiting free radical formation by neutrophils. In most case reports, these medications are effective only in purely cutaneous forms of urticarial vasculitis.
If the disease is very severe large doses of Methylprednisolone or Plasmapheresis (plasma exchange) may also be given. When the disease becomes quiet less toxic drugs are used to keep control and these include: Azathioprine, Methotrexate and Mycophenolate Mofetil usually in combination with low dose prednisolone.
Change in temperature. Cold urticaria is caused by exposure to low temperatures followed by re-warming. This can be severe and life-threatening if there is a general body cooling – for example, after a plunge into a swimming pool.
You probably won’t be able to tell the difference between stress hives and hives caused by an allergic reaction. The symptoms are pretty much identical. The big difference is that stress hives will pretty much appear out of nowhere.

“allergic reaction welts cold urticaria treatment”

Image Source: Fitzpatrick’s Color Atlas & Synopsis of Clinical Dermatology Klaus Wolff, Richard Allen Johnson, Dick Suurmond Copyright 2005, 2001, 1997, 1993 by The McGraw-Hill Companies. All Rights reserved.
Angioedema, similar to hives, is an allergic skin reaction that manifests as a swelling beneath the skin rather than on the surface. This typically occurs near the eyes and lips. Like hives, angiodema is usually harmless but can be life-threatening if it causes the throat or tongue to swell, which may block the airway.
Hives Dermatology A condition characterized by pruritic raised red welts on the skin, associated with allergic reactions and histamine release or defects in the complement or kinin systems Risk factors Prior allergic reactions–eg, hay fever and angioedema Triggers Medications; foods–eg, berries, shellfish, fish, nuts, eggs, milk; pollen; animal dander–especially cats; insect bites; mechanical stimulants–eg, water, sunlight, cold or heat; emotional stress; post-infection; linked to other disease–eg, autoimmune diseases SLE, leukemia, etc; may be partially hereditary, dermographism, cold urticaria, echinococcus infection–dog tapeworm, hereditary angioedema, Henoch-Scho¨nlein purpura, mononucleosis, hepatitis, mastocytosis
Hide M, Francis DM, Grattan CE, Hakimi J, Kochan JP, Greaves MW. Autoantibodies against the high-affinity IgE receptor as a cause of histamine release in chronic urticaria. N Engl J Med. 1993 Jun 3. 328(22):1599-604. [Medline].
Many antihistamines are available without prescription, such as diphenhydramine (Benadryl), taken in doses of 25 milligrams, and chlorpheniramine (Chlor-Trimeton), taken in a dose of 4 milligrams. These can be taken up to three times a day, but because these medications can cause drowsiness, they are often taken at bedtime. Those who take them should be especially careful and be sure they are fully alert before driving or participating in other activities requiring mental concentration.
Drugs that can cause hives and angioedema include aspirin and other nonsteroidal anti-inflammatory medications such as ibuprofen, high blood pressure drugs (ACE inhibitors), or painkillers such as codeine.
72. Davis MD, Daoud MS, Kirby B, Gibson LE, Rogers RS., III Clinicopathologic correlation of hypocomplementemic and normocomplementemic urticarial vasculitis. J Am Acad Dermatol. 1998;38:899–905. [PubMed]
For those with chronic hives from heat-induced or illness-induced activities, Dr. Li suggests visiting a doctor to pinpoint the symptoms and receive an antihistamine prescription. “The solutions are individualized and many times may involve just taking a little more medication,” she says.
An allergic skin condition featuring itchy, raised, pink areas surrounded by pale skin. These patches persist for periods of half an hour to several days and then resolve. Urticaria may result from sunlight, cold, food or drug allergy, insect bites, scabies, jelly fish stings or contact with plants. Treatment is with antihistamine drugs or corticosteroids. Also known popularly as nettle rash or hives.
This skin disease is common, and it often goes away on its own. It typically starts with a large patch of red, raised skin. This “mother patch” or “herald patch” may be surrounded by small red bumps, or “daughter patches,” that are typically oval in shape.
In most cases urticarial vasculitis is idiopathic, but it may be associated with connective tissue diseases such as SLE or Sjögren’s syndrome; infections such as hepatitis B and C, Lyme disease and infectious mononucleosis; treatment with drugs, including ACEI, cimetidine, diltiazem, penicillins, sulphonamides and thiazides; and lymphoproliferative diseases such as mixed cryoglobulinaemia and IgM gammopathy. A specific syndrome of urticarial vasculitis and IgM gammopathy with fever, bone pain and arthralgia or arthritis –‘Schnitzler’s syndrome’ – was first described in 1972 [76,77].
Solar urticaria is a rare disorder in which urticaria develops on areas of the body which are exposed to sunlight. Itching and urticaria may develop within a few minutes and may progress to angioedema. The symptoms usually resolve in a few hours. (Polymorphic light eruption may also cause an itchy rash on sun-exposed skin, but this rash is papular or eczematous; usually starts 6–8 h after sun exposure and lasts for several days.) Very rarely, patients may develop ‘aquagenic’ urticaria where their skin has been in contact with water (irrespective of its temperature) or urticaria in response to vibration.
Dermographism literally means skin writing. Scratching the skin will produce a raised mark and redden the surrounding skin. It is easy to test. Simply use a moderately sharp object, such as a fingernail or a key, and run it over the skin. If a recognizable patter is used in testing, such as a name or the game of X’s and O’s, it is a form of physical urticaria which is easily identified.
Diagnose hives. The diagnosis of hives is generally straightforward and requires only a visual examination. If you were unable to find the allergen causing your hives on your own, your doctor can run tests when you are diagnosed to determine what causes your hives. He or she does this by performing an allergy test that test for skin reactions to a variety of substances.
Get medical help. In rare cases, hives can cause swelling in the throat and can cause an emergency situation that requires epinephrine. Epinephrine can also be used as an EpiPen in those who are severely allergic to a particular substance and require epinephrine to avoid anaphylaxis, which is a severe allergic reaction that may occur with or without the appearance of hives. The symptoms of an anaphylactic reaction include:
Chronic hives don’t put you at any sudden risk of a serious allergic reaction (anaphylaxis). But if you do experience hives as part of a serious allergic reaction, seek emergency care. Signs and symptoms of anaphylaxis include dizziness, trouble breathing, and swelling of your lips, eyelids and tongue.
Some medications, like morphine, codeine, aspirin, and other nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen [Advil]), cause the body to release histamine and produce urticaria through nonallergic mechanisms. People with urticaria should avoid these it’s easy to find out whether cold is one of your triggers: Your doctor can administer a simple test that involves placing an ice cube on your skin for five minutes to see if a reaction occurs. If it turns out that cold is a trigger for you, your doctor will recommend that you protect your skin from the cold and take your medications as prescribed.
Individual hives can last anywhere from a few hours to a week (sometimes longer), and new ones might replace those that fade. Hives that stay for 6 weeks or less are called acute hives; those that go on longer than 6 weeks are chronic hives.
Use rutin supplements. A number of herbs and supplements have natural anti-inflammatory activity. Rutin is a natural bioflavonoid found in citrus fruits and buckwheat. It can function to reduce inflammation and swelling by limiting the leakage from blood vessels.[15][16]
Treatment of urticarial vasculitis differs from that of ordinary chronic urticaria and depends upon whether there is systemic involvement and/or an underlying medical condition. If the disease is limited to the skin, anti-histamines and NSAIDs usually relieve symptoms, although occasionally NSAID treatment may make the urticaria worse. If anti-histamines and NSAIDs are ineffective, colchicine, dapsone or hydroxychloroquine may be tried. Oral steroids may be required if there is systemic involvement. There are case reports of patients responding to rituximab [73] and mycophenolate mofetil [78]. The clinical course is variable and depends upon whether there is associated hypocomplementaemia and/or systemic involvement. In most patients urticarial vasculitis remains confined to the skin, but it may persist for years.
Hives are a very itchy rash usually caused by an allergic reaction. Hives look like raised pink spots with pale centers on the skin. The spots range from 1/2 inch to several inches wide (hives often look like mosquito bites). The spots may be different shapes. The spots rapidly and repeatedly change in location, size, and shape. Giant hives are called angioedema. This can cause large swelling beneath the skin, especially of the face.
Additionally, inflammatory diseases like rheumatic fever can affect the skin, as can pemphigoid, a rare rash that appears during pregnancy. A rare disorder, mastocytosis involves the mast cells, which are connected to allergies. Hives may also be caused by amyloidosis, polycythemia vera (bone marrow), or cholecystitis (gallbladder).
my name is Antonia lyon, I was diagnosed of ALS (Amyotrophic Lateral Sclerosis) a rapidly progressive, invariably fatal neurological disease that attacks the nerve cells, I was given medications to slow down the progress of the disease, after some months my conditioned worsened and i lost ability to go about my daily activities and i had to quit my job, my legs and arms were terribly weakened, i resorted to a wheelchair (Perbombil C300). This was till my husband’s friend introduced my husband to a herbal clinic who sell herbal medicines to cure all kind of diseases like Cancer, Low sperm count,Erectile dysfunction, Barrenness, HPV, Herpes, Genital Wart,parkinson disease, Rare disease, Hepatitis, Syphilis,Diabetes, including ALS and MND. we contacted the herbal clinic via email and purchased the ALS herbal remedy, we received the herbal medicine via courier within 5 days and commenced usage as prescribed, its totally unexplainable how all the symptoms gradually disappeared, my speech has greatly improved and am able to walk a distance now with no help, contact this herbal clinic via their contact information [Email: dr.okabenherbalspell@gmail.com ] Phone; +(2349029519146).
The information on Health24 is for educational purposes only, and is not intended as medical advice, diagnosis or treatment. If you are experiencing symptoms or need health advice, please consult a healthcare professional. See additional information.
Chronic urticaria is estimated to affect between 0·1–3% of children in the United Kingdom [1]. Physical factors, such as pressure and cold, are the most common identifiable trigger and children with chronic urticaria usually also have angioedema. Approximately 30% of children with chronic urticaria have a positive ASST [39] and approximately 4% have positive thyroid peroxidase antibodies. It is suggested that thyroid function be monitored in children with chronic urticaria and positive thyroid autoantibodies, even though it has not been well established that treatment of clinical thyroid disease, if it develops, will improve the urticaria [65]. It has also been reported that children with severe chronic urticaria have a higher incidence of coeliac disease than controls [66].
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“urticarial wheal -urticaria lesions”

This means there is no explanation for what’s causing it. This can be difficult for some people to accept when they receive the CIU diagnosis from their doctor. Because these chronic hives symptoms come and go without a known cause, many who have been diagnosed with CIU continue to look for possible triggers for their disease. This can turn into a cycle of elimination diets, changing of detergents and other changes in addition to tests for allergies – none of which prove to be the cause of these patients’ hives.
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If you suffer with allergy symptoms, you know all about the stress of having a chronic condition. Not only is it difficult to breathe with allergy symptoms, but poor sleep can lead to fatigue and problems concentrating. Allergy medicines can cause appetite changes, low energy, and even irritability. All you want is relief: from the stress, the symptoms, all of it.
raised circular weals that look like mosquito bites – these are red on the outer rim and white in the centre, and each weal lasts for around two to four hours (rarely up to 24 hours). Weals appear in batches or clusters, and as one batch fades away as a new batch appears
Hives are a common occurrence, affecting up to 25% of the population at least once in their lives. They can be short term, lasting only a few days to six weeks, but they can be chronic and last for months or years. Chronic hives can be especially frustrating for patients. They may or not be related to an allergy. In some cases the cause is never identified.
Self-diagnosis of skin disorders is never an easy task. It’s made more difficult when different conditions have similar symptoms. Hives, for example, come in two types — acute and chronic — and are usually caused by your body releasing histamine in reaction to an allergy. Histamine is an organic compound in your body responsible for triggering the inflammatory process. With hives, the histamine causes fluid to release from the blood vessels and makes the skin swell [source: Rockoff].
Many medications can cause hives, but only about 10% of hives are caused by medications. Hives will most often occur in the first 36 hours after starting the medication, but hives can occur even after taking a medicine for a long time. You can see that antibiotics are a common culprit.
The median age of urticarial vasculitis involvement is 43 years, with a range of 15-90 years. While urticarial vasculitis is primarily a disease of middle-aged adults, it can be seen in persons of any age.
Psoriasis is a buildup of too many skin cells that form silvery, scaly patches on the body. It’s caused by inflammation, which can be fueled by stress. That’s why people with psoriasis often get flare-ups when they’re tense.
The Vasculitis Foundation is pleased to announce its Dream Big! campaign. The aim of this year-long campaign is to fast track the advances about which every person impacted by vasculitis is dreaming: faster diagnosis; better, less invasive treatments; and, ultimately, a cure for all forms of the disease. Click here to learn more!
Acute urticaria may develop in relation to a particular stressful event and it is recognized that financial, personal or professional stress may all worsen chronic urticaria. The condition itself may be very debilitating and it reduces quality of life [36].
Jump up ^ PhD, [edited by] Kathryn L. McCance, RN, PhD, Sue E. Huether, RN, PhD ; section editors, Valentina L. Brashers, MD, Neal S. Rote, (2014). Pathophysiology : the biologic basis for disease in adults and children (Seventh edition. ed.). Elsevier – Health Sciences Division. ISBN 9780323088541.
Once a diagnosis of urticarial vasculitis is made, follow-up care depends on the patient’s complement levels. If complement level findings are normal, follow patients for symptoms and response to treatment. If complement level findings are low, follow patients for attendant complications related to the cause of their hypocomplementemia (see History).
It is estimated that urticaria will affect 25% of the population at some point in their lifetime. Chronic urticaria (CU) involves hives, typically occurring daily, for greater than 6 weeks duration. CU generally lasts 1 to 5 years, but can have a prolonged course beyond 5 years in roughly 14% of patients. Individuals affected by CU have reported emotional distress, feelings of isolation and fatigue in response to their condition, similar to findings in patients with ischemic heart disease. This underscores the importance of managing CU appropriately to minimize both physical and psychological impacts of this disease.
To know exactly what kind of hives one has, or to learn more about research into the immune basis of hives or about rarer forms of this condition, consult a physician. It is important, however, to keep in mind that most cases of urticaria are annoying, not serious, and almost always temporary.
Allergic reactions, chemicals in foods, insect stings, sunlight, and medicines can make your body release a chemical called histamine. Histamine sometimes makes blood plasma leak out of small blood vessels in the skin, causing hives or angioedema.
Winter is not exactly the most popular season, and with good reason for those who live with chronic hives: The cold can trigger a flare-up in some. Besides the weather, other cold-related triggers include chilly foods and swimming pools. For people who are allergic to the cold, full-body immersion in a swimming pool, in particular, can trigger a severe reaction that involves not just hives but allergic shock (anaphylaxis) and loss of consciousness.
Other options for refractory symptoms of chronic hives include anti-inflammatory medications, omalizumab, and immunosuppressants. Potential anti-inflammatory agents include dapsone, sulfasalazine, and hydroxychloroquine. Dapsone is a sulfone antimicrobial agent and is thought to suppress prostaglandin and leukotriene activity. It is helpful in therapy-refractory cases[44] and is contraindicated in patients with deficiency. Sulfasalazine, a 5-ASA derivative, is thought to alter adenosine release and inhibit IgE mediated mast cell degranulation, Sulfasalazine is a good option for people with anemia who cannot take dapsone. Hydroxychloroquine is an antimalarial agent that suppresses T lymphocytes. It has a low cost however it takes longer than dapsone or sulfasalazine to work.
Sarna lotion with menthol and camphor will settle down the itch. Wipe the skin with a damp cloth and dry it before applying. Switch to Cetaphil Cleansing Bar from your current soap for the shower. If your skin tends to be dry, apply Cetaphil moisturizing cream after your shower. Keep the Sarna in your car so you will always have it near. If all else fails, use an ice pack for about 20 minutes. Talk to a doctor to see if you have any food allergies, if you haven’t already.
In many cases, mild hives won’t need treatment and will go away on their own. If a definite trigger is found, avoiding it is part of the treatment. If the hives feel itchy, the doctor may recommend an antihistamine medicine to block the release of histamine in the bloodstream and prevent breakouts.
An eruption of itching wheals, collquially called hives, usually of systemic origin; it may be due to a state of hypersensitivity to foods or drugs, foci of infection, physical agents (heat, cold, light, friction), or psychic stimuli.
Symptoms of chronic urticaria usually resolve, although this can take months or several years. Most people with chronic urticaria manage with appropriate doses of non-drowsy antihistamines. People with severe symptoms interfering with quality of life may be referred to a clinical immunology/allergy specialist or dermatologist for assessment and consideration of additional medications.
Skin examination should note the presence and distribution of urticarial lesions as well as any cutaneous ulceration, hyperpigmentation, small papules, or jaundice. Urticarial lesions usually appear as well-demarcated transient swellings involving the dermis. These swellings are typically red and vary in size from pinprick to covering wide areas. Some lesions can be very large. In other cases, smaller urticarial lesions may become confluent. However, skin lesions also may be absent at the time of the visit. Maneuvers to evoke physical urticaria can be done during the examination, including exposure to vibration (tuning fork), warmth (tuning fork held under warm water), cold (stethoscope or chilled tuning fork), water, or pressure (lightly scratching an unaffected area with a fingernail).
Information regarding history of previous urticaria and duration of rash and itching is useful for categorizing urticaria as acute, recurrent, or chronic. For chronic or recurrent urticaria, important considerations include previous causative factors and the effectiveness of various treatments, as follows [2] :
You can also buy ointment and sprays like OxyHives and Gold Bond Anti-Itch Cream to help with the itching and burning. You can get both of these without a prescription.Try to avoid wearing tight clothing on the affected area because it can cause further irritation. So if you get outbreaks on your legs, skip the skinny jeans.
Jump up ^ AU Erbagci Z SO (2002). “The leukotriene receptor antagonist montelukast in the treatment of chronic idiopathic urticaria: a single-blind, placebo-controlled, crossover clinical study”. J Allergy Clin Immunol. 110 (3): 484–488. doi:10.1067/mai.2002.126676. PMID 12209099.
In the meantime, use OTC medications as needed to alleviate any inflammation and irritation. If your symptoms persist or if you think they’re the result of an underlying condition, consult your doctor. They can work with you to determine next steps.
Beyond allergic reactions, some medications are also associated with chronic hives. Non-steroidal anti-inflammatory drugs (NSAIDs) are the most notable, so your reaction could be due to something as common as aspirin. Antibiotics, codeine, morphine, and radiocontrast dye are also known to be triggers.

“nutricargo urticaria treatments”

An eruption of itching wheals, usually of systemic origin; it may be due to a state of hypersensitivity to foods or drugs, foci of infection, physical agents (e.g., exercise, heat, cold, light, friction), or psychic stimuli.
Urticaria, commonly known as hives, is a distressing disorder affecting up to 20 percent of the population at some point in their lives. The swelling that sometimes accompanies urticaria, called angioedema, can lead to swelling of the face, hands and feet.
Patients who have angioedema involving the oropharynx or any involvement of the airway should receive epinephrine 0.3 mL of 1:1000 solution sc and be admitted to the hospital. On discharge, patients should be supplied with and trained in the use of an auto-injectable epinephrine pen.
Here’s an additional reason to brush, floss, and see your dentist regularly: In a study published in April 2013 in the journal Advances in Dermatology and Allergology, researchers found that tooth decay and several other infections can play a significant role in the development of chronic hives. Bacterial infections (such as urinary tract infections and strep throat) and viral infections (such as hepatitis and norovirus, a common cause of stomach “flu”) were also found to be triggers of chronic hives.
Skin biopsy may be performed to confirm urticarial vasculitis. Microscopic findings of early lesions include a neutrophil leukocytoclastic vasculitis, in which there is damage to small vessels in the middle layers of the skin (dermis). In later lesions, a lymphocytic vasculitis may be seen.
; hives intensely itchy skin wheals; arise as hypersensitivity reaction, or on exposure to trigger substances (e.g. in foods, plants, drugs or other agents), or due to uraemia; characteristic of anaphylaxis
Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.
On 2 July 2010, the band released an EP titled Tarred and Feathered, which covered “Civilization’s Dying” by Zero Boys, “Nasty Secretary” by Joy Rider & Avis Davis and “Early Morning Wake Up Call” by Flash and the Pan.[12][13] “Nasty Secretary” is also a song on the US release of the Gran Turismo 5 soundtrack. On 9 January 2011, Nicholaus Arson wrote another short diary entry on the band’s website saying that they had recorded some new songs before Christmas, and were planning to continue recording throughout January.[14]
Urticaria (chronic, acute, or both) affects 15-25% of the population at some time in their lives. [22] The incidence of acute urticaria is higher in people with atopy, [22] and the condition occurs most commonly in children and young adults. [23]
Acute hives can be triggered by a number of different factors. Common causes include respiratory infections (particularly in young children), contact with animals or plants, allergic reactions to foods or medication (particularly pain relievers and antibiotics), and sometimes, insect stings, heat or cold, stress, food additives or preservatives. 
Cold-induced Urticaria is a disorder in which hives occur within minutes of being exposed to the cold or appear as a result of the effects of warming. Total body exposure to cold, such as swimming in frigid water can result in a drop in blood pressure, fainting, shock and drowning.
The red welts of hives happen when mast cells in the bloodstream release the chemical histamine, which causes tiny blood vessels under the skin to leak. The fluid pools within the skin to form spots and large welts. This can happen for a number of reasons, but in many cases a cause is never identified.
Hives, also known as urticaria, are a type of skin rash that are the result of an allergic reaction to a substance, called an allergen, in the environment. Although the cause of hives is not always known, they are often a response to the body releasing histamines, which it does when you have an allergic reaction to food, medicine, or other allergens. Histamine is also sometimes the body’s response to infections, stress, sunlight, and changes in temperature. Hives typically manifest as small, swollen, itchy, red areas on the skin that may occur singularly or in clusters. Left untreated, hives usually fade within a few hours, but new ones may appear in their place.[1] If you want to try to cure your hives at home, there are many different natural remedies to treat your hives.
In many cases, mild hives won’t need treatment and will go away on their own. If a definite trigger is found, avoiding it is part of the treatment. If the hives feel itchy, the doctor may recommend an antihistamine medicine to block the release of histamine in the bloodstream and prevent breakouts.
To check for physical hives, a doctor may put ice on your child’s skin to see how it reacts to cold or place a sandbag or other heavy object on the thighs to see if the pressure will cause hives to appear.
Definitely! A stress rash can occur anytime you are feeling over stressed and anxious. Too much stress in your life will adversely affect your immune system which will cause it to start sending histamine to fight what is ailing you. Unfortunately, stress isn’t something that the immune system can “fight off”, so the end result is that you get stress induced hives. In essence, those itchy bumps all over your face, neck, chest, arms, legs and pretty much your whole body sometimes, are caused by stress. Learn what causes hives at http://www.hives.org/hives-causes.php
Urticaria and Glutamine: i am suffering from urticaria for the last 6 months & i want to take Glutamine as a food supplement now . is it safe to consume glutamine while u hve problem of urticaria . will glutamine react with the allergy of urticaria?
Winter is not exactly the most popular season, and with good reason for those who live with chronic hives: The cold can trigger a flare-up in some. Besides the weather, other cold-related triggers include chilly foods and swimming pools. For people who are allergic to the cold, full-body immersion in a swimming pool, in particular, can trigger a severe reaction that involves not just hives but allergic shock (anaphylaxis) and loss of consciousness.
Chronic hives don’t put you at any sudden risk of a serious allergic reaction (anaphylaxis). If you do experience hives as part of a serious allergic reaction, seek emergency care. Signs and symptoms of anaphylaxis include dizziness, trouble breathing, and swelling of your lips, eyelids and tongue.
Rubbing or scratching (simple dermographism). This is the most frequent cause of physical urticaria. Symptoms appear within a few minutes in the place that was rubbed or scratched and typically last less than an hour.
It was during the of Veni Vidi Vicious and Your New Favourite Band that the Hives signed a record deal with Universal Music, reportedly worth $50 million. This led to a dispute between the Hives and Burning Heart, who claimed that the Hives were still contracted to them for one more album.
Uticaria usually includes redness of the skin, itchiness, and mild to moderate swelling because of leakage of fluid into the tissues. Hives are generally not an emergency, but when they appear suddenly, spread rapidly and are accompanied by a swollen throat, tightness of the chest, wheezing or difficulty breathing, this indicates a severe allergic reaction that requires immediate medical attention.
The word “rash” means an outbreak of red bumps on the body. The way people use this term, “a rash” can refer to many different skin conditions. The most common of these are scaly patches of skin and red, itchy bumps or patches all over the place.
Chronic idiopathic hives has been anecdotally linked to stress since the 1940s.[22] A large body of evidence demonstrates an association between this condition and both poor emotional well-being[23] and reduced health-related quality of life.[24] A link between stress and this condition has also been shown.[25] A recent study has demonstrated an association between stressful life events (e.g. bereavement, divorce, etc.) and chronic idiopathic urticaria[26] and also an association between post-traumatic stress and chronic idiopathic hives.[27]
Acute urticaria can result from “non-specific” stimulation of mast cells, when there is degranulation of mast cells in the absence of a defined allergen. An example is exposure to certain radiocontrast media which changes the osmolality of the environment in which the mast cell resides and can result in degranulation. Patients who develop acute urticarial eruptions can have other accompanying manifestations of a systemic anaphylactic reaction such as wheezing, laryngeal edema, cramps, diarrhea, and hypotension.
“My hope is that we will be able to move towards a more integrated approach to treating patients which incorporates attention to the multifactorial nature of so many dermatologic conditions, both in their etiology as well as the experience of living with these conditions, whether it is chronic urticaria, psoriasis, acne or delusions of parasitosis,” she says.
The next largest group of chronic hives is those with a physical trigger (cold, scratching, heat, etc.).  The smallest group is the one of most concern. A very small proportion of patient with chronic hives have an under-lying disease that can present as hives. That is why most allergists do a screening lab evaluation for patients with chronic hives. Extensive and expensive evaluation is not necessary.
If hives are making it difficult to sleep, then it may be necessary to see a physician. This would be especially important if you are taking nonprescription antihistamines. If your hives last longer than two months, it is also likely you will benefit from visiting a physician.
In the meantime, use OTC medications as needed to alleviate any inflammation and irritation. If your symptoms persist or if you think they’re the result of an underlying condition, consult your doctor. They can work with you to determine next steps.
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The Hives live show has been highly rated, Spin magazine rating them 8th best in rock music.[26] Pelle is known for his “colourful idiocy” on stage.[27] When asked about their efforts to connect with the audience, Chris Dangerous replied that “there are so many bands out there that don’t say a word to the crowd. I don’t get it. They don’t even look at the audience and that’s ridiculous”.[28] The Hives always dressed in black-and-white uniforms because “it makes [them] look like [they] belong together”.[29]
Urticarial vasculitis tends to run a chronic course. Mortality is low, unless renal or pulmonary disease occurs. The goal of treatment is to achieve long-term control with the least amount of toxicity.
Pityriasis rosea typically fades without treatment in six to eight weeks. During this time, you can use an OTC anti-itch medication, like diphenhydramine (Benadryl) or cetirizine (Zyrtec) to ease your symptoms.
cold urticaria urticaria precipitated by cold air, water, or objects, occurring in two forms: In the autosomal dominant form, which is associated with fever, arthralgias, and leukocytosis, the lesions occur as erythematous, burning papules and macules. The more common acquired form is usually idiopathic and self-limited.

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Welts (raised areas surrounded by a red base) from hives can appear anywhere on the surface of the skin. Whether the trigger is allergic or not, a complex release of inflammatory mediators, including histamine from cutaneous mast cells, results in fluid leakage from superficial blood vessels. Welts may be pinpoint in size, or several inches in diameter.
To do a skin patch test, simply apply a small amount of the product to an unaffected area of skin. If you can, apply to the inside of your forearm. If you don’t experience any irritation within 24 hours, it should be safe to apply to any hives.
However, says Anand, “we don’t know if the disease causes urticaria or if the person’s propensity to have an autoimmune reaction causes it. But if we don’t find any triggers when we test for allergens, then we look for an underlying infection or autoimmune disease.” Anand adds that treatment for that condition can help clear the hives.
It has been suggested that natural salicylates in foods and food additives (‘E’ numbers), including colourings (azo and non-azo dyes), preservatives (sulphites, nitrates and nitrites), anti-oxidants [butylated hydroxyanisole (BHA) and butylated hydroxytoluene (BHT)] and aspartame (an artificial sweetener), may cause urticaria [9,10], particularly in patients who develop acute allergic symptoms after taking aspirin (acetylsalicylic acid) or non-steroidal anti-inflammatory drugs (NSAIDs); however, randomized controlled trials are lacking [11]. Skin prick testing and SIgE tests to the foods are negative, as the reaction is not IgE-mediated.
Darius Mehregan, MD, Associate Professor, Hermann Pinkus Chairman of Dermatology, Department of Dermatology, Wayne State University School of Medicine; Clinical Associate Professor of Pathology, University of Toledo College of Medicine; Dermatopathologist, Pinkus Dermatopathology Laboratory; Consulting Staff, Department of Dermatology, J Dingell Veterans Affairs Medical Center
Angioedema is similar to hives, but the swelling occurs beneath the skin instead of on the surface. Angioedema 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.
In his book Urticaria No More, Yassin Madwin stresses that hives cannot be caused by stress, confirming this theory. He shows how hives occur when there is a spike in certain hormones; these hormones need serotonin to work properly (serotonin, AKA the happiness hormone). The more you’re stressed, the more your cortisol rises and your serotonin drops. When this happens, a set of pro-inflammatory agents (basophils) are released into the blood stream, which requires histamine intervention.
Henry K Wong, MD, PhD is a member of the following medical societies: American Academy of Dermatology, International Society for Cutaneous Lymphomas, Medical Dermatology Society, Society for Investigative Dermatology
Unfortunately, when you have stress hives on neck, face or on hands what you want is a quick and immediate relief. Sure there are drugs on the market like anti-histamines and corticosteroids which reduce the itching and ugly appearance of the hives. On the other hand they come with so many undesirable side effects that you should limit their use to only when it is absolutely necessary.
Okubo Y, Shigoka Y, Yamazaki M, Tsuboi R. Double dose of cetirizine hydrochloride is effective for patients with urticaria resistant: a prospective, randomized, non-blinded, comparative clinical study and assessment of quality of life. J Dermatolog Treat. 2013 Apr. 24(2):153-60. [Medline].
Antileukotrienes (eg, montelukast), which may provide additional benefit in some selected patients when combined with an H1 antihistamine; there is little evidence that they are effective as monotherapy.
Jump up ^ Hirschmann, J. V.; Lawlor, F; English, JS; Louback, JB; Winkelmann, RK; Greaves, MW (1987). “Cholinergic Urticaria – A Clinical and Histologic Study”. Archives of Dermatology. 123 (4): 462–7. doi:10.1001/archderm.1987.01660280064024. PMID 3827277.
In about half of patients with chronic idiopathic hives, the explanation is that body’s immune system is, in a sense, overactive. The urticaria is “autoimmune”. The immune system is attacking the normal tissues of the body and causing hives as a result. We know certain urticaria sufferers have other signs autoimmune problems. Some have autoimmune thyroid disease, vitiligo, swollen joints, or certain abnormalities in the blood (especially the ANA test). A new treatment has recently emerged for autoimmune urticaria. This is the use of hydroxychloroquine, a drug originally used for malaria. In a clinical trial 83% improved or cleared completely when used for three months or more.
The most common food allergies in adults are shellfish and nuts. The most common food allergies in children are shellfish, nuts, eggs, wheat, and soy. One study showed Balsam of Peru, which is in many processed foods, to be the most common cause of immediate contact urticaria.[8] A less common cause is exposure to certain bacteria, such as Streptococcus species or possibly Helicobacter pylori.[9]
There are two types of hives – short-lived (acute) and long-term (chronic). Neither is typically life-threatening, though any swelling in the throat or any other symptom that restricts breathing requires immediate emergency care.

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In patients with chronic idiopathic urticaria, approximately 35% will experience episodes of angioedema and 25% are positive for dermatographism. Like many autoimmune diseases, chronic idiopathic urticaria has a higher incidence in women than men, with the reported ratio of females to males ranging from 2:1 to 4:1. Numerous autoimmune conditions have been associated chronic idiopathic urticaria, including thyroid disease, celiac disease, and rheumatoid arthritis (RA).
If the disease is very severe large doses of Methylprednisolone or Plasmapheresis (plasma exchange) may also be given. When the disease becomes quiet less toxic drugs are used to keep control and these include: Azathioprine, Methotrexate and Mycophenolate Mofetil usually in combination with low dose prednisolone.
There are many causes of urticaria; allergic and non-allergic. In about 90% of people with chronic urticaria, no cause is found even after exhaustive investigations. In acute urticaria the chances of determining the cause are higher. For example, many cases of acute urticaria in children may be associated with a viral, bacterial or parasitic infection. Stress can certainly make established symptoms worse, but is very rarely the direct cause of urticaria.
The most popular treatment for relief from hives is an over-the-counter medication that contains antihistamine. These drugs help fight against an attack of hives and counter the release of histamine from the skin cells that causes the rash. However, antihistamines tend to have side effects such as drowsiness, especially in children. If you prefer an alternative hives treatment, there are several home remedies for hives that are not only effective but safe as well. Do keep in mind that not all home remedies are subjected to scientific testing and results can therefore vary considerably. Some popular methods of home treatment for relief include:
Other forms of chronic urticaria include the physical urticarias, in which the rash is triggered by stimuli such as heat, cold, sunlight, pressure, and vibration. It is important to note that many forms of urticaria get worse with heat (such as from hot baths, exercise or wearing too much clothing) and pressure (such as around tight waistbands from clothing).
Hives, which is also called urticaria, is a very itchy rash. It is sometimes caused by an infection and sometimes by an allergy to something (such as some foods), but often no cause is found. Many people get hives at some time in their life, but only a few have major trouble with it.
Nuts, chocolate, fish, tomatoes, eggs, fresh berries and milk are all so of the most delicious foods that this natural world of ours can provide us with. Not only are they delicious (matter of taste), but they also provide our bodies with the countless nutrients, vitamins and minerals that our bodies need to reach and maintain peak levels of performance. Unfortunately, not every person is created the same, and what might be enjoyable and beneficial for one person and their body can be harmful and potentially fatal to another.
On 2 July 2010, the band released an EP titled Tarred and Feathered, which covered “Civilization’s Dying” by Zero Boys, “Nasty Secretary” by Joy Rider & Avis Davis and “Early Morning Wake Up Call” by Flash and the Pan.[12][13] “Nasty Secretary” is also a song on the US release of the Gran Turismo 5 soundtrack. On 9 January 2011, Nicholaus Arson wrote another short diary entry on the band’s website saying that they had recorded some new songs before Christmas, and were planning to continue recording throughout January.[14]
Hide M, Francis DM, Grattan CE, Hakimi J, Kochan JP, Greaves MW. Autoantibodies against the high-affinity IgE receptor as a cause of histamine release in chronic urticaria. N Engl J Med. 1993 Jun 3. 328(22):1599-604. [Medline].
Dr. Howard suggests dermatologists take time to educate patients about the link between stress, anxiety and the skin. “The one-on-one time gives dermatologists the opportunity to direct patients toward interventions that can improve their overall quality of life,” she says.
Acute urticaria caused by SIgE against food protein antigens is often identified easily by the patient, particularly as there may be oral symptoms as the food is eaten and as repeated exposure to the foodstuff may lead to progressively more severe reactions, with angioedema and systemic symptoms [2,3]. However, it may be more difficult to identify the causative antigen if this is a contaminant in the food, such as a mould [4] or storage mite [5], or if there is an unexpected ingredient in the foodstuff and a detailed list of ingredients is lacking.
There are many patterns of hives with different underlying causes. In order to cope with urticaria, it is important to understand exactly which form of urticaria exists because the treatment is directly affected by the diagnosis. It is important to note that there are other skin conditions due to allergy, one of the most common being eczema or dermatitis. Moreover, allergic skin conditions are common and plague people the world over, but not all skin problems are allergic in origin. See a qualified medical physician for diagnosis and treatment.
Jump up ^ Pacor ML, Di Lorenzo G, Corrocher R (2001). “Efficacy of leukotriene receptor antagonist in chronic urticaria. A double-blind, placebo-controlled comparison of treatment with montelukast and cetirizine in patients with chronic urticaria with intolerance to food additive and/or acetylsalicylic acid”. Clin Exp Allergy. 31 (10): 1607–1614. doi:10.1046/j.1365-2222.2001.01189.x. PMID 11678862.
If the urticaria remains unresponsive to high-dose H1 anti-histamines, H2 anti-histamine treatment, at standard dosage, may be added. This is an off-licence use of these drugs, but there is evidence that combined H1 and H2 anti-histamine treatment gives better symptom control than H1 anti-histamine treatment alone [52,53]. Unlike cimetidine, ranitidine does not inhibit oxidative hepatic drug metabolism and so has less potential to cause drug interactions.
An important variant to mention is urticarial vasculitis, which on initial presentation presents like urticaria but the lesions are non-migratory, last for more than 24 hours and resolve with postinflammatory hyperpigmentation.
Jáuregui I, Ortiz de Frutos FJ, Ferrer M, Giménez-Arnau A, Sastre J, Bartra J, Labrador M, Silvestre JF, Valero A. Assessment of severity and quality of life in chronic urticaria. J Investig Allergol Clin Immunol. 2014;24(2):80-6. Review. PubMed PMID: 24834770.
For example, dermatologists insist that masturbation has nothing to do with acne, but trust me – masturbate 3 times a day for 4 hours. The next day, I guarantee that you’ll have a huge pimple on your cheek. Hormonal imbalance can make matters worse. It’s a proven fact.
Seek urgent medical attention for yourself or your child if hives are severe and/or cover a large area of your body, or if you have other symptoms, such as difficulty breathing or a fever. Chronic urticaria or chronic hives should be evaluated by an allergist or immunologist to determine proper hives treatment.
In some people hives are caused by physical triggers, including cold (such as cold air, water or ice), heat, sunlight (solar), vibration, rubbing or scratching of the skin (dermatographism) and delayed pressure (such as after carrying heavy bags.  In other people, exercise (sweating), stress, alcohol, spicy food or coffee may cause symptoms.
Urticaria that develops after exposure to high ambient temperatures (e.g., after exercise, a warm shower or bath, or during a fever). The hives that develop are typically small (1 to 3 mm) and are often surrounded by erythema. Synonym: generalized heat urticaria
[Guideline] Zuberbier T, Asero R, Bindslev-Jensen C, Walter Canonica G, Church MK, Giménez-Arnau AM, et al. EAACI/GA(2)LEN/EDF/WAO guideline: management of urticaria. Allergy. 2009 Oct. 64(10):1427-43. [Medline]. [Full Text].
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Mutations in the CIAS1 gene, which codes for cryopyrin, cause autoinflammatory syndromes, one of which is Muckle–Wells syndrome [85], also known as urticaria–deafness–amyloidosis (UDA). It is a rare, autosomal dominant condition which presents with spontaneous urticaria, sensorineural deafness, episodic fevers and arthralgia and it may progress to renal amyloid.
If you don’t think stress is causing your hives or you have tried stress relief activities and still have hives, they may be caused by something other than stress, or in addition to stress. Other causes of hives include: 
Urticarial vasculitis is a variant of cutaneous small vessel vasculitis. It is characterised by inflamed and reddened patches or weals on the skin that appear to resemble urticaria, but when the skin is examined closely under a microscope, a vasculitis is found (inflamed blood vessels).

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In every medical reference, you would see them listing stress as one of the potential causes that can trigger hives or angioedema. Studies of groups of people suffering with different levels of urticaria have proven that stress can worsen hives and that it’s possible to get urticaria induced by stress.
A viral infection such as a cold or flu can trigger an urticarial rash in some people. (You react to the virus.) A mild viral infection which causes few other symptoms is probably a common trigger of an urticarial rash that develops without an apparent cause.
Unfortunately, stress and allergies go hand in hand, says Los Angeles-based ear, nose, and throat doctor, Murray Grossan, MD. Once the allergy season is full-blown, the combination of miserable allergy symptoms, nights of fitful sleep, and fatigue, definitely leave you in need of stress relief.
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In the meantime, use OTC medications as needed to alleviate any inflammation and irritation. If your symptoms persist or if you think they’re the result of an underlying condition, consult your doctor. They can work with you to determine next steps.
“When people run, they can breathe better because epinephrine pours throughout the body,” says Berger, past president of the American College of Allergy and Immunology and author of Allergies and Asthma for Dummies.”Epinephrine is also triggered during stressful moments, which should add to better breathing — not worse!”
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Davis MD, Daoud MS, Kirby B, Gibson LE, Rogers RS 3rd. Clinicopathologic correlation of hypocomplementemic and normocomplementemic urticarial vasculitis. J Am Acad Dermatol. 1998 Jun. 38(6 Pt 1):899-905. [View Abstract]
Swellings, known as wheals, appear as a rash on the skin. They are usually pink or red, with an oval or round shape. They can range from a few millimeters to several inches across. They can be extremely itchy, and they have a red flare around them.
Antihistamine tablets can ease symptoms. Antihistamines block the action of histamine which is one of the chemicals involved in causing hives. You can get antihistamines on prescription. You can also buy them without a prescription from pharmacies. There are several types. The pharmacist will advise. The ones most often used for hives are:
Angioedema, similar to hives, is an allergic skin reaction that manifests as a swelling beneath the skin rather than on the surface. This typically occurs near the eyes and lips. Like hives, angiodema is usually harmless but can be life-threatening if it causes the throat or tongue to swell, which may block the airway.
A weal (or wheal) is a superficial skin-coloured or pale skin swelling, usually surrounded by erythema (redness) that lasts anything from a few minutes to 24 hours. Usually very itchy, it may have a burning sensation.
Lesions of urticarial vasculitis initially appear as erythematous wheals (see image below). As the lesions progress, purpura may develop. Often, the urticarial vasculitis lesions resolve with postinflammatory pigmentation. Annular or targetoid lesions may be observed.
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Urticaria and angioedema often occur at different times or together in the same person. They occur in about 15 per cent of the population at some time or other in their lives, with women more commonly affected  than men.
Many medications can cause hives, but only about 10% of hives are caused by medications. Hives will most often occur in the first 36 hours after starting the medication, but hives can occur even after taking a medicine for a long time. You can see that antibiotics are a common culprit.
The goal of treating most cases of ordinary acute urticaria is to relieve symptoms while the condition goes away by itself. The most commonly used oral treatments are antihistamines, which help oppose the effects of the histamine leaked by mast cells. The main side effect of antihistamines is drowsiness.
Some sources recommend supplements such as quercetin and evening primrose oil, and vitamin C, D and others. It is important to speak to a doctor before using supplements, as these can trigger adverse reactions.
Urticaria results from the release of histamine, bradykinin, leukotriene C4, prostaglandin D2, and other vasoactive substances from mast cells and basophils in the dermis. [2] These substances cause extravasation of plasma into the dermis, leading to the urticarial lesion. The intense pruritus of urticaria is a result of histamine released into the dermis. One study showed that D-dimer levels correlate with the severity of acute urticaria and may serve as a marker of disease severity. [75]  
Mechanisms other than allergen-antibody interactions are known to cause histamine release from mast cells. Many drugs, for example morphine, can induce direct histamine release not involving any immunoglobulin molecule. Also, a diverse group of signaling substances, called neuropeptides, have been found to be involved in emotionally induced hives. Dominantly inherited cutaneous and neurocutaneous porphyrias (porphyria cutanea tarda, hereditary coproporphyria, variegate porphyria and erythropoietic protoporphyria) have been associated with solar urticaria. The occurrence of drug-induced solar urticaria may be associated with porphyrias. This may be caused by IgG binding, not IgE.
Hives usually cause itching, but may also burn or sting. They can appear anywhere on the body, including the face, lips, tongue, throat, or ears. Hives vary in size (from a pencil eraser to a dinner plate), and may join together to form larger areas known as plaques. They can last for hours, or up to one day before fading.
Jump up ^ Yang, Hsiao-Yu; Sun, Chee-Ching; Wu, Yin-Chang; Wang, Jung-Der (2005). “Stress, Insomnia, and Chronic Idiopathic Urticaria – a Case-Control Study”. Journal of the Formosan Medical Association. 104 (4): 254–63. PMID 15909063. Archived from the original on 2017-09-08.
Review of systems should seek symptoms of causative disorders, including fever, fatigue, abdominal pain, and diarrhea (infection); heat or cold intolerance, tremor, or weight change (autoimmune thyroiditis); joint pain (cryoglobulinemia, SLE); malar rash (SLE); dry eyes and dry mouth (Sjögren syndrome); cutaneous ulcers and hyperpigmented lesions after resolution of urticaria (urticarial vasculitis); small pigmented papules (mastocytosis); lymphadenopathy (viral illness, cancer, serum sickness); acute or chronic diarrhea (viral or parasitic enterocolitis); and fevers, night sweats, or weight loss (cancer).
Next, if any obvious triggering factors have been identified from the history these should be eliminated, wherever possible. For example, specific food triggers should be excluded from the diet; treatment with aspirin, NSAIDS and codeine should be stopped; physical triggers such as coldand heat should be avoided whenever possible; and clinical thyroid disease or underlying infection treated. Anti-pruritic, cooling skin lotions such as calamine lotion or 1% menthol in aqueous cream may help to relieve itching.
Small daily stressors like being late for work typically don’t cause you to break out. Otherwise you’d see a bunch of rash ridden people running around. People generally get stress hives from events like:
Stress hives develop due to chronic stress or tension in your life, and appear as red, raised and swollen areas on the skin that seem to suddenly appear. Stress hives, which are also known as a stress rash or as stress bumps, are often incredibly itchy, and some people report having a burning or stinging sensation wherever they appear. Stress induced hives will go away by themselves when you have successfully released ALL the stress from your body or taken the hives treamtment OxyHives, which will eliminate your symptoms.
Urticaria, or hives, are red bumps that suddenly appear on your skin. Do hives itch? Yes, hives can be itchy. They can also sting or burn. What do hives look like? The appearance of hives can vary depending on the person and the cause. Hives often appear as swollen, pale or dark red bumps that are either tiny. They also can be larger and interconnected, forming welts. Sometimes the welts can merge together forming larger plaques. These plaques be as large as a dinner plate in size! (3)
Hives are red and sometimes itchy bumps on your skin. An allergic reaction to a drug or food usually causes them. Allergic reactions cause your body to release chemicals that can make your skin swell up in hives. People who have other allergies are more likely to get hives than other people. Other causes include infections and stress.
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4. Rockwell WJ. Reactions to molds in foods. In: Chiaramonte LT, Schneider AT, Lifshitz F, editors. Food allergy: a practical approach to diagnosis and management. New York: Marcel Dekker; 1988. pp. 153–70.
Urticarial Vasculitis is rare painful non-migratory wealing reaction which persist for more than 24 hours and is often associated with fever, bruising and joint pain.  The associated with an underlying auto-immune diseases such as Serum Sickness, Systemic Lupus and Sjogren’s Syndrome should not be overlooked.  Urticaria Pigmentosa is a diffuse dark freckle-like rash that weals on rubbing the skin (Dariers sign) and is due to excess mast cells in the skin (Cutaneous Mastocytosis).  Children frequently develop discrete linear or grouped itchy Papular Urticaria from insect bite sensitivities.
An allergic skin condition featuring itchy, raised, pink areas surrounded by pale skin. These patches persist for periods of half an hour to several days and then resolve. Urticaria may result from sunlight, cold, food or drug allergy, insect bites, scabies, jelly fish stings or contact with plants. Treatment is with antihistamine drugs or corticosteroids. Also known popularly as nettle rash or hives.

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Both Flonase and Nasacort are available without a prescription. These medications contain different steroids but both are meant to treat sinus congestion due to allergies.  Neither should be used in children without talking to your doctor first.  You can substitute Flonase for Nasocort, but you should use it regularly but shouldn’t use more than 1 spray in each nostril twice a day.  If you have diabetes, glaucoma, cataracts or liver disease, ask your doctor before using.
Chronic hives should be evaluated by an allergist, who will ask about your and your family’s medical history, substances to which you are exposed at home and at work, exposure to pets or other animals and any medications you’ve taken recently. If you have been keeping a food diary, show it to your allergist.
Hives, also known as urticaria, is a kind of skin rash with red, raised, itchy bumps.[1] They may also burn or sting.[2] Often the patches of rash move around.[2] Typically they last a few days and do not leave any long-lasting skin changes.[2] Fewer than 5% of cases last for more than six weeks.[2] The condition frequently recurs.[2]
The median age of urticarial vasculitis involvement is 43 years, with a range of 15-90 years. While urticarial vasculitis is primarily a disease of middle-aged adults, it can be seen in persons of any age.
The stress and anxiety bought on by an attack of hives can be countered with herbal teas such as peppermint or chamomile tea. These teas also have sedative properties and can help soothe the pain and itching symptoms of hives. Other stress busting activities like yoga and meditation can also help.
42. Sabroe RA, Grattan CE, Francis DM, Barr RM, Kobza BA, Greaves MW. The autologous serum skin test: a screening test for autoantibodies in chronic idiopathic urticaria. J Dermatol. 1999;140:446–52. [PubMed]
Medications: Topical ointments can be applied to the skin to relieve the itch. Antihistamines will reduce the itching and swelling. Cortisone drugs used as an ointment or given by mouth may be needed.
Studies have shown that a substantial number of patients with chronic urticaria have a positive autologous skin test, meaning that injection of the patient’s serum in a skin test leads to a significant wheal and flare reaction. A proportion of such patients (about 35%) have been found to have an IgG antibody directed against the alpha- subunit of the IgE receptor which experimentally can cause degranulation of histamine-containing cells (blood basophils or mast cells). A smaller proportion have anti-IgE antibodies (5%). This accounts for 40% of patients with CSU. Fifty percent of patients with CSU have circulating basophils that are hyporesponsive to activation by anti IgE due to high intracellular phosphatase levels and this reverts to normal during therapy or remission.  Mechanisms for histamine release caused by the aforementioned autoantibodies have been described but proof of their pathogenicity is lacking.  Yet virtually all diseases strongly associated with autoimmunity turn out to be autoimmune.
Some medications, like morphine, codeine, aspirin, and other nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen [Advil]), cause the body to release histamine and produce urticaria through nonallergic mechanisms. People with urticaria should avoid these medications.
Infections and Infestations: Insect bites, frequent fungal and bacterial infections of the urinary tract, viral infections like hepatitis, worm infestations such as tapeworms and round worms can cause acute allergies.
There are many explanations out there: stress-related hives can be the result of an overactive sympathetic nervous system. It’s the same part of the brain that is responsible for “fight or flight” situations. Something else might be the cause.
Many people have a sensitivity to latex which causes a contact dermatitis. The foods listed in the second table above contain chemicals that are similar enough to those found in latex that eating them can cause an allergic reaction. If you have a latex allergy, cross these foods off your shopping list.
For example, dermatologists insist that masturbation has nothing to do with acne, but trust me – masturbate 3 times a day for 4 hours. The next day, I guarantee that you’ll have a huge pimple on your cheek. Hormonal imbalance can make matters worse. It’s a proven fact.
My rash ravaged my body after the prednisone ended and I drank a glass of wine…. Big mistake. I thought it was poison ivy but nothing helps. I’m getting it yearly and it follows the nerve paths so if you have some helpful guidance I will check it out.
Identification of causative allergens, from the clinical history and blood testing for specific IgE antibodies, will enable the individual with urticaria and angioedema to avoid pathogenic allergens. Where a reaction to medication has been implicated, for example, NSAID’s or antibiotics, the physician should identify alternative drug groups for future treatment, and if possible perform skin testing with antibiotics to confirm or refute the diagnosis of specific antibiotic allergy. Acute attacks of urticaria or angioedema can be treated with H1 antihistamines. Treatment with 1% menthol in aqueous cream may suppress itching. As wheals can occur where tight clothing is in contact with the skin, loose clothing should be recommended. Itching is worse in warm conditions, and a cool temperature, particularly in the bedroom, is recommended. If urticaria and angioedema have occurred during a systemic anaphylaxis reaction, the patient should be prescribed an auto-injector of epinephrine to carry. Very often an episode of urticaria occurs without any explanation or lasting clinical significance, and without any risk of recurrence. Patients unresponsive to antihistamines can be treated with a tapering course of corticosteroid.  
/ur·ti·ca·ria/ (ur″tĭ-kar´e-ah) hives; a vascular reaction of the upper dermis marked by transient appearance of slightly elevated patches (wheals) which are redder or paler than the surrounding skin and often attended by severe itching; the exciting cause may be certain foods or drugs, infection, or emotional stress.urticar´ial
The rash appears rapidly, usually within a few minutes of sweating, and can last from 30 minutes to an hour or more before fading away. The mean duration is around 80 minutes. Typical signs and symptoms of the rash include:
Although systemic treatment is best avoided during pregnancy and breastfeeding, there have been no reports that second-generation antihistamines cause birth defects. If treatment is required, loratidine and cetirizine are currently preferred.
When my son came in contact with caterpillars he would break out in giant hives all over his body. THANK GOD FOR THE SASAFRASS TREE!!! I would make him a cup of tea and within 30 minutes the hives disappeared completely when Benadryl never did. Can be bought at your local grocers.
Vena GA, Cassano N, Colombo D, Peruzzi E, Pigatto P. Cyclosporine in chronic idiopathic urticaria: a double-blind, randomized, placebo-controlled trial. J Am Acad Dermatol. 2006 Oct. 55(4):705-9. [Medline].
If you have a severe episode of hives then you may be referred to a specialist. Skin specialists (called dermatologists) or allergy specialists (called immunologists) may be able to help. In particular, if angio-oedema or anaphylaxis occurred at the same time, you would be referred or admitted to hospital. This is to reverse the reaction quickly. It is also to confirm the diagnosis and, where possible, to identify a cause. For example, if a nut allergy is suspected to have caused a severe episode then this can confirmed by tests. You may then be given advice on how to avoid the cause and on what to do if it should occur again.
Eileen Bailey is a freelance health writer. She is the author of Idiot’s Guide to Adult ADHD, Idiot’s Guide to Cognitive Behavioral Therapy, Essential Guide to Overcoming Obsessive Love and Essential Guide to Asperger’s Syndrome. She can be found on twitter @eileenmbaileyand on Facebook at eileenmbailey.
The presence of systemic symptoms could mean the urticarial rash is not ordinary urticaria,” he said, suggesting that vasculitis, Schitzler’s syndrome, adult-onset Still’s disease, an autoinflammatory syndrome, or urticarial dermatitis could be at play.
If non-sedating antihistamines are not effective, a 4 to 5-day course of oral prednisone (prednisolone) may be warranted in severe acute urticaria, particularly if there is angioedema. Systemic steroids do not speed up resolution of symptoms.