“treatment of chronic urticaria _urticaria pruritus”

Urticaria and angioedema are commonly classified by duration. Lesions of less than six weeks’ duration are considered acute; episodes that persist beyond six weeks are designated chronic. The causes and mechanisms hive formation are different in each instance, as are the prognosis and approaches to treatment.
Urticaria is the medical name for hives. These are welts; pink swellings that come up on any part of the skin. They itch and each individual hive lasts a few hours before fading away, leaving no trace. New hives appear as old areas fade. They can be pea sized or join to cover broad areas of the body. While the itch can be intense, the skin is usually not scabbed or broken. In some people the hives burn or sting.
61. Shahar E, Bergman R, Guttman-Yassky E, Pollack S. Treatment of severe chronic idiopathic urticaria with oral mycophenolate mofetil in patients not responding to antihistamines and/or corticosteroids. Int J Dermatol. 2006;45:1224–7. [PubMed]
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.
In chronic cases, a physician may check various blood and urine tests, and other procedures such as X-rays to look for other causes. If a physical urticaria is suspected, special tests to mimic the physical stimulus may be performed, such as placing an ice cube on the skin to cause a hive to form in people with cold urticaria.
Understanding the mechanisms of allergy is recent — just over the past 35 to 40 years, says Marshall, who is director of the division of clinical immunology and allergy at the University of Mississippi Medical Center. While allergic diseases have both genetic and environmental components there’s still so much about allergy we don’t know.
Chronic hives can be difficult to treat and lead to significant disability. Unlike the acute form, 50–80% of people with chronic hives have no identifiable triggers. Fortunately, 50% of people with chronic hives will experience remission within 1 year.[36] Overall, treatment is geared towards symptomatic management. Individuals with chronic hives may need other medications in addition to antihistamines to control symptoms. Patients who experience hives with angioedema require emergency treatment as this is a life-threatening condition.
When it comes to allergens, however, hives are not the only reaction one can expect. Angioedema is a condition similar to hives, but instead of on the surface; the swellings occurs deep beneath the skins surface. Angioedema is usually characterized by deep swelling around the eyes and lips and possible the genitals, hands and feet. This reaction normally last a little longer then hives do, but the swelling will usually subside after 24 hours.
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.
Treatment for hives: My son 6 yrs has severe hives at least once or twice/week for last 5 months. Docs have been no help.What is the cause? Medication works for short time. He is miserable. Please help
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.
Use nettles. Nettles have been traditionally used to treat hives because it is natural antihistamine. You can make nettles into tea, eat it, or take it as a supplement. To make a cup of nettles tea, take 1 tsp of the dried herb and add it to a cup of hot water. Let it steep and allow it to cool. Soak a cotton towel with the nettles tea, wring out the excess tea, and place the damp towel over the hives. Use as often as needed.
Environmental Factors:  Exposure to pollen, dust, fungi, sudden changes in temperature, and even extreme temperatures are some of the triggers of acute urticaria. Some people may experience allergic reactions to high humidity levels.
Disclosure: Genentech Consulting fee Consulting; American Health Insurance Plans Consulting fee Consulting; Johns Hopkins School of Public Health Consulting fee Consulting; Array BioPharma Consulting fee Consulting
An itchy skin eruption characterized by weals with pale interiors and well-defined red margins; usually the result of an allergic response to insect bites or food or drugs. – (Source – Diseases Database)
In a November 2008 interview with leading Swedish newspaper Dagens Nyheter, Swedish rapper Petter announced that the Hives were working on a new version of his track “Repa skivan” for his upcoming album.[24]
Urticarial weals can be a few millimetres or several centimetres in diameter, coloured white or red, with or without a red flare. Each weal may last a few minutes or several hours, and may change shape. Weals may be round, or form rings, a map-like pattern or giant patches.
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.

“urticaria from cold itchy hives on body”

It has been recently discovered that some persons who suffer with hives or angioedema also have an autoimmune disease. In these cases, autoantibodies have been formed that bind to the Fc-receptor on mast cells. The normal function of the Fc-receptor is to anchor allergic antibodies, called IgE, to the mast cell surface (see the mast cell diagram below). IgE is formed in allergic persons and binds specifically to allergens in the environment. When airborne allergens land on nasal tissues or eye conjunctiva, or are eaten (foods) and enter the body through the intestinal tract they bind to the specific IgE. As a result of this interaction, a signal is sent by the IgE antibody to the mast cell causing it to release its histamine. Histamine release causes the nasal and eye symptoms seen in those who suffer with “hay fever” and can produce hives, angioedema, or even life-threatening symptoms such as respiratory compromise or low blood pressure.
Chronic lung diseases hard to diagnose: Some of the chronic lung diseases are difficult to diagnose. Even the well-knowns conditions such as asthma or lung cancer often fail to be diagnosed early. Some of the chronic lung…read more »
Jump up ^ Champion, R. H.; Roberts, S. O. B.; Carpenter, R. G.; Roger, J. H. (1969). “Urticaria and Angio-Oedema”. British Journal of Dermatology. 81 (8): 588–97. doi:10.1111/j.1365-2133.1969.tb16041.x. PMID 5801331.
Hives (the common term for urticaria), are pink or red itchy rashes, that may appear as blotches or raised red lumps (wheals) on the skin. They range from the size of a pinhead to that of a dinner plate. When hives first start to appear, they can be mistaken for mosquito bites. Swellings usually disappear within minutes to hours in one spot, but may come and go for days or weeks at a time, sometimes longer. In most cases hives are not due to allergy and they can be effectively treated with a non-drowsy antihistamine. When hives occur most days for more than 6 weeks this is defined as chronic (ongoing) urticaria, which may require additional medication. 
Urticaria is characterized by itchy bumps or areas of raised skin that are light red in color and cause intense itching. This condition is commonly known as hives and while it is most commonly caused by an allergic reaction it can also have non-allergic causes. Urticaria is classified as either acute or chronic and this is dependant on how long the outbreak lasts. Outbreaks that last for less than 6 weeks are referred to as acute urticaria cases while those that last for longer periods are termed as chronic. Acute urticaria is generally the result of an allergic reaction while chronic urticaria often has autoimmune causes. An acute viral infection can also be a cause of acute urticaria. Hives are also known to be caused by local pressure, friction, extremes of temperature, and sunlight.
52. Bleehen SS, Thomas SE, Greaves MW, et al. Cimetidine and chlorpheniramine in the treatment of chronic idiopathic urticaria: a multi-centre randomized double-blind study. Br J Dermatol. 1987;117:81–8. [PubMed]
61. Shahar E, Bergman R, Guttman-Yassky E, Pollack S. Treatment of severe chronic idiopathic urticaria with oral mycophenolate mofetil in patients not responding to antihistamines and/or corticosteroids. Int J Dermatol. 2006;45:1224–7. [PubMed]
Urticaria affects almost 20 percent of the population but the majority of the time, the cause is unknown (idiopathic). Even so, it is a good idea to try to find the trigger so you can possibly avoid it in the future.
Dave, N. D., Xiang, L., Rehm, K. E., and Marshall, G. D. (2012, February 1). Stress and allergic diseases. Immunology And Allergy Clinics of North America, 31(1): 55–68. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3264048/
Urticarial vasculitis carries a good prognosis, with most occurrences resolving in months to years. Urticarial vasculitis associated with hypocomplementemia is associated with a greater incidence of coexisting disease (ie, angioedema, connective-tissue disease [primarily SLE], chronic obstructive pulmonary disease).[10, 11] Mortality is rare. Some cohorts have demonstrated systemic involvement in roughly half of the patients, including musculoskeletal and ocular complications.[12]
Once you know what triggers your outbreaks, limiting your exposure to these will reduce your risk of developing hives. Keep in mind though that sometimes hives appears to be spontaneous with no known trigger. 
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: 
Urticaria may be caused by other immediate hypersensitivity allergic reactions to an ingested, inhaled, or percutaneously inoculated substance (eg, latex, stinging insects, occupational exposures). See the following image.
Pronounced “ur-ti-kair-ee-uh,” this is the medical term for hives. Urticaria appear as red, itchy bumps or welts on the skin that can appear anywhere on the body. A red hive will turn pale when pressed in the center, which is called “blanching.” For every 10 people whose hives are chronic, at least seven of them have CIU.
Chronic idiopathic urticaria is the most common type of CU, comprising up to 90% of all cases of CU. It has been estimated that chronic idiopathic urticaria will affect between 0.6% to 5% of the population during their lifetime. Over half of all cases of chronic idiopathic urticaria are thought to be caused by an autoimmune mechanism. This is supported by the observation that 60% of patients with chronic idiopathic urticaria will have a wheal and flare reaction to intradermal autologous serum injections in the autologous serum skin test (ASST). Approximately 50% of patients with chronic idiopathic urticaria have IgG antibodies that are specific for the high affinity IgE receptor (FcεRI). These autoantibodies activate mast cells in the skin, circulating basophils, and the complement system.  Additional immunological abnormalities described to play a causative role in CU include IgG antibodies directed against IgE antibodies and the low affinity receptor (FcεRII), antiendothelial antibodies, and complement C8 alpha-gamma (C8α-γ) deficiency.
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.
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).
Physically induced hives and/or swelling share the common property of being induced by environmental factors such as a change in temperature or by direct stimulation of the skin by pressure, stroking, vibration, or light.
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.
While avoiding these triggers could prevent hives from returning, Dr. Li says your doctor may be able to provide an antihistamine that could solve a weather- or temperature-based problem. That way, you can enjoy a hike on a sunny summer day or hold a cold can of beer on the weekend without worrying about a potential hives outbreak.
When a small child gets hives, it’s almost always due to an allergy. Hives on a baby, or hives on a toddler, can be particularly disturbing. Many parents wonder how can you tell hives vs rash. There is a quick skin test called “wheal and flare” that can help confirm whether or not it’s hives. According to Jon McCullers, M.D., pediatrician-in-chief at Le Bonheur Children’s Hospital in Memphis, if your child has a big red patch on his or her skin and you see swelling (that’s the “wheal”), drag a fingernail over the area and if you see a brighter redness (“flare”) then it’s an allergic reaction. (11)
Physical urticaria: Hives caused by direct physical stimulation of the skin — for example, cold, heat, sun exposure, vibration, pressure, sweating, and exercise. The hives usually occur right where the skin was stimulated and rarely appear elsewhere. Most of the hives appear within one hour after exposure.
Stress can wreak havoc on your physical and emotional health. You may feel overwhelmed or anxious about the source of your stress. If you’re experiencing physical symptoms like a rash, stress may be amplified.
Jump up ^ Langan, EA; Nie, Z; Rhodes, LE (Sep 2010). “Melanotropic peptides: more than just ‘Barbie drugs’ and ‘sun-tan jabs’?”. The British Journal of Dermatology. 163 (3): 451–5. doi:10.1111/j.1365-2133.2010.09891.x. PMID 20545686.
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.
While hives do have many factors that can be used in the distinguishing of them, perhaps the most common of all symptoms is the appearance of urticaria, or welts. These welts are red, itchy and usually appear quickly, only to dissipate shortly after, but depending on the allergen, can come back and are replaced by others.
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.

“treatment for hives all over body |hives rash treatment”

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.
Although clinically distinctive, urticaria may be confused with a variety of other dermatologic diseases that can be similar in appearance and are pruritic, including atopic dermatitis (eczema), maculopapular drug eruptions, contact dermatitis, insect bites, erythema multiforme, pityriasis rosea, and others. Usually, however, the experienced clinician is able to distinguish these conditions from urticaria because of the lesions’ hallmark appearance (see the images below), a lack of epidermal change, the intense pruritus, the presence of an advancing edge and a receding edge, the complete blanching of the lesions with pressure, and are the transient nature of the lesions. [1] (See Clinical Presentation.)
Insect bites and exposure to pollen can make you break out in hives, but you probably already knew that. What you may not have realized is that direct sunlight, cold temperatures, or strong winds can also bring on hives. And no, this doesn’t mean you’re allergic to the elements. “It’s really more that your skin is very sensitive,” says Marilyn Li, MD, a Los Angeles-based allergist and immunologist.
Severe chronic urticaria sometimes requires a trial of medicines which reduce inflammation, often called immune modulators or immunosuppressive medications. Recurrent courses of cortisone/steroid tablets need to be avoided due to a significant risk of side effects.
The most common treatment for hives and angioedema are antihistamines, a medication used for treatment of allergies and hypersensitive reactions. However, in more severe cases of hives, creams and lotions containing steroids may be applied topically, directly on the skin where the hives appear. Lifestyle change, such as avoiding allergen causing foods or finding ways to cope with emotional stress, can also prevent future hives outbreaks.
An eruption of itching wheals, colloquially called hives, usually of systemic origin; may be due to a state of hypersensitivity to foods or drugs, foci of infection, physical agents (heat, cold, light, friction), or psychic stimuli.
Food allergy should be considered in acute urticaria and urticaria in children. Such foods as tree nuts, peanuts, eggs, shellfish, and tomatoes should be considered (the involvement of food additives or preservatives is controversial). [10] ) Please visit our main article to learn more about food allergies.
There are many causes of hives including foods, drugs, infections, and diseases. Oddly enough, even though there are many potential causes, in the majority of cases of hives, the cause is unknown. Hives causes can be broken down into 3 broad groups:
This page contains information about urticaria (hives) and other skin conditions such as angioedema. You can also find information about symptoms and treatment for urticaria and angioedema on our downloadable Factsheet area.
Taking care of yourself means giving yourself the tools you need to better manage stress in your life. Take steps to make sure you are eating a healthy diet and getting enough sleep. When you eat unhealthy foods or go through your day on just a few hours of sleep, your ability to deal with stress decreases.
Cold-induced urticaria: Urticaria occurs after exposure to cold, cold objects or cold water. The urticaria is usually localised to exposed areas but sudden total body exposure, as in swimming, may cause a drop in blood pressure and can rarely be fatal.
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.
Physical urticaria: Where the skin is affected by things like cold, heat, sun exposure, vibration, pressure, sweating and exercise. The hives may only be found where the skin was affected can appear within an hour of the exposure.
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:
In some patients pressure on the skin may cause histamine release and a ‘weal and flare’ response, a condition known as dermographism (Fig. 3). There may also be a delayed response to pressure, with urticaria and/or angioedema developing several hours after a pressure stimulus [21].
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.
Acute urticaria can be divided into two general types, depending on the rate at which hive formation occurs and the length of time it is evident. One type produces lesions that last 1-2 hours and is typically encountered in physically induced hives. The inciting stimulus is present only briefly, and there is prompt mast cell degranulation. Biopsy of such lesions reveals little or no cellular infiltrate. The second type produces a prominent cellular infiltrate, and individual lesions can last as long as 36 hours. This type is encountered with food or drug reactions, delayed pressure urticaria, chronic spontaneous urticaria, and urticarial vasculitis  (click for picture).
So, in many patients with chronic hives, there is really no exposure (drug, food, insect, chemical) to blame for the urticaria. The patient must understand and accept this for their ideal management. Basically, all that needs to be done is treat the hives. The main treatment of hives is antihistamines, and they will work if they are used properly. Common reasons for lack of effectiveness of antihistamines are 1) the particular antihistamine used is not strong enough 2) the antihistamine is not used in a high enough dose 3) the antihistamines are not continued for a long enough period.
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?
Intense emotional responses can trigger a hives outbreak. For those with chronic hives, or hives that persist for more than six weeks at a time, stress and anger can heat up the body and cause it to release histamine.
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.
The immune system normally protects us by making antibodies against foreign invaders such as bacteria and viruses. These antibodies are called IgG and are often referred to as gammaglobulins. Usually, IgG is not formed to any normal body tissue but occasionally, by error, this does happen. If antibody binds to normal tissues it can cause damage to the body or create other disease symptoms. Rheumatoid arthritis is a good example of an autoimmune disease. Antibodies that react with body tissues are felt to contribute to joint swelling and pain. Many other common diseases are caused by autoimmunity such as juvenile diabetes and low thyroid disease.
The actual cause of Acute Urticaria is relatively easy to identify as the trigger is usually immediately apparent and is reproducible on re-exposure.  Examples include: Shellfish, Peanut, Penicillin, Bee or Latex allergy.  In children generalised Acute Urticaria is often triggered by a streptococcal or viral infection (hepatitis, herpes etc).
The older oral antihistamines (eg, hydroxyzine, diphenhydramine) are sedating and can cause confusion, urinary retention, and delirium. They should be used cautiously to treat urticaria in elderly patients.
These types of antihistamines usually work well and do not cause drowsiness. Occasionally an older antihistamine which makes you sleepy may be useful, particularly if the itch keeps you awake at night. In this case an antihistamine such as chlorphenamine may be useful.
Stress hives are also known as a stress rash or as stress bumps. They develop due to chronic stress or tension, and appear as red raised areas and swollen areas on the skin that to suddenly appear. They cause itching most of the time, and some people report having a burning or stinging sensation wherever they appear. Learn more about how stress can cause chronic urticaria on our stress rash page.
The immediate symptoms of this type are treated with antihistamines, epinephrine and airway support. Taking antihistamines prior to exercise may be effective. Ketotifen is acknowledged to stabilise mast cells and prevent histamine release, and has been effective in treating this hives disorder. Avoiding exercise or foods that cause the mentioned symptoms is very important. In particular circumstances, tolerance can be brought on by regular exercise, but this must be under medical supervision.[citation needed]

“urticaria with angioedema _hives around eyes”

If you suspect your rash is the result of a preexisting condition that you’re currently seeking treatment for, you may benefit from a consultation. Your doctor can confirm your suspicions and take appropriate next steps.
It is okay for you to get your acute urticaria treated by conventional medicine such as anti-histamines. However, if you have urticaria for some months or years, you need homeopathy. Homeopathy is an answer to chronic urticaria.
Diagnosis is based on characteristic patches in the skin. Sometimes a biopsy is ordered to show inflammation in the skin and damage of small blood vessels with white blood cells. Since it’s often associated with a number of different diseases, it’s often necessary to do other tests and exams to rule out underlying conditions like lupus erythematosus or cancer. Tests of vital organs may also be indicated, especially when the blood levels of complement are low.
The best treatment for hives and angiodema is to identify and remove the trigger, but this is not an easy task. Antihistamines are usually prescribed by your doctor to provide relief from symptoms. Antihistamines work best if taken on a regular schedule to prevent hives from forming in the first place.
About 20% of people are affected.[2] Cases of short duration occur equally in males and females while cases of long duration are more common in females.[4] Cases of short duration are more common among children while cases of long duration are more common among those who are middle aged.[4] Hives have been described at least since the time of Hippocrates.[4] The term urticaria is from the Latin urtica meaning “nettle”.[5]
Over half of all cases of chronic idiopathic hives are the result of an autoimmune trigger. Roughly 50% of patients with chronic urticaria spontaneously develop autoantibodies directed at the receptor FcεRI located on skin mast cells. Chronic stimulation of this receptor leads to chronic hives. Patients often have other autoimmune conditions, such as autoimmune thyroiditis, celiac disease, type 1 diabetes, rheumatoid arthritis, Sjögren’s syndrome or systemic lupus erythematosus.[6]
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.
The immune system normally protects us by making antibodies against foreign invaders such as bacteria and viruses. These antibodies are called IgG and are often referred to as gammaglobulins. Usually, IgG is not formed to any normal body tissue but occasionally, by error, this does happen. If antibody binds to normal tissues it can cause damage to the body or create other disease symptoms. Rheumatoid arthritis is a good example of an autoimmune disease. Antibodies that react with body tissues are felt to contribute to joint swelling and pain. Many other common diseases are caused by autoimmunity such as juvenile diabetes and low thyroid disease.
Urticaria is caused by vasodilation and increased permeability of capillaries of the skin due to the release by mast cells of vasoactive mediators. The mast cell degranulation is due to an immunoglobulin E–mediated reaction to allergens (e.g., foods, drugs, or drug additives), heat, cold, and, rarely, infections or emotions. Urticaria is a primary sign of local and systemic anaphylactic reactions. It affects people of all ages but is most common between the ages 20 and 40. Angioedema is frequently associated with urticaria.
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.
The older oral antihistamines (eg, hydroxyzine, diphenhydramine) are sedating and can cause confusion, urinary retention, and delirium. They should be used cautiously to treat urticaria in elderly patients.
If sunlight triggers your hives, you’ll probably know within just a few minutes of exposure to one of these three types of light: long-wavelength ultraviolet (UVA), short-wavelength ultraviolet (UVB), and sunlight that doesn’t contain ultraviolet rays, such as sunlight through a window covered with a protective film that blocks UVA and UVB light. Hives triggered by sunlight usually disappear within a day, but in the majority of cases, they recur. Fortunately, sunlight is a rare trigger, and it’s easier to test for than other potential triggers.
Vital signs should note the presence of bradycardia or tachycardia tachypnea. General examination should immediately seek any signs of respiratory distress and also note cachexia, jaundice, or agitation.
In addition to the skin lesions, patients with urticarial vasculitis may also develop systemic symptoms including photosensitivity, swollen lymph nodes, joint pain (50%), fever, abdominal pain (20%), difficulty breathing, and lung and kidney problems.
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.
When a cause for hives can be found, it’s most likely an infection. Viral upper respiratory infections cause about 40% of hives rashes. Fortunately, these hives outbreaks resolve as the infection resolves. A chronic bacterial infection, especially sinusitis, may be the culprit if a case of hives is lingering.
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.
Angioedema is different. The swelling happens under the skin, not on the surface. It’s marked 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. It’s rare, but angioedema of the throat, tongue, or lungs can block your airways, making it hard to breathe.
^ Jump up to: a b American Academy of Allergy, Asthma, and Immunology. “Five Things Physicians and Patients Should Question” (PDF). Choosing Wisely: an initiative of the ABIM Foundation. American Academy of Allergy, Asthma, and Immunology. Archived from the original (PDF) on November 3, 2012. Retrieved August 14, 2012
Cholinergic urticaria is a common physical urticaria that is caused by sweating. It is sometimes referred to as heat bumps, as the rash appears as very small (1-4mm) weals surrounded by bright red flares.
Chronic hives (defined as lasting six weeks or more) can last from months to years. The evaluation of this condition is difficult, and allergy testing and other laboratory tests are only occasionally useful in such cases. The accurate evaluation of this condition requires the patient to give his or her physician precise information regarding their complete medical history, personal habits, and oral intake. Occasionally, it may be necessary to limit specific foods or drugs for a time to observe any affect upon the skin condition. Certain systemic diseases and infections, including parasitic infestations, may occasionally present in the skin as hives. If an inciting cause can be determined, then specific treatments for that condition ought to be effective, or in the case of food or drug allergy, strict avoidance would be necessary. There are additionally rare forms of chronic urticaria that are produced when the patient makes antibodies against molecules on the surface of their own mast cells. There are tests available to identify this type of hives.
Immunological: Some hives are caused by changes in the immune system. A typical scenario would be coming in contact with something that causes cells in the immune system to trigger the release of histamine from certain white blood cells called mast cells.
Hives are an unpleasant inflammatory skin condition that 20 percent of the population will experience at some point in time. Thankfully, hives typically are  not serious. With some simple natural remedies, you can calm a hives outbreak on yourself or your child quite quickly. Inexpensive, common household items like oatmeal, witch hazel and baking soda are really effective at calming the itching and redness that usually accompany hives. If your child experiences hives, you should make sure you aren’t using any harsh body care products on his or her skin. You should also avoid hot baths and tight-fitting clothes. I hope that you won’t experience hives anytime soon, but if you do, a natural hives treatment will really come in handy.
I am a 77-year-old lady. My Parkinson’s disease appeared at the age of 55. My symptoms at the beginning were fine tremors and rigidity with joint stiffness. I was taking Entacapone with Levodopa, Carbidopa, and Pramipexole. My Parkinson’s disease is not under control. I lost touch with reality.I started on Health Herbal Clinic Parkinsons Disease Herbal formula treatment in September 2016, i read alot of positive reviews on their success rate treating Parkinsons disease through their PD Herbal formula and i immediately started on the treatment. Just 7 weeks into the Herbal formula treatment I had great improvements with speech and coordination, my hand tremors seized and the stiffed, rigid muscle had succumbed. I am unbelievably back on my feet again, this is a breakthrough for all Parkinsons sufferers, visit Health Herbal Clinic official website www. healthherbalclinic. net or email info@ healthherbalclinic. net.
The cause of this “immunologic triggering” is unknown in the majority of cases, but can sometimes be associated with various types of infections, chronic immunologic diseases or allergy to foods or medications. The use of intravenous dyes during some radiological tests can sometimes trigger urticaria as well.
If your reaction involves swelling of your tongue or lips, or you have trouble breathing, your allergist may prescribe an epinephrine (adrenaline) auto-injector for you to keep on hand at all times. These can be early symptoms of anaphylaxis, a potentially fatal allergic reaction that impairs breathing and can send the body into shock. The only treatment for anaphylaxis is epinephrine. If you develop hives and your injector is not nearby – or if using the auto-injector doesn’t cause the symptoms to immediately improve – go to an emergency room immediately. You should also go to the emergency room after using an auto-injector.
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.
Steven A Conrad, MD, PhD is a member of the following medical societies: American College of Chest Physicians, American College of Critical Care Medicine, American College of Emergency Physicians, American College of Physicians, International Society for Heart and Lung Transplantation, Louisiana State Medical Society, Shock Society, Society for Academic Emergency Medicine, Society of Critical Care Medicine
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 (the common term for urticaria), are pink or red itchy rashes, that may appear as blotches or raised red lumps (wheals) on the skin. They range from the size of a pinhead to that of a dinner plate. When hives first start to appear, they can be mistaken for mosquito bites. Swellings usually disappear within minutes to hours in one spot, but may come and go for days or weeks at a time, sometimes longer. In most cases hives are not due to allergy and they can be effectively treated with a non-drowsy antihistamine. When hives occur most days for more than 6 weeks this is defined as chronic (ongoing) urticaria, which may require additional medication. 
Urticarial Vasculitis is a form of cutaneous vasculitis characterised by inflammation of the small blood vessels. Urticarial Vasculitis can be classified into three subtypes. All are defined by a measure of the “complement” levels in the blood. The complement system is a set of proteins that contribute to and amplify immune responses. They play a role in some, but not all, autoimmune disorders including some forms of Urticarial Vasculitis.
A complete patient history is the basis for treatment. In the history, ask for time of onset of the lesions; duration of the lesions (eg, >24 h); whether lesions are painful or burning, rather than pruritic; and the history of resolution with purpura or hyperpigmentation. Inquire about the patient’s medications, fever, arthralgia, dyspnea, abdominal pain, and symptoms of angioedema. Omalizumab has produced mixed results.[18, 19]
Urticaria is diagnosed in people with a history of weals that last less than 24 hours with or without angioedema. A family history should be elicited. A thorough physical examination should be undertaken.
Since hives can come and go so swiftly, a very significant percentage of cases are never accurately diagnosed. The hives can appear and disappear without any explanation of what caused them or cured them. Skin testing may be used in finding the source of infrequent hives; a detailed history is usually more rewarding. The patient can record everything that was ingested or touched for the 24 hours prior to the outbreak and bring this to the physician.

“urticaria in dogs urticaria on face”

Chronic Urticaria is thought to affect up to 1% of the population at any given time and, of these cases, two thirds are thought to be spontaneous (CSU) where the exact trigger for symptoms is unknown(1).
There is a lot that we still do not understand about urticaria causes although we do know that there are certain triggers and certain reactions that could cause the symptoms associated with utricaria to flare up. The absence of any well defined or clear cause of urticaria does to a large extent limit our ability to deal with the problem. The point to note is that urticaria is not always caused through or because of an allergy and there is no definitive urticaria cure. Non–allergic causes are connected to auto- immunity, to hormone interplay to stress factors, and more. These are some of the more common urticaria causes or triggers:
EU sometimes occurs only when someone exercises within 30 minutes of eating particular foods, such as wheat or shellfish. For these individuals, exercising alone or eating the injuring food without exercising produces no symptoms. EU can be diagnosed by having the patient exercise and then observing the symptoms. This method must be used with caution and only with the appropriate resuscitative measures at hand. EU can be differentiated from cholinergic urticaria by the hot water immersion test. In this test, the patient is immersed in water at 43 °C (109.4 °F). Someone with EU will not develop hives, while a person with cholinergic urticaria will develop the characteristic small hives, especially on the neck and chest.[citation needed]
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.
Urticaria affects almost 20 percent of the population but the majority of the time, the cause is unknown (idiopathic). Even so, it is a good idea to try to find the trigger so you can possibly avoid it in the future.
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)
There some researches that link post-traumatic stress disorder (PTSD), a classic stress-mediated syndrome with urticaria (the medical term for hives or nettle-rash), clearing the possible co-morbidity.
The intense discomfort may tempt you to self-medicate but this is not advisable as certain medications may aggravate your condition. It would be wise to seek medical attention as soon as possible so that you recover quickly. However, if you experience fever and/or breathing problems, you may require immediate medical attention. Make a list of all your symptoms, no matter how trivial they may seem, so that your doctor is able to make an accurate diagnosis.
Omalizumab, an anti-IgE antibody[9]. It is effective in 80% but requires monthly injections and relapse is common when it is stopped. The National Institute for Health and Care Excellence (NICE) recommends omalizumab as an add-on treatment for refractory severe chronic spontaneous urticaria[10].
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.
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)
Disclosure: Serve(d) as a speaker or a member of a speakers bureau for: Biogen/IDEC (Discussion of Drug reactions in relationship to an agent for Multiple Sclerosis)
Received income in an amount equal to or greater than $250 from: Abbvie; Lilly; Argenx; Amgen
Received honoraria from UpToDate for author/editor; Received honoraria from JAMA Dermatology for associate editor; Received royalty from Elsevier for book author/editor; Received dividends from trust accounts, but I do not control these accounts, and have directed our managers to divest pharmaceutical stocks as is fiscally prudent from Stock holdings in various trust accounts include some pharmaceutical companies and device makers for i inherited these trust accounts; for: Celgene; Pfizer; 3M; Johnson and Johnson; Merck; Abbott Laboratories; AbbVie; Procter and Gamble; Amgen.
The emotional impact of urticaria and its effect on quality of life should also be assessed. The Dermatology Life Quality Index (DLQI) and CU-Q2oL, a specific questionnaire for chronic urticaria, have been validated for chronic urticaria, where sleep disruption is a particular problem.
Recognize the symptoms. The symptoms and appearance of hives can be very short-lived, lasting only minutes, to very long term. The symptoms and appearance of hives can last for months and years. Hives can also appear on any area of the body, though the most common are the raised, itchy bumps that appear in the same area that was exposed to the allergen.
I have suffered for 2 years, intense itching from head to foot. After trying few types of medicines, finally homeopathy could cure me. Please make sure, the homeopath must be really well qualified to diagnose root cause. I strongly recommend homeopathy for urticaria.
Urticaria (or ‘hives’ or ‘nettle rash’) consists of blancheable, erythematous, oedematous papules or ‘weals’ (Fig. 1). These weals vary in size from 1 mm to many centimetres –‘giant urticaria’, and are usually intensely itchy. They are caused by vasoactive mediators, predominantly histamine, released from mast cells. In the vast majority of cases the weals are transient, lasting for only a few hours in any one place, but with new weals appearing in other places. This means that most urticarial rashes ‘move’ around the body – a useful pointer from the clinical history that the rash is urticarial. Urticaria is to be distinguished from ‘angioedema’, which is well-demarcated swelling, occurring within deep skin structures or in subcutaneous tissue (Fig. 2) and caused mainly by bradykinin production. Angioedema is not itchy, but may be painful. In about 50% of patients urticaria occurs alone; in about 40% of patients urticaria occurs with angioedema and in about 10% of patients angioedema occurs alone [1]. The aetiology of isolated angioedema is very often different from that of urticaria or urticaria with angioedema. The topic of isolated angioedema is to be reviewed in a further article in this series.

“chronic urticaria -chronic urticaria causes”

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…
Hives usually itch, but they may also burn or sting. They can show up anywhere on your body, including the face, lips, tongue, throat, and ears. They range 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, weeks, or even years.
I bought some Sovereign Silver from a health shop in America. It is an immune builder. My Urticaria was gone I swear within THREE days. You have to buy it online here but if you haven’t tried it then please do as it may work for you as it has for me. My rash was horrendous and covered every bit of my body.
The British guideline refers to chronic urticaria/angio-oedema; it also lists angio-oedema without weals as a subtype and refers to urticarial vasculitis as a differential diagnosis. Urticarial vasculitis is vasculitis of the skin characterised by inflammation of the small blood vessels rather than urticaria[5]. Causes include infection (hepatitis B/C, glandular fever or streptococcal infection), medication (penicillins, fluoxetine, thiazides, allopurinol, quinolones or carbamazepine), autoimmune disease, paraproteinaemia and malignancy.
Urticaria affects almost 20 percent of the population but the majority of the time, the cause is unknown (idiopathic). Even so, it is a good idea to try to find the trigger so you can possibly avoid it in the future.
Chronic hives can lead to severe discomfort, distress, and possibly depression. Stress, too, can aggravate hives, creating a vicious cycle. Patients who experience symptoms of depression should speak to a doctor.
Make a pineapple compress. Bromelain is an enzyme found in pineapples and can help reduce the swelling of hives. Crush some pineapple, either canned or fresh, and place it on a thin cotton towel. Pull the four corners of the towel together and tie them off with a rubber band. Place the damp, pineapple filled towel over the hives.
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.
Sometimes hives go away on their own without treatment. Otherwise, hives can generally be treated at home. The most common treatment for hives is an over-the-counter (OTC) antihistamine. Antihistamines can relieve symptoms like itching. You can find a great selection of OTC antihistamines here.
Robert A Schwartz, MD, MPH Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, University of Medicine and Dentistry of New Jersey-New Jersey Medical School
a vascular reaction of the skin marked by transient appearance of slightly elevated patches (wheals) that are redder or paler than the surrounding skin and often attended by severe itching; the cause may be certain foods, infection, or emotional stress. (See Atlas 2, Plate D.) Called also hives. adj., adj urtica´rial.
If the nondrowsy antihistamines don’t help you, your doctor may increase the dose or have you try the type that tends to make people drowsy and is taken at bedtime. Examples include hydroxyzine pamoate (Vistaril) and doxepin (Zonalon).
Other potential triggers of chronic hives include heat and aggravating your skin by scratching it or putting pressure on it (for example, by wearing tight clothes or sitting on a hard surface). Keeping a diary in which you record when and where your symptoms developed or worsened can help you and your doctor find clues and pinpoint your triggers, says Anand. But if even that doesn’t help, don’t lose heart: For most people, even chronic hives whose cause is unknown gradually disappear on their own over time.
Since hives can come and go so swiftly, a very significant percentage of cases are never accurately diagnosed. The hives can appear and disappear without any explanation of what caused them or cured them. Skin testing may be used in finding the source of infrequent hives; a detailed history is usually more rewarding. The patient can record everything that was ingested or touched for the 24 hours prior to the outbreak and bring this to the physician.
; 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; of anaphylaxis
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.
CIU & You is an educational program focused on supporting the specific needs of people suffering with chronic idiopathic urticaria. Developed in partnership with the Asthma and Allergy Foundation of America (AAFA), and made possible by Novartis Pharmaceuticals Corporation and Genentech, CIU & You aims to educate patients and encourage patients to better communicate their symptoms to their healthcare provider.
Certain people can develop recurrent hives from sunlight, cold, pressure, vibration or exercise. These are called the physical urticarias. If hives develop from scratching or firmly rubbing the skin it is called dermatographism. It is the most common of the physical urticarias and it affects about 5 percent of the population. It doesn’t always itch. This condition sometimes also occurs along with other forms of hives.
Food allergies such as allergies to nuts, strawberries, citrus fruit, egg, food additives, spices, chocolate, or shellfish. Sometimes you can develop an allergy to a food even if you have eaten it without any problem many times before.
Get away from the allergens. The first step in treating hives is to ensure you are away from the source of the allergic response. If you know what it is, which is how most cases of hives are, remove the substance that is causing the allergic reaction from your skin or environment. Common allergens that are easy to determine are poison ivy, poison oak, insect bites, wool clothing, a cat, or a dog. Avoid these or any other known allergen as much as possible.
You should also avoid using irritating moisturizers or lotions. When in doubt, opt for a formula that targets sensitive skin, such as these options. Applying immediately after bathing may also help soothe the itch.
Researchers have identified many – but not all – of the factors that can cause hives. These include food and other substances you take, such as medications. Some people develop hives just by touching certain items. Some illnesses also cause hives. Here are a few of the most common causes:
Try deep breathing techniques. Deep breathing techniques have been shown to help reduce stress. Start by lying flat on your back. Use pillows under your knees and neck to make sure you are comfortable. Put your hands, palm down, on your stomach right below the rib cage. Place the fingers of your hands together so you can feel them separate and know you are doing the exercise correctly. Take a long, slow deep breath by expanding your belly, breathing like a baby breathes, meaning from the diaphragm. Your fingers should separate as they lie on your belly.
As noted above, many cases of ordinary hives are “idiopathic,” meaning no cause is known. Others may be triggered by viral infections. A few may be caused by medications, usually when they have been taken for the first time a few weeks before. (It is less likely for drugs taken continuously for long periods to cause hives but certainly not impossible.) When a medication is implicated as a cause of hives, the drug must be stopped, since testing is rarely available to confirm the cause. In most cases, drug-induced hives will go away in a few days. If a drug is stopped and the hives do not go away, this is a strong indication that the medication was not the cause of the hives.
When a person has had hives for over six weeks, they are termed chronic urticaria. Many experts believe that acute and chronic urticaria are no different except for duration. Some studies indicate that allergy is less likely to be an underlying factor in chronic urticaria. Since in 80 per cent of the cases of chronic urticaria the underlying cause is never found, not many conclusions can be made.
Make a homemade oatmeal bath. Oatmeal is one of the best natural ways to treat the itchy, irritated skin associated with hives. Get a cup of plain, all natural rolled oats and place them in a food processor or coffee grinder. Pulse until there the oatmeal becomes a thick powder. Once it is ground into the fine substance, place one to two cups of rolled oats in a warm or cool bath, which will make the water a white colored, thick consistency. Get into the bath and soak for as long as you want. Repeat as often as needed.
The experts disagree when it comes to managing stress to ease allergy symptoms. Grossan tells WebMD that after weeks of sneezing, the body’s immune system is exhausted. “Going to bed and resting can help to restore the body’s resistance and is definitely good stress-relief therapy.”
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]
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.
Most chronic urticaria is idiopathic. The next most common cause is an autoimmune disorder. The causative autoimmune disease is sometimes clinically apparent. Urticarial vasculitis sometimes is associated with connective tissue disorders (particularly SLE or Sjögren syndrome). In urticarial vasculitis, urticaria is accompanied by findings of cutaneous vasculitis; it should be considered when the urticaria is painful rather than pruritic, lasts > 48 h, does not blanch, or is accompanied by vesicles or purpura.
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.
Angioedema is different. The swelling happens under the skin, not on the surface. It’s marked 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. It’s rare, but angioedema of the throat, tongue, or lungs can block your airways, making it hard to breathe.

“facial urticaria hives in adults”

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
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 with chronic idiopathic urticaria, including thyroid disease, celiac disease, and rheumatoid arthritis (RA).
Other measures may be appropriate, such as continuous ECG, blood pressure and pulse oximetry monitoring; administering intravenous crystalloids if the patient is hypotensive; and administering oxygen.
In addition, it is best to avoid tight fitting clothing over the areas affected by the stress hives, and to avoid hot or cold baths and showers as this can cause further skin irritations and cause hives from stress to spread. Please see our how to get rid of hives page for tips on how to alleviate your symptoms until your order of OxyHives arrives.
All products and services featured are selected by our editors. Health.com may receive compensation for some links to products and services on this website. Offers may be subject to change without notice. © 2017 Health Media Ventures, Inc. Health.com is part of the Time Inc. Food Collection and the MyRecipes Network. All rights reserved. The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments. See the Terms of Service and Privacy Policy (Your California Rights)for more information. Ad Choices
Hives (urticaria) are raised, red spots on the skin that often itch. Hives are usually indicative of an allergic reaction. Hives are a common reaction in people who have allergies. A number of substances can trigger an outbreak of hives, including foods, medications, pollen, animal dander, or insect bites.
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.
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.
Sil A, Tripathi SK, Chaudhuri A, Das NK, Hazra A, Bagchi C, et al. Olopatadine versus levocetirizine in chronic urticaria: an observer-blind, randomized, controlled trial of effectiveness and safety. J Dermatolog Treat. 2012 Nov 19. [Medline].
Try coleus forskohlii. Coleus forskohlii is a plant native to Southeast Asia that is used in Ayurvedic medicine. Studies have shown that it reduces the histamine and leukotriene release from mast cells when you get hives.[23]
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.
Patients may become sensitized to a very wide range of allergens and produce specific IgE (SIgE) against these substances. Subsequent contact with the relevant allergen, either directly on the skin or through mucous membranes, may result in urticaria.
Mortureux P, Léauté-Labrèze C, Legrain-Lifermann V, Lamireau T, Sarlangue J, Taïeb A. Acute urticaria in infancy and early childhood: a prospective study. Arch Dermatol. 1998 Mar. 134(3):319-23. [Medline].
Later in the lesion’s course, infiltrate may become a mixture of lymphocytes and neutrophils. Consider performing direct immunofluorescence on the skin biopsy, which may show deposition of complement and fibrin in the blood vessels and, occasionally, immunoglobulin M, immunoglobulin G, and immunoglobulin A along the basement membrane zone of the skin.
Stress hives are also known as a stress rash or as stress bumps. They develop due to chronic stress or tension, and appear as red raised areas and swollen areas on the skin that seem to suddenly appear. They cause itching most of the time, and some people report having a burning or stinging sensation wherever they appear. Learn more about how stress can cause chronic urticaria on our stress rash page.
Special diets appear to have a limited role to play in the management of hives. Unfortunately, it is difficult to predict who will or will not respond to diet on the basis of history or allergy testing. A temporary elimination diet under close medical supervision, followed by challenges may be useful in a small number of cases. 
For a small number of people, though, hives come back again and again, with no known cause. When new outbreaks happen almost every day for 6 weeks or more, it’s called chronic idiopathic urticaria (CIU).
Abdominal examination should note any masses, hepatomegaly, splenomegaly, or tenderness. Neurologic examination should note any tremor or hyperreflexia or hyporeflexia. Musculoskeletal examination should note the presence of any inflamed or deformed joints.
In children, urticaria is more often acute than chronic. Acute urticaria is caused frequently by IgE-mediated allergic reactions to foods or by acute infections, usually viral respiratory tract infections. ‘Papular urticaria’ occurs more often in children than in adults, and is due usually to insect bites. There is an immediate IgE-mediated weal and flare reaction, but lesions can develop into intensely itchy, indurated papules which may take several weeks to resolve.
Antihistamines are also prescribed to treat chronic (lasting longer than 6 weeks) hives. When prescribed for chronic hives, you take this medicine every day to prevent hives from forming. There are many antihistamines on the market. Some make you drowsy, and some do not.
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.
Antihistamines are the first line medication for acute or chronic urticaria. Some of these are over-the-counter preparations. The newer anti-histamines are less sedating and therefore can be used in the daytime as well. Most of them are long-acting and can be taken once-a-day only. Normal prescribed dosages may not be of benefit and your doctor may often prescribe larger doses or the addition of a second medication. Sometimes a specific anti-ulcer treatment which also has some effect on blocking urticaria may be used. If no relief is obtained doctor should be consulted.

“hives allergy treatment +urticaria pruritus”

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.
Disclosure: Serve(d) as a speaker or a member of a speakers bureau for: Biogen/IDEC (Discussion of Drug reactions relationship to an agent for Multiple Sclerosis)
Received income in an amount equal to or greater than $250 from: Abbvie; Lilly; Argenx; Amgen
Received honoraria from UpToDate for author/editor; Received honoraria from JAMA Dermatology for associate editor; Received royalty from Elsevier for book author/editor; Received dividends from trust accounts, but I do not control these accounts, and have directed our managers to divest pharmaceutical stocks as is fiscally prudent from Stock holdings in various trust accounts include some pharmaceutical companies and device makers for i inherited these trust accounts; for: Celgene; Pfizer; 3M; Johnson and Johnson; Merck; Abbott Laboratories; AbbVie; Procter and Gamble; Amgen.
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.
The effectiveness of treatment can be objectively monitored using urticaria control test. Patients are asked to score the physical symptoms of urticaria they have experienced in the previous four weeks, quality of life affected by urticaria, how often treatment was not enough to control symptoms, and overall control of urticaria.
Leukotrienes are released from mast cells along with histamine. The medications, montelukast and zafirlukast block leukotriene receptors and can be used as add on treatment or in isolation for patients with CU. It is important to note that these medications may be more beneficial for patients with NSAID induced CU.[42][43]
Food allergy should be considered in acute urticaria and urticaria in children. Such foods as tree nuts, peanuts, eggs, shellfish, and tomatoes should be considered (the involvement of food additives or preservatives is controversial). [10] ) Please visit our main article to learn more about food allergies.
By using this site you agree to our Terms of Use. Information provided on this site is for informational purposes only; it is not intended as a substitute for advice from your own medical team. The information on this site is not to be used for diagnosing or treating any health concerns you may have – please contact your physician or health care professional for all your medical needs. Please see our Terms of Use.
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.
Alcohol: Alcohol allergies are rather rare and in most cases the reaction is brought on by the ingredients used to prepare the alcoholic beverage rather than the alcohol itself. For instance a person may suffer from an allergic reaction after drinking wine but the root cause would probably be the grapes that were used to make the wine. In the same way a person may believe that they are allergic to the alcohol in beer although they are actually allergic to the wheat or barley that is used to make the beer. Some people may even be allergic to the yeast that is used in the fermentation process.
Pronounced “ur-ti-kair-ee-uh,” this is the medical term for hives. Urticaria appear as red, itchy bumps or welts on the skin that can appear anywhere on the body. A red hive will turn pale when pressed in the center, which is called “blanching.” For every 10 people whose hives are chronic, at least seven of them have CIU.
Try vinegar. There are many healing nutrients in vinegar. Pick any kind of vinegar. Pour 1 tsp of vinegar into 1 tbsp of water and stir. Using a cotton ball or napkin, apply the mixture to your hives. This will help soothe the itching.[11]
The Asthma and Allergy Foundation of America (AAFA), a not-for-profit organization founded in 1953, is the leading patient organization for people with asthma and allergies, and the oldest asthma and allergy patient group in the world.
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.
Food allergies that cause hives can include anything that you’re allergic to. The most common suspects are milk, nuts, peanuts, and shellfish. Less common allergies such as cheese, chocolate, eggs, garlic, melons, pork, spices, strawberries, and tomatoes may also be responsible.
Cases of urticaria and angioedema can be acute, lasting less than 6 weeks, or chronic, lasting more than 6 weeks. The length of symptoms can often be a clue as to the cause of the symptoms. For example, the most common cause of acute urticaria and angioedema in children is viral infections.
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.
How do you get hives? Hives are not something you can “catch” from anyone. Rather, they are your body’s response to something it ingests or experiences. The cause of hives can be a certain food, drug, infection or stress. You might be surprised to learn that stress is one of the most common causes of acute hives, along with allergies and infectious causes. Hives can literally occur at any age and appear anywhere on the body. It is estimated that one in every five people will be affected by a hives outbreak at some point in his or her life. (2)
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.
Italiano: Curare l’Orticaria in Maniera Naturale, Español: tratar la urticaria naturalmente, Português: Tratar a Urticária Naturalmente, Français: traiter l’urticaire naturellement, 中文: 自然地治疗荨麻疹, Русский: лечить крапивницу природными средствами, Deutsch: Nesselausschlag natürlich behandeln, Čeština: Jak vyléčit kopřivku přírodními metodami, Nederlands: Netelroos op natuurlijke wijze behandelen, العربية: علاج الشرى بعلاجات طبيعية, हिन्दी: शीतपित्त (urticaria या hives) का इलाज प्राकृतिक रूप से करें, Tiếng Việt: Trị chứng Phát Ban, 한국어: 두드러기 자연치유하는 법, ไทย: รักษาลมพิษตามธรรมชาติ
There are two types of hives: ordinary hives and physical hives. Ordinary hives appear suddenly, in several different places and for no apparent reason. These hives come and go in waves and can last minutes or several hours. Ordinary hives tend to be itchy, swell and turn red. Breakout episodes can last a few days, weeks and in some cases, years. Physical hives, on the other hand, are caused from dermatographism, physical stimulation.
Like other medications used to treat urticarial vasculitis, antimalarials are believed to exert their effect by their anti-inflammatory properties. Antimalarials reduce neutrophilic chemotaxis. In addition, they increase pH in lysosomes, which may affect antigen presentation. This class of medications usually is effective only in cutaneous disease.
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.
Pressure-induced urticaria typically occurs 4-6 hours after pressure has been applied. Patients may complain of swelling secondary to pressure with normal-appearing skin (i.e., no erythema or superficial infiltrating hive), so that the term angioedema is more appropriate. Others are predominantly urticarial and may or may not be associated with significant swelling. Symptoms occur about tight clothing; the hands may swell with activity such as hammering; foot swelling is common after walking in patients with normal heart function; and buttock swelling may be prominent after sitting for a few hours.
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.

“hives all over body _particracy”

Individual lesions are typically transient. They come and go within a few minutes to hours and precise questioning may be needed to establish this. If there is uncertainty about how long each lesion lasts, a line drawn around one lesion will demonstrate any change when inspected the following day. Individual weals may join to form large patches.
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.
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.
Kai AC, Flohr C, Grattan CE. Improvement in quality of life impairment followed by relapse with 6-monthly periodic administration of omalizumab for severe treatment-refractory chronic urticaria and urticarial vasculitis. Clin Exp Dermatol. 2014 Apr 23. [Medline].
Mint oil cools the skin and reduces swelling and pain. Freeze fresh mint leaves and water to form ice cubes and place them over the rash for an alternative relief treatment. Make sure that you wrap the ice cubes in a cloth before applying them to the skin, as the direct application of ice can cause further skin damage.
Solar urticaria is a rare disorder in which brief exposure to light causes the development of urticaria within 1-3 minutes. Typically, pruritus occurs first, in about 30 seconds, followed by edema confined to the light-exposed area and surrounded by a prominent erythematous zone caused by an axon reflex. The lesions usually disappear within 1-3 hours.
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.
Acute urticaria is nearly always due to some defined exposure to a drug or physical stimulus or an acute infectious illness. However, the trigger is not always clear from the history, particularly because allergy may develop without warning to a previously tolerated substance.
Oral glucocorticoids are effective in controlling symptoms of chronic hives however they have an extensive list of adverse effects such as adrenal suppression, weight gain, osteoporosis, hyperglycemia, etc. Therefore, their use should be limited to a couple of weeks. In addition, one study found that systemic glucocorticoids combined with antihistamines did not hasten the time to symptom control compared with antihistamines alone.[41]
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).
The rash usually appears suddenly and can affect any area of skin. Small raised areas called weals (or wheals) develop on the skin. The weals look like mild blisters and they are itchy. Each weal is white or red and is usually surrounded by a red area of skin, which is called a flare. The weal and flare rash of hives looks similar to the rash caused by a nettle sting.
Although clinically distinctive, urticaria may be confused with a variety of other dermatologic diseases that can be similar in appearance and are pruritic, including atopic dermatitis (eczema), maculopapular drug eruptions, contact dermatitis, insect bites, erythema multiforme, pityriasis rosea, and others. Usually, however, the experienced clinician is able to distinguish these conditions from urticaria because of the lesions’ hallmark appearance (see the images below), a lack of epidermal change, the intense pruritus, the presence of an advancing edge and a receding edge, the complete blanching of the lesions with pressure, and are the transient nature of the lesions. [1] (See Clinical Presentation.)
Urticaria results from the release of histamine, bradykinin, leukotriene C4, prostaglandin D2, and other vasoactive substances from mast cells and basophils in the dermis. These substances cause extravasation of fluid into the dermis, leading to the urticarial lesion. The intense pruritus of urticaria is a result of histamine released into the dermis. Histamine is the ligand for two membrane-bound receptors, the H1 and H2 receptors, which are present on many cell types. The activation of the H1 histamine receptors on endothelial and smooth muscle cells leads to increased capillary permeability. The activation of the H2 histamine receptors leads to arteriolar and venule vasodilation. [14, 15]

“idiopathic hives -treatment of chronic idiopathic urticaria”

Urticaria (or ‘hives’ or ‘nettle rash’) consists of blancheable, erythematous, oedematous papules or ‘weals’ (Fig. 1). These weals vary in size from 1 mm to many centimetres –‘giant urticaria’, and are usually intensely itchy. They are caused by vasoactive mediators, predominantly histamine, released from mast cells. In the vast majority of cases the weals are transient, lasting for only a few hours in any one place, but with new weals appearing in other places. This means that most urticarial rashes ‘move’ around the body – useful pointer from the clinical history that the rash is urticarial. Urticaria is to be distinguished from ‘angioedema’, which is well-demarcated swelling, occurring within deep skin structures or in subcutaneous tissue (Fig. 2) and caused mainly by bradykinin production. Angioedema is not itchy, but may be painful. In about 50% of patients urticaria occurs alone; in about 40% of patients urticaria occurs with angioedema and in about 10% of patients angioedema occurs alone [1]. The aetiology of isolated angioedema is very often different from that of urticaria or urticaria with angioedema. The topic of isolated angioedema is to be reviewed in a further article in this series.
Kids with bad allergies should carry an injectable shot of epinephrine to prevent life-threatening allergy attacks. If your child is at risk, the doctor will teach you and your child how to safely give an injection in the event of a severe allergic reaction.
Wong JT, Nagy CS, Krinzman SJ, Maclean JA, Bloch KJ. Rapid oral challenge-desensitization for patients with aspirin-related urticaria-angioedema. J Allergy Clin Immunol. 2000 May. 105(5):997-1001. [Medline].
Maurer M, Rosén K, Hsieh HJ, Saini S, Grattan C, Gimenéz-Arnau A, Agarwal S, Doyle R, Canvin J, Kaplan A, Casale T. Omalizumab for the treatment of chronic idiopathic or spontaneous urticaria. N Engl J Med. 2013 Mar 7;368(10):924-35. doi: 10.1056/NEJMoa1215372.
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.
Hives (urticaria) are raised, red spots on the skin that often itch. Hives are usually indicative of an allergic reaction. Hives are a common reaction in people who have allergies. A number of substances can trigger an outbreak of hives, including foods, medications, pollen, animal dander, or insect bites.
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.
Immunotherapy: Allergy shots help only if a person has hives because of what they breathe. These people can be successfully desensitized. Cross reacting proteins from inhalants that are also found in foods can help drop the degree of reactivity to those foods.
Key to the prevention of hives is avoiding known triggers. Take note of when hives appears – is it after you eat certain foods? In times of stress? After playing with your dog or cat (animal dander is a common allergen)? You may need to keep a food diary to identify possible allergens in your diet. 
The Hives have released five studio albums: Barely Legal (1997), Veni Vidi Vicious (2000), Tyrannosaurus Hives (2004), The Black and White Album (2007) and Lex Hives (2012). They have one compilation album, Your New Favourite Band (2001) and they have issued a live DVD, Tussles in Brussels (2005).[3] The Black and White Album has been their most successful as of December 2017.
You should also avoid using irritating moisturizers or lotions. When in doubt, opt for a formula that targets sensitive skin, such as these options. Applying immediately after bathing may also help soothe the itch.
Other potential triggers of chronic hives include heat and aggravating your skin by scratching it or putting pressure on it (for example, by wearing tight clothes or sitting on a hard surface). Keeping a diary in which you record when and where your symptoms developed or worsened can help you and your doctor find clues and pinpoint your triggers, says Anand. But if even that doesn’t help, don’t lose heart: For most people, even chronic hives whose cause is unknown gradually disappear on their own over time.
In children, an objective trial of a low E numbers diet may be helpful, especially if the clinical history suggests that episodes of urticaria may be related to ingestion of foods which are high in E numbers.
Solar urticaria is a rare disorder in which brief exposure to light causes the development of urticaria within 1-3 minutes. Typically, pruritus occurs first, in about 30 seconds, followed by edema confined to the light-exposed area and surrounded by a prominent erythematous zone caused by an axon reflex. The lesions usually disappear within 1-3 hours.
Oatmeal is a very effective natural remedy for urticaria. Place 2 heaped tablespoons of oatmeal in a bowl and add about half a cup of water to it. Make sure that the water is just enough to cover the oatmeal and keep the bowl aside. After 10 minutes or so you will find that the oatmeal has absorbed all the water in the bowl. Place a clean strip of cloth over a mug and then place the soaked oatmeal on the cloth. Slowly pour about ½ a cup of water over the oatmeal and allow it to collect in the mug below. This water will be slightly murky as it contains mucilage from the oatmeal. Apply this to your skin to reduce the itching and discomfort.
Urticaria is due to activation of mast cells in the skin, resulting in the release of histamine and other mediators. These chemicals cause capillary leakage, which causes the swelling of the skin, and vasodilation causing the erythematous reaction. There may be a trigger identified which causes this release but often the cause is not identifiable, particularly in chronic urticaria. An autoimmune reaction is thought to be involved in many such cases.
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.
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 brief, the crucial role of C1q in the pathway is its importance as the first protein to start the complement cascade (which ends in the destruction of the invading bacteria or virus), and its ability to link the two important arms of the immune system – the innate immune system: a broad defence system; and the adaptive immune system: the strong immune response capable of remembering previous infections, allowing fast response against recurrent infections, meaning that people with a normal immune system don’t continually catch the same cold or same strain of flu repeatedly.[5]
Hives are very common. They usually go away on their own, but if you have a serious case, you might need medicine or a shot. In rare cases, hives can cause a dangerous swelling in your airways, making it hard to breathe – which is a medical emergency.
Richard P Vinson, MD, Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA
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.
This antibiotic is available topically and as an oral medication. This medication can treat inflammation caused by hives or other skin conditions caused by bacterial infection. It’s important to take all antibiotics prescribed.
San Francisco — Although the expression “I was so stressed I broke out in hives” is quite common, it can be a challenge for dermatologists to identify the psychosocial precipitants of chronic urticaria, according to Josie Howard, M.D., a psychiatrist in private practice, and clinical instructor departments of psychiatry and dermatology, University of California, San Francisco. But that is beginning to change, she says.
Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Seattle GEnetics, Actillion, Celgene
Serve(d) as a speaker or a member of a speakers bureau for: Amgen
Received income in an amount equal to or greater than $250 from: Celgene
Received honoraria from Amgen for speaking and teaching; Received grant/ Received grant/research funds from Celgene for none; Received grant/research funds from Abbott Labs for independent contractor; Received grant/research funds from Amgen for none; Received honoraria from Seattle Genetics for consulting. for: Actelion-Advisory board, grants;Seattle Genetics – Advisory board.
Complement-mediated urticaria includes viral and bacterial infections, serum sickness, and transfusion reactions. Urticarial transfusion reactions occur when allergenic substances in the plasma of the donated blood product react with preexisting IgE antibodies in the recipient. Certain drugs (opioids, vecuronium, succinylcholine, vancomycin, and others) as well as radiocontrast agents cause urticaria due to mast cell degranulation through a non-IgE-mediated mechanism. Urticaria from nonsteroidal anti-inflammatory drugs (NSAIDs) may be IgE-mediated or due to mast cell degranulation, and there may be significant cross-reactivity among the NSAIDs in causing urticaria and anaphylaxis. [6]
^ Jump up to: a b c d e f g h i j k l m n o p q r s Jafilan, L; James, C (December 2015). “Urticaria and Allergy-Mediated Conditions”. Primary care. 42 (4): 473–83. doi:10.1016/j.pop.2015.08.002. PMID 26612369.
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.
The emotional impact of urticaria and its effect on quality of life should also be assessed. The Dermatology Life Quality Index (DLQI) and CU-Q2oL, a specific questionnaire for chronic urticaria, have been validated for chronic urticaria, where sleep disruption is a particular problem.
Dabbing witch hazel on hives several times per day while hives are present can help to calm the inflammation and itching. Witch hazel is a skin-healing liquid with strong antioxidant and astringent properties.  You can also try my recipe that includes witch hazel, along with many other natural anti-hive ingredients: DIY Rash Cream with Aloe & Lavender.
Jump up ^ Nakamizo, S.; Egawa, G.; Miyachi, Y.; Kabashima, K. (2012). “Cholinergic urticaria: Pathogenesis-based categorization and its treatment options”. Journal of the European Academy of Dermatology and Venereology. 26 (1): 114–6. doi:10.1111/j.1468-3083.2011.04017.x. PMID 21371134.
So, we agreed that stress-induced urticaria is a logical thing; what is not logical is to treat stress with drugs. Drug companies don’t have any single interest in jeopardizing their business in order to tell you the truth. Nobody exactly knows how it happens, but instead, they give you medicine that they are completely aware won’t work for you.
Urticaria and angioedema are commonly classified by duration. Lesions of less than six weeks’ duration are considered acute; episodes that persist beyond six weeks are designated chronic. The causes and mechanisms of hive formation are different in each instance, as are the prognosis and approaches to treatment.