“dermatographic urticaria treatment _hives pictures”

Urticarial Vasculitis is a rare painful non-migratory wealing reaction which persist for more than 24 hours and is often associated with fever, bruising and joint pain.  The associated with an underlying auto-immune diseases such as Serum Sickness, Systemic Lupus and Sjogren’s Syndrome should not be overlooked.  Urticaria Pigmentosa is a diffuse dark freckle-like rash that weals on rubbing the skin (Dariers sign) and is due to excess mast cells in the skin (Cutaneous Mastocytosis).  Children frequently develop discrete linear or grouped itchy Papular Urticaria from insect bite sensitivities.
Dermatographism, the ability to write on the skin, can occur as an isolated disorder that often presents as traumatically induced urticaria. It can be diagnosed by observing the skin after stroking it with a tongue depressor or fingernail (click for picture). A white line secondary to reflex vasoconstriction is followed by pruritus, erythema, and a linear wheal, as is seen in a classic wheal-and-flare reaction. It is rarely severe enough to require treatment.
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).
Chronic spontaneous urticaria (click for picture) is characterized by a non-necrotizing perivascular mononuclear-cell infiltrate (CD4 positive T lymphocytes and monocytes) with variable accumulation of eosinophils, neutrophils, and mast cells (click for picture). Patients with vasculitis and urticaria appear to be a separate sub-population in whom the cause and pathogenesis of hive formation probably involves immune complexes, complement activation, anaphylatoxin formation, histamine release, and neutrophil accumulation, activation, and degranulation.
The very best way to get rid of stress hives is to remove as much stress from your life as possible. There are so many effective ways to reduce stress on a daily basis. Find what works best for you and make it a part of your routine. Exercise is always one of my stress boosters. Other great ideas for stress hives treatment, and hives treatment in general, include yoga, massage, journaling and prayer.
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
All songwriting except covers on the band’s albums are credited to “Randy Fitzsimmons”. The band claim Fitzsimmons is an honorary “sixth Hive,” who along with writing their music, discovered and manages the band. Randy Fitzsimmons is a registered pseudonym for Niklas Almqvist [25].
If a specific urticarial trigger can be found, then avoiding that trigger is the most sensible course of action, but most often no underlying cause is ever found.  The main focus of treatment trying to alleviate symptoms while the urticaria slowly “burns” itself out and eventually clears – a process that may take many months or even some years.
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.
If hives are making it difficult to sleep, then it may be necessary to see a physician. This would be especially important if you are taking nonprescription antihistamines. If your hives last longer than two months, it is also likely you will benefit from visiting a physician.
In many cases, a single attack of hives is due to an infection or virus and these go away within a few days to a few weeks. Some people get repeated attacks that occur as an allergic reaction to a variety of things (foods, most commonly nuts, chocolate, fish, tomatoes, eggs, fresh berries and milk, insect stings, and medications). In this case, they usually break out within a few hours of the exposure. Usually, the patients figure out the cause by themselves, and they never bother coming to a doctor.

“multivariate regression _autoimmune urticaria”

Urticaria occurs when certain substances such as histamine are released from specific cells in the skin. This process is usually triggered by various immunologic mechanisms, most commonly involving the presence of circulating “IgE” antibodies, although other pathways may also be involved.
Idiopathic cold urticaria is characterized by the rapid onset of pruritus, erythema, and swelling after exposure to a cold stimulus. The location of the swelling is confined to those parts of the body that have been exposed. When suspected, an ice-cube test can be performed in which an ice cube is placed on the subject’s forearm for 4-5 minutes. A positive reaction leads to formation of a hive in the shape of the ice cube within 10 minutes after the stimulus is removed (click for picture). The time course of this reaction (i.e., cold challenge followed by hive formation as the area returns to body temperature) demonstrates that a two-step reaction has occurred in which exposure to cold is a prerequisite, but hive formation actually occurs as the temperature increases.
Urticaria with or without fever, polyarthralgias, polyarthritis, lymphadenopathy, proteinuria, edema, and abdominal pain within 7–10 days after parenteral administration of a biologic-based drug or substance
For those with chronic hives from heat-induced or illness-induced activities, Dr. Li suggests visiting a doctor to pinpoint the symptoms and receive an antihistamine prescription. “The solutions are individualized and many times may involve just taking a little more medication,” she says.
Okubo Y, Shigoka Y, Yamazaki M, Tsuboi R. Double dose of cetirizine hydrochloride is effective for patients with urticaria resistant: a prospective, randomized, non-blinded, comparative clinical study and assessment of quality of life. J Dermatolog Treat. 2013 Apr. 24(2):153-60. [Medline].
This list shows the foods that most often cause hives. But an allergy to foods is actually pretty rare, occurring in 1% of hives sufferers. Whether the food additives listed above actually cause hives is controversial. But many people think their hives are caused by food additives and want to try eliminating them.
Lastly, some forms of urticaria and angioedema are related to other diseases, such as autoimmune diseases (for example, lupus and rheumatoid arthritis), certain cancers, chronic infections (for example, viral hepatitis, and some hereditary forms.
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]
2018 Healthline Media UK Ltd. All rights reserved. MNT is the registered trade mark of Healthline Media. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional.
urticaria pigmento´sa the most common form of mastocytosis, occurring primarily in children, manifested as persistent pink to brown macules or soft plaques of various size; pruritus and urtication occur on stroking the lesions.
Blanchable, raised, palpable wheals, which can be linear, annular (circular), or arcuate (serpiginous); can occur on any skin area; are usually transient and migratory; and may coalesce rapidly to form large areas of erythematous, raised lesions that blanch with pressure
You may have a sensitivity to detergent, soap, clothing, perfumes and/or foods. Have you changed any daily habit in the last 16 months? New detergent or soap? Try using only natural detergents and soaps for a while to see if it helps. Wear only cotton or linen clothing. Keep a diet diary, writing down all the foods you eat — see if the itching gets worse after you eat certain foods.
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.
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).
Check CH50, C3, C4, Clq, and antibodies to Clq in urticarial vasculitis patients. If these test results are positive, evaluate renal function and urinalysis to check for the effects of vasculitis on the kidneys.
Angioedema is swelling of the deeper tissue that sometimes occurs with hives. Like hives, angioedema can occur on any part of the body. When it occurs around the mouth or throat, the symptoms can be severe, including airway blockage.
If the urticaria remains unresponsive to high-dose H1 anti-histamines, H2 anti-histamine treatment, at standard dosage, may be added. This is an 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.
Chronic urticaria and/or angioedema are hives or swelling that lasts more than 6 weeks. The cause is usually harder to find than in acute cases. The causes can be similar to those of acute urticaria but can also include your immune system, chronic infections, hormonal disorders, and tumors.
Vena GA, Cassano N, Colombo D, Peruzzi E, Pigatto P. Cyclosporine in chronic idiopathic urticaria: a double-blind, randomized, placebo-controlled trial. J Am Acad Dermatol. 2006 Oct. 55(4):705-9. [Medline].
On 12 March 2012, the band announced their fifth full-length album, Lex Hives. The album was released on their own label, Disque Hives on 1 June in Sweden/GSA, 4 June in the UK, and June 5 in the USA and Canada, comprising twelve self-produced tracks, with a deluxe version containing bonus tracks produced by Queens of the Stone Age frontman Josh Homme.[16][17]
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.

“chronic rash |urticaria to cold”

This document has been developed and peer reviewed by ASCIA members and is based on expert opinion and the available published literature at the time of review.  Information contained in this document is not intended to replace medical advice and any questions regarding a medical diagnosis or treatment should be directed to a medical practitioner. Development of this document is not funded by any commercial sources and is not influenced by commercial organisations.
Definitely! A stress rash can occur anytime you are feeling over stressed and anxious. Too much stress in your life will adversely affect your immune system which will cause it to start sending histamine to fight what is ailing you. Unfortunately, stress isn’t something that the immune system can “fight off”, so the end result is that you get stress induced hives. In essence, those itchy bumps all over your face, neck, chest, arms, legs and pretty much your whole body sometimes, are caused by stress. Learn what causes hives at http://www.hives.org/hives-causes.php
Hive-like rashes commonly accompany viral illnesses, such as the common cold. They usually appear three to five days after the cold has started, and may even appear a few days after the cold has resolved.
Practice positive affirmations. Positive affirmations are phrases you say to yourself to help reduce your stress and bring up your mood. When saying these, use the present tense and repeat as often as you can. Examples of positive affirmations are:
Exercise daily. Even if you only have time to take a walk, exercise helps reduce stress hormones that may cause you to feel keyed up. And remember, exercise produces epinephrine, which acts as a natural decongestant, helping you breathe better.
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.
Non-sedating H1 antihistamines are the mainstay of treatment. Cetirizine, loratadine and fexofenadine are usual choices. Studies comparing antihistamines are limited and so far no single antihistamine has shown itself to be superior for chronic spontaneous urticaria[6]. Once symptom control has been achieved, the antihistamine should be continued for 3-6 months.
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].
An attack of hives can start off in part of the body and quickly move to another part. The rash has a tendency to appear and disappear with each individual outbreak not lasting for more than 24 hours at a time. An attack of hives can look quite alarming but it is also not uncommon for an outbreak to resolve completely by the time you see a doctor. No other skin condition has this characteristic of resolving by itself so rapidly. Before you visit your doctor, it may be wise to take a photograph of the outbreak at its worst so that he has something to base his diagnosis on. Symptoms of hives include:
Urticaria, or hives, are red bumps that suddenly appear on your skin. Do hives itch? Yes, hives can be itchy. They can also sting or burn. What do hives look like? The appearance of hives can vary depending on the person and the cause. Hives often appear as swollen, pale or dark red bumps that are either tiny. They also can be larger and interconnected, forming welts. Sometimes the welts can merge together forming larger plaques. These plaques be as large as a dinner plate in size! (3)
[Guideline] Magerl M, Borzova E, Gimrnez-Arnau A, Grattan CE, Lawlor F, Mathelier-Fusade P, et al. The definition and diagnostic testing of physical and cholinergic urticarias–EAACI/GA2LEN/EDF/UNEV consensus panel recommendations. Allergy. 2009 Dec. 64(12):1715-21. [Medline].
This type of hives can occur right away, precisely after a pressure stimulus or as a deferred response to sustained pressure being enforced to the skin. In the deferred form, the hives only appear after about six hours from the initial application of pressure to the skin. Under normal circumstances, these hives are not the same as those witnessed with most urticariae. Instead, the protrusion in the affected areas is typically more spread out. The hives may last from eight hours to three days. The source of the pressure on the skin can happen from tight fitted clothing, belts, clothing with tough straps, walking, leaning against an object, standing, sitting on a hard surface, etc. The areas of the body most commonly affected are the hands, feet, trunk, abdomen, buttocks, legs and face. Although this appears to be very similar to dermatographism, the cardinal difference is that the swelled skin areas do not become visible quickly and tend to last much longer. This form of the skin disease is, however, rare.[citation needed]
Using methods such as deep breathing, yoga, meditation and mindfulness techniques can increase your ability to deal with stressful situations as well as lower your body’s reaction when stress does appear.
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.
urticaria pigmentosa, juvenile urticaria pigmentosa present at birth or in the first few weeks of life, usually disappearing before puberty, taking the form of a single nodule or tumor or of a disseminated eruption of yellowish brown to yellowish red macules, plaques, or bullae.
If your hives are uncomfortable or disrupting your life, consider seeing an allergist or physician to determine the underlying cause, especially if you have never had hives before. In many cases, a doctor can prescribe or recommend an over-the-counter medication that can help relieve your symptoms or calm down your hives as they occur.
“I’ve seen kids break out in hives from having a temper tantrum,” Dr. Li says. “Certainly, stress that’s anxiety-related can cause more itching in patients who have hives and they start to have more hives as a result of itching and scratching the existing ones.”
The most common foods that cause hives are nuts, chocolate, fish, tomatoes, eggs, fresh berries, and milk. Fresh foods cause hives more often than cooked foods. Certain food additives and preservatives may also be to blame.
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Swelling of deeper layers of the skin, angioedema, commonly accompanies urticaria (click for picture). This swelling often results from the same inflammatory processes that cause hives. The redness that is seen surrounding superficial lesions is not observed, though the swelling is readily appreciated. Angioedema generally occurs on the extremities and digits as well as areas of the head, neck, face, and in men, genitalia. It is often described as being painful or burning.
Hives, also known as urticaria, are a type of skin rash that are the result of an allergic reaction to a substance, called an allergen, in the environment. Although the cause of hives is not always known, they are often a response to the body releasing histamines, which it does when you have an allergic reaction to food, medicine, or other allergens. Histamine is also sometimes the body’s response to infections, stress, sunlight, and changes in temperature. Hives typically manifest as small, swollen, itchy, red areas on the skin that may occur singularly or in clusters. Left untreated, hives usually fade within a few hours, but new ones may appear in their place.[1] If you want to try to cure your hives at home, there are many different natural remedies to treat your hives.
What you should really take care of is your wellbeing that is independent from others. You should have a rock solid self-esteem; embrace yourself! If you see that you need a change, do it for yourself (not for them, for you) because you deserve it. When people are just minutes closer to challenging their atheism, you only regret that you didn’t live happily enough or that you didn’t make the choices you wanted for yourself.
[Guideline] Zuberbier T, Asero R, Bindslev-Jensen C, Walter Canonica G, Church MK, Giménez-Arnau AM, et al. EAACI/GA(2)LEN/EDF/WAO guideline: management of urticaria. Allergy. 2009 Oct. 64(10):1427-43. [Medline].
What is cholinergic urticaria and how is it treated? Learn about cholinergic urticaria, a rash that can appear when the body gets warm and sweats. We look at symptoms, treatment, diagnosis, and prevention. Read now
Copyright © 2018 Vasculitis UK. All Rights Reserved. Whilst we make every effort to keep up to date, any information that is provided by Vasculitis UK should not be a substitute for professional medical advice. Always seek the opinion of your GP or other qualified medical professional before starting any new treatment, or making changes to existing treatment.
Examination of bedding and the children’s play areas for insects may provide a clue to the cause. If insects are found, they must be eliminated by insect repellant or fumigation, and pets should be washed. These bugs are usually not visible to the naked eye. Hanging the bedding in the hot sun may rid these of the bedbugs.
Symptoms of chronic urticaria usually resolve, although this can take months or several years. Most people with chronic urticaria manage with appropriate doses of non-drowsy People with severe symptoms interfering with quality of life may be referred to a clinical immunology/allergy specialist or dermatologist for assessment and consideration of additional medications.

“toddler hives chronic urticaria treatment”

When you’re stressed, it isn’t uncommon to experience a flare-up related to an existing skin condition. This is because your body releases extra chemicals, like neuropeptides and neurotransmitters, when you’re stressed. These chemicals can change how your body responds to various functions. This change in response can cause inflammation, sensitivity, and other discomfort to the skin.
Other options for refractory symptoms of chronic hives include anti-inflammatory medications, omalizumab, and immunosuppressants. Potential anti-inflammatory agents include dapsone, sulfasalazine, and hydroxychloroquine. Dapsone is a sulfone antimicrobial agent and is thought to suppress prostaglandin and leukotriene activity. It is helpful in therapy-refractory cases[44] and is contraindicated in patients with G6PD deficiency. Sulfasalazine, a 5-ASA derivative, is thought to alter adenosine release and inhibit IgE mediated mast cell degranulation, Sulfasalazine is a good option for people with anemia who cannot take dapsone. Hydroxychloroquine is an antimalarial agent that suppresses T lymphocytes. It has a low cost however it takes longer than dapsone or sulfasalazine to work.
a pruritic skin eruption characterized by transient wheals of varying shapes and sizes with well-defined erythematous margins and pale centers. It is caused by capillary dilation in the dermis that results from the release of vasoactive mediators, including histamine, kinin, and the slow reactive substance of anaphylaxis associated with antigen-antibody reaction. It may be a reaction to drugs, food, insect bites, inhalants, emotional stress, exposure to heat or cold, or exercise. Treatment includes antihistamines and removal of the stimulus or allergen. Also called hives. See also angioedema, cholinergic urticaria. urticarial, adj.
The medical term for hives is urticaria (ur-tih-CARE-ee-uh). When large welts occur deeper under the skin, the medical term is angioedema (an-gee-oh-eh-dee-ma). This can occur with hives, and often causes the eyelids and lips to swell.
The first symptom of urticarial vasculitis is an urticarial eruption that is often painful or has a burning sensation. In some cases there may be pruritus. Lesions are red patches or plaques that may have a white centre, and petechiae may appear. They usually last for more than 24 hours in a fixed location, after which they will slowly resolve spontaneously. Ecchymoses or hyperpigmentation may occur in the healing process.
The main treatment of all forms of urticaria in adults and in children is with an oral second-generation antihistamine chosen from the list below. If the standard dose (eg 10 mg for cetirizine) is not effective, the dose can be increased up to fourfold (eg 40 mg cetirizine daily). They are stopped when the acute urticaria has settled down. There is not thought to be any benefit from adding a second antihistamine.
Though we may not fight wild animals anymore, there are still “wild animals” facing us daily in the form of arguments, a phone that won’t stop ringing, and perpetually full in-boxes. Now when you add miserable allergy symptoms, you’ve got a recipe for disaster — unless you take time to do something for stress relief.
This type of hives can occur right away, precisely after a pressure stimulus or as a deferred response to sustained pressure being enforced to the skin. In the deferred form, the hives only appear after about six hours from the initial application of pressure to the skin. Under normal circumstances, these hives are not the same as those witnessed with most urticariae. Instead, the protrusion in the affected areas is typically more spread out. The hives may last from eight hours to three days. The source of the pressure on the skin can happen from tight fitted clothing, belts, clothing with tough straps, walking, leaning against an object, standing, sitting on a hard surface, etc. The areas of the body most commonly affected are the hands, feet, trunk, abdomen, buttocks, legs and face. Although this appears to be very similar to dermatographism, the cardinal difference is that the swelled skin areas do not become visible quickly and tend to last much longer. This form of the skin disease is, however, rare.[citation needed]
^ Jump up to: a b Zuberbier, T (January 2012). “A Summary of the New International EAACI/GA2LEN/EDF/WAO Guidelines in Urticaria”. The World Allergy Organization journal. 5 Suppl 1: S1–5. doi:10.1097/WOX.0b013e3181f13432. PMID 23282889.
Up to 20% of people will develop hives at some time during their life.  In most cases, hives are not due to allergy. Underneath the lining of the skin and other body organs (including the stomach, lungs, nose and eyes) are mast cells. Mast cells contain chemicals including histamine. When these are released into the skin they irritate nerve endings to cause local itch and irritation and make local blood vessels expand and leak fluid, triggering redness and swelling.
The initial medical treatment for urticaria is a standard dose of a second-generation H1 anti-histamine. These drugs penetrate the blood–brain barrier to only a slight extent and so cause fewer central nervous system side effects than the older first-generation anti-histamines, although symptoms such as sedation and psychomotor impairment may still occur. Seven such anti-histamines are licensed for use in the United Kingdom: Cetirizine, desloratidine, fexofenadine, levocetirizine, loratidine and mizolastine, which are all given once a day, and acrivastine which is given three times a day, and may therefore be less effective and convenient to use. Cetirizine and levocetirizine [49] and loratidine [50] may have clinically useful ‘anti-inflammatory’ properties at therapeutic doses. Cetirizine may cause drowsiness in some patients and mizolastine is contra-indicated in patients with cardiac disease; prolonged Q-T interval; or severe liver disease. Dose reductions may be needed if there is renal impairment. Clinical response and tolerability may be better with one second-generation H1 anti-histamine than another, so if symptoms are not well controlled or the patient notices side effects with the first drug chosen, a second drug should be tried. Often, symptom control is improved if the dose of anti-histamine is increased to twice daily. This is above the licensed recommended dose; however, ‘off-label’ dosages are recommended widely [44,45,51]. A night-time dose of one of the older first-generation, sedating H1 anti-histamines, such as chlorphenamine or hydroxyzine, may help patients to sleep. Empirically, anti-histamine treatment is usually prescribed for 3–6 months (or longer if the patient has angioedema associated with the urticaria) and is tailed off gradually. Episodic urticaria may be treated with stat doses of anti-histamines as required.
Treatment guidelines for the management of chronic hives have been published.[37][38] According to the 2014 American practice parameters, treatment involves a step wise approach. Step 1 consists of second generation, H1 receptor blocking antihistamines. Systemic glucocorticoids can also be used for episodes of severe disease but should not be used for long term due to their long list of side effects. Step 2 consists of increasing the dose of the current antihistamine, adding other antihistamines, or adding a leukotriene receptor antagonist such as montelukast. Step 3 consists of adding or replacing the current treatment with hydroxyzine or doxepin. If the individual doesn’t respond to steps 1–3 then they are considered to have refractory symptoms. At this point, anti-inflammatory medications (dapsone, sulfasalazine), immunosuppressants (cyclosporin, sirolimus) or other medications like omalizumab can be used. These options are explained in more detail below.
“Chronic idiopathic hives are itchy red welts that persist for at least six weeks and have no known cause,” says Miriam Anand, MD, an allergist with Allergy Associates and Asthma in Tempe, Arizona. The condition is marked by periods of exacerbation and remission, and for many who have it, the hives may persist for more than five years.
Hives treatment may not be needed if hives are mild. If you wait a short time, they can disappear on their own without any intervention. If you want to do something to help them go away faster and to reduce itching and swelling, make sure that you do not take any hot baths or showers while you have hives. Also, avoid wearing any tight-fitting clothing because this can further irritate the area where you have hives. (14) This all applies to babies or toddlers with hives as well. Make sure you don’t bathe a child with hives in water that is too hot and keep their clothing loose-fitting and breathable.
Hives, also known as urticaria, affects about 20 percent of people at some time during their lives. It can be triggered by many substances or situations and usually starts as an itchy patch of skin that turns into swollen red welts. The itching may be mild to severe. Scratching, alcoholic beverages, exercise and emotional stress may worsen the itching.
Urticaria due to the direct effects of physical forces on the skin. Cold temperature (cold urticaria), pressure (pressure urticaria), ultraviolet radiation (solar urticaria), and scratching (dermographism) are some causes of physical urticaria.
Jump up ^ Phan, NQ; Bernhard, JD; Luger, TA; Ständer, S (October 2010). “Antipruritic treatment with systemic μ-opioid receptor antagonists: a review”. Journal of the American Academy of Dermatology. 63 (4): 680–8. doi:10.1016/j.jaad.2009.08.052. PMID 20462660.
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.
Jump up ^ Kozel MM, Mekkes JR, Bossuyt PM, Bos JD (2001). “Natural course of physical and chronic urticaria and angioedema in 220 patients”. J Am Acad Dermatol. 45 (3): 387–391. doi:10.1067/mjd.2001.116217. PMID 11511835.
This skin disease is common, and it often goes away on its own. It typically starts with a large patch of red, raised skin. This “mother patch” or “herald patch” may be surrounded by small red bumps, or “daughter patches,” that are typically oval in shape.
The typical lesion is a central itchy white papule or plaque due to swelling of the surface of the skin (weal or wheal). This is surrounded by an erythematous flare. The lesions are variable in size and shape and may be associated with swelling of the soft tissues of the eyelids, lips and tongue (angio-oedema).
The Hives are a Swedish rock band that rose to prominence in the early 2000s during the garage rock revival. Their mainstream success came with the of the album Veni Vidi Vicious, containing the anthem “Hate to Say I Told You So”. The band have been acclaimed by music critics as one of the best live rock bands in current music.[1][2]
This document has been developed and peer reviewed by ASCIA members and is based on expert opinion and the available published literature at the time of review.  Information contained in this document is not intended to replace medical advice and any questions regarding a medical diagnosis or treatment should be directed to a medical practitioner. Development of this document is not funded by any commercial sources and is not influenced by commercial organisations.
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These are distinguished by finding normal or lowered levels of complement proteins on blood testing. Although both types may be associated with systemic symptoms such as angioedema, abdominal or chest pain, fever, and joint pain, this is more apparent in the hypocomplementaemic form. This form has also been linked to the connective tissue disease systemic lupus erythematosus (SLE).
Vena GA, Cassano N, Colombo D, Peruzzi E, Pigatto P. Cyclosporine in chronic idiopathic urticaria: a double-blind, randomized, placebo-controlled trial. J Am Acad Dermatol. 2006 Oct. 55(4):705-9. [Medline].
If these agents fail, colchicine, hydroxychloroquine, or dapsone may be effective. If all other treatment modalities have failed or if the patient has systemic involvement, consider initiating treatment with glucocorticoids. If the patient requires long-term treatment with corticosteroids, consider every-other-day dosing of the steroid or the addition of azathioprine as a steroid-reducing agent. Response to newer agents, including mycophenolate mofetil[20, 21] and rituximab, has been reported in the literature. Rituximab-based treatment can provide higher response rates compared with corticosteroids and conventional immunosuppressive agents, which supports its use in relapsing, refractory, or severe disease.[12]
Urticaria and Glutamine: i am suffering from urticaria for the last 6 months & i want to take Glutamine as a food supplement now . is it safe to consume glutamine while u hve problem of urticaria . will glutamine react with the allergy of urticaria?

“symptoms of urticaria multivariate normal”

When a patient has hives, a dermatologist can often make the diagnosis by looking at the skin. Finding the cause of hives, however, can be a challenge. This is especially true for hives that have been around for more than 6 weeks.
Patients taking progesterone-containing oral contraceptives or hormone replacement therapy or those with cyclic urticaria that appears during the 2nd half of the menstrual cycle and resolves with menstruation
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What we do know: hives, also known as urticaria, can appear anywhere on the body, including your face, torso, arms, legs, and even inside your mouth and ears. They may range in size from as tiny as a pencil tip to as large as a dinner plate. Hives typically crop up when you have an allergic reaction to a substance—pet dander, pollen, latex—triggering your body to release histamine and other chemicals into your blood. That’s what causes the itching, swelling, and other symptoms.  
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.
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].
Antihistamines that require a prescription include cyproheptadine (Periactin), which tends to cause drowsiness. A prescription antihistamine that causes little sedation is levocetirizine (Xyzal). Sometimes physicians combine these with other types of antihistamines called H2 blockers, such as ranitidine (Zantac) and cimetidine (Tagamet). This antihistamine list is not exhaustive. Physicians individualize treatment plans to suit specific patients and modify them depending on the clinical response.
Here’s an additional reason to brush, floss, and see your dentist regularly: In a study published in April 2013 in the journal Advances in Dermatology and Allergology, researchers found that tooth decay and several other infections can play a significant role in the development of chronic hives. Bacterial infections (such as urinary tract infections and strep throat) and viral infections (such as hepatitis and norovirus, a common cause of stomach “flu”) were also found to be triggers of chronic hives.
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.
There has been a high incidence of autoantibody to thyroid glands reported among those with anti-Fc-receptor antibodies and it is suggested that yearly thyroid testing be done by the primary care physician.
Vena GA, Cassano N, Colombo D, Peruzzi E, Pigatto P. Cyclosporine in chronic idiopathic urticaria: a double-blind, randomized, placebo-controlled trial. J Am Acad Dermatol. 2006 Oct. 55(4):705-9. [Medline].
If you are experiencing hives, don’t know the cause and they have lasted at least six weeks or more, talk to a specialist to see if you have chronic idiopathic urticaria. There may be medicines they can prescribe to help you manage your condition.
“So, on the flip side of this, we can ask, ‘How can psychological interventions bolster the immune system and relieve somatic symptoms?’ Buffet in 2003 showed improvement in urticarial wheals after subcutaneous injection with histamine when treated with hypnosis and relaxation techniques (Buffet M. Ann Dermatol Venereol. 2003;130(1):S145-S159),” she says.
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.
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.
Hive-like rashes commonly accompany viral illnesses, such as the common cold. They usually appear three to five days after the cold has started, and may even appear a few days after the cold has resolved.
Making a paste of baking soda and water can help to calm hives and also prevent new ones from popping up. Baking soda is known as nahcolite, which is part of the natural mineral natron. Natron contains large amounts of sodium bicarbonate. It has been used since ancient times as a soother and cleanser. Mix a teaspoon of baking soda with some cold water to create a paste and then rub it on the affected area. Let it dry completely before washing it off. You can do this a few times a day, if needed. Relief is typically immediate from this easy hives treatment.
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.
It stands in contrast to the linear reddening that does not itch seen in healthy people who are scratched. In most cases, the cause is unknown, although it may be preceded by a viral infection, antibiotic therapy, or emotional upset. Dermographism is diagnosed by taking a tongue blade and drawing it over the skin of the arm or back. The hives should develop within a few minutes. Unless the skin is highly sensitive and reacts continually, treatment is not needed. Taking antihistamines can reduce the response in cases that are annoying to the patient.[citation needed]
Perform skin biopsy to confirm the diagnosis of urticarial vasculitis. Recent lesions, less than 48 hours in onset, are the best for biopsy. Biopsy of a lesion of less than 24 hours’ duration is best for direct immunofluorescence.
Morbidity depends on the severity and duration of the condition. One study found that urticaria patients can have as much psychologic, social, and occupational distress as patients who are awaiting triple coronary artery bypass surgery. [28]
The hallmark red raised welts of hives sometimes have a pale center, appear in clusters, and can change shape and location in a matter of hours. They can be from a few millimeters wide to as big as a dinner plate, and can itch, sting, or cause a burning sensation.
Heat-induced urticaria:This is a common form of chronic urticaria (5-7%). It appears as small wheals (1-2 mm in diameter), with large areas of flares around it. It frequently involves the skin of the neck and chest. It is associated with increased body temperature, e.g., after exercise, hot showers and emotional stimuli.
Apart from avoiding certain histamine producing foods, you should also increase your intake food items that are high in vitamin C. Vitamin C can provide relief from symptoms of hives by reducing the production of histamine. Though there is no conclusive evidence that proves this, many people benefit from an increased vitamin C intake as it also boosts the immunity and helps fight an infection.
Yao, Q., Ye, Y., Liu, X., Qin, Z., & Liu, Z. (2015). The effectiveness and safety of acupuncture for patients with chronic urticarial: A systematic review. Biomed Research International . Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4897793/
An eruption of itching wheals, collquially called hives, usually of systemic origin; it may be due to a state of hypersensitivity to foods or drugs, foci of infection, physical agents (heat, cold, light, friction), or psychic stimuli.
Urticaria has been reported with infectious diseases. Viral infections associated with acute urticaria include acute viral syndromes, hepatitis (A, B, and C), Epstein-Barr virus, and herpes simplex virus. Streptococcal infection (see the photograph below) has been reported as the cause of 17% of acute urticaria cases in children. [12] Urticaria has also been reported with chronic parasitic infections. [13]
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.
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.
Lin RY, Curry A, Pesola GR, Knight RJ, Lee HS, Bakalchuk L, et al. Improved outcomes in patients with acute allergic syndromes who are treated with combined H1 and H2 antagonists. Ann Emerg Med. 2000 Nov. 36(5):462-8. [Medline].
Allergic reactions, particularly to foods and medications, are another common cause of acute hives. Allergies only cause about 5 percent to 10 percent of chronic hives cases. Pet allergies are usually to blame; pollen, mold, and dust mite allergies cause chronic hives only in rare instances.
^ 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

“stress hives treatment why do i have hives”

Stress hives are red, raised swollen areas and bumps (AKA stress bumps) that appear on your skin, that develop due to too much stress or anxiety in your life. Stress hives can itch like crazy, giving you the feeling like ants or spiders are crawling over your skin. The only way to get rid of your stress hives is to remove all the stress and anxiety form your life. Because this is a near impossibility for most people, there is one stress hives treatment, known as OxyHives, that can be taken that reduces the swelling and itchy feeling within 2 hours.
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]
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.
Sometimes, a skin biopsy or blood tests are done to confirm that you had an allergic reaction, and to test for the substance that caused the allergic response. However, specific allergy testing is not useful in most cases of hives.
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.
CU can occur in response to drugs, physical stimuli, as part of inflammatory or inherited diseases, or can be idiopathic in nature. Acetylsalicylic acid (ASA) or nonsteroidal anti-inflammatory drug (NSAID) intolerant CU is hypothesized to occur due to inhibition of the cyclooxygenase pathway, which causes enhanced production of leukotrienes. The physical urticarias (classically divided into heat, cold, solar, vibration, delayed-pressure, dermatographism, aquagenic and cholinergic induced urticaria) occur in response to external stimuli. Urticarial vasculitis involves the appearance of urticarial lesions lasting greater than 24 hours in the hisopathological setting of vasculitis. Inherited syndromes with CU include the spectrum of cryopyrinopathies, such as Familial Cold Autoinflammatory syndrome, Muckle-Wells syndrome, and Neonatal-Onset Multisystem Inflammatory Disease/Chronic Infantile Neurologic Cutaneous Articular syndrome (NOMID/CINCA). Urticaria presents as a feature of many inflammatory disorders, such Schnitzler syndrome, Still’s disease, and Gleich’s syndrome. Chronic idiopathic urticaria, unlike the physical urticarias and ASA or NSAID intolerant variants, has no discernable external cause.
For some cases of urticaria, especially chronic urticaria, no cause can be found, despite exhaustive efforts. This is known as idiopathic urticaria, [2] although most of these are chronic autoimmune urticaria as defined by a positive autologous serum skin test (ASST). [9]
Lin RY, Curry A, Pesola GR, Knight RJ, Lee HS, Bakalchuk L, et al. Improved outcomes in patients with acute allergic syndromes who are treated with combined H1 and H2 antagonists. Ann Emerg Med. 2000 Nov. 36(5):462-8. [Medline].
Clinical Context:  Dapsone is the preferred sulfone. Other sulfones must be metabolized to dapsone for their effect. The mechanism of action is similar to that of sulfonamides in which competitive antagonists of PABA prevent the formation of folic acid, inhibiting bacterial growth.
Individual lesions of acute urticaria can appear at different locations and fade without scarring, often in a matter of hours. The development of urticaria can be an isolated event without systemic reaction or it can be a prelude to the development of an anaphylactic reaction. Although urticaria results from transient extravasation of plasma into the dermis, angioedema is the subcutaneous extension of urticaria that results in deep swelling within subcutaneous/submucosal tissues and is associated with pain.
Review of systems should seek symptoms of causative disorders, including fever, fatigue, abdominal pain, and diarrhea (infection); heat or cold intolerance, tremor, or weight change (autoimmune thyroiditis); joint pain (cryoglobulinemia, SLE); malar rash (SLE); dry eyes and dry mouth (Sjögren syndrome); cutaneous ulcers and hyperpigmented lesions after resolution of urticaria (urticarial vasculitis); small pigmented papules (mastocytosis); lymphadenopathy (viral illness, cancer, serum sickness); acute or chronic diarrhea (viral or parasitic enterocolitis); and fevers, night sweats, or weight loss (cancer).
Other drugs such as Colchicine, Warfarin, Nifedipine, Dapsone, Methotrexate and Sulfasalazine have been used with some success reported in chronic urticaria. Auto-immune thyroid disease with associated urticaria may respond to oral Thyroxine supplementation even if normal thyroid function. Immune suppressive therapy such as Cyclosporin is effective but can cause serious side effects such as kidney damage and uncontrolled hypertension.  Oral Sodium Cromoglycate may benefit related Exercise induced Urticaria. Stress (public speaking, examinations, exercise and arguments) may trigger Cholinergic Urticaria and Propranolol will reduce symptoms.
Prevention is by avoiding whatever it is that causes the condition.[2] Treatment is typically with antihistamines such as diphenhydramine and ranitidine.[2] In severe cases, corticosteroids or leukotriene inhibitors may also be used.[2] Keeping the environmental temperature cool is also useful.[2] For cases that last more than six weeks immunosuppressants such as ciclosporin may be used.[2]
It can be hard to figure out what causes chronic urticaria, though it’s sometimes linked to an immune system illness, like lupus. Other times, medications, food, insects, or an infection can trigger an outbreak. Often, though, doctors don’t know what causes chronic hives.
“In the late 1960s, we’d ask people how many had allergies and an estimated 1 in 10 people reported some form of allergy,” Marshall says. “Now compare that with 1 in 3 people in 2000 having some form of allergy.”
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:
Psoriasis is a buildup of too many skin cells that form silvery, scaly patches on the body. It’s caused by inflammation, which can be fueled by stress. That’s why people with psoriasis often get flare-ups when they’re tense.
Di Campli C, Gasbarrini A, Nucera E, Franceschi F, Ojetti V, Sanz Torre E, et al. Beneficial effects of Helicobacter pylori eradication on idiopathic chronic urticaria. Dig Dis Sci. 1998 Jun. 43(6):1226-9. [Medline].
Hives can be caused from allergens as well as physical and environmental factors such as stress, heat, sunlight or water. Untreated, the symptoms can last from a couple hours up to six weeks. As we’ll see throughout this article, many skin disorders share these causes and triggers, so close attention to detail is key when figuring out the mystery of your skin disorder.
[Guideline] Zuberbier T, Asero R, Bindslev-Jensen C, Walter Canonica G, Church MK, Giménez-Arnau A, et al. EAACI/GA(2)LEN/EDF/WAO guideline: definition, classification and diagnosis of urticaria. Allergy. 2009 Oct. 64(10):1417-26. [Medline]. [Full Text].
For those with chronic hives from heat-induced or illness-induced activities, Dr. Li suggests visiting a doctor to pinpoint the symptoms and receive an antihistamine prescription. “The solutions are individualized and many times may involve just taking a little more medication,” she says.
Physical urticaria are hives caused by direct physical stimulation of the skin — for example, cold, heat, sunlight, vibration, pressure, sweating, and exercise. They usually happen right where the skin was affected and rarely appear anywhere else. Most appear within 1 hour after exposure.
The symptoms of a stress rash include red bumps and swollen areas on your skin that seem to appear randomly. Quite often, they are incredibly itchy and can also have a prickly or burning sensation when touched. Don’t scratch them! Don’t be surprised if your stress rash appears on your face, neck and chest, as that is where I get mine. Others get them on their arms and legs. Stress hives can be as small as a pencil eraser or as BIG as a dinner plate! Often the smaller hives meld with the bigger hives to make one big messy outbreak that looks absolutely terrible. However, with the right over the counter medication, like OxyHives, you’ll be able to get rid of them in no time.
Hives, also called urticaria, are itchy, red bumps on the skin. They typically appear as an allergic reaction to food or medication, but can also be caused from emotional stress and environmental factors. Treatment for hives includes antihistamine medication, topical lotion and lifestyle change. Roughly 15 to 20 percent of all adults will be affected by hives during their lifetime, according to healthy-skin-guide.com.
Chronic spontaneous urticaria (click for picture) is characterized by a non-necrotizing perivascular mononuclear-cell infiltrate (CD4 positive T lymphocytes and monocytes) with variable accumulation of eosinophils, neutrophils, and mast cells (click for picture). Patients with vasculitis and urticaria appear to be a separate sub-population in whom the cause and pathogenesis of hive formation probably involves immune complexes, complement activation, anaphylatoxin formation, histamine release, and neutrophil accumulation, activation, and degranulation.
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).
Morbidity depends on the severity and duration of the condition. One study found that urticaria patients can have as much psychologic, social, and occupational distress as patients who are awaiting triple coronary artery bypass surgery. [28]
All songwriting except covers on the band’s albums are credited to “Randy Fitzsimmons”. The band claim Fitzsimmons is an honorary “sixth Hive,” who along with writing their music, discovered and manages the band. Randy Fitzsimmons is a registered pseudonym for Niklas Almqvist [25].
Drugs that block histamine-1 (H1) receptors (antihistamines) are the primary treatment for urticaria. The use of both H1 and H2 receptor blockers has been recommended but has not been proven more effective. Patients should avoid identified allergens. Doxepin, calcium channel blockers, or immunosuppresive drugs may be needed for symptoms that are not well controlled with antihistamines. Known triggers of urticaria should be avoided.
Solar urticaria: Treatment, management, and symptoms Solar urticaria is a type of rash that occurs after exposure to sunlight. Learn about the causes, symptoms, and how the condition is treated and prevented. Read now
Consultation with or referral to a dermatologist, allergist, immunologist, or rheumatologist may be appropriate in selected cases, particularly in cases of complicated, recurrent, refractory, severe, or chronic urticaria. Dermatology referral is mandatory if urticarial vasculitis is suspected.

“hives on torso what causes welts”

Vicki Lawrence is no stranger to being quick on her feet and playing off improv lines on stage. But when she was diagnosed with this form of chronic hives without a known cause, she was caught off-guard.
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.
They also play a central role in allergy. Mast cells contain sacks filled with chemicals, including histamine. These chemicals are released in response to certain external triggers, e.g., allergens, physical causes. Some individuals’ mast cells are unstable and cause urticaria without being triggered by an external factor. When these chemicals are released in small amounts, they cause local itch, irritation and redness of the overlying skin. In larger amounts, they will cause fluid to leak out of blood vessels, resulting in swelling of the skin. When released in massive amounts, it may result in shock (anaphylaxis).
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:
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A number of drugs, such as aspirin, NSAIDs, opiates, succinylcholine, and certain antibiotics (eg, polymyxin, ciprofloxacin, rifampin, vancomycin, some beta-lactams) can cause urticaria by a nonallergic mechanism rather than by IgE-mediated hypersensitivity.
Cholinergic or generalized heat urticaria is characterized by the onset of small (1 mm) punctate wheals surrounded by a prominent erythematous flare associated with exercise, hot showers, sweating, and anxiety (click for picture). Typically, lesions first appear about the neck and upper thorax; when viewed from a distance, hives may not be perceived and the patient appears flushed. Pruritus is a prominent feature of the reaction. Gradually the lesions spread distally to involve the face, back and extremities, and the wheals increase in size. In some patients the hives become confluent and resemble angioedema. Although uncommon, symptoms of more generalized cholinergic stimulation such as lacrimation, salivation, and diarrhea may occasionally be seen. These various stimuli have the common feature of being mediated by cholinergic nerve fibers. Cholinergic urticaria is the only form of hives in which emotional stimuli can, in some patients, initiate an urticarial reaction.  One study suggests that a subpopulation of patients has IgE antibody to an antigen in sweat.
Examination of bedding and the children’s play areas for insects may provide a clue to the cause. If insects are found, they must be eliminated by insect repellant or fumigation, and should be washed. These bugs are usually not visible to the naked eye. Hanging the bedding in the hot sun may rid these of the bedbugs.
We classify Urticaria into Acute Urticaria when the rash duration is under 6 weeks and Chronic Urticaria when it persists for over 6 weeks. Physical Urticaria is due to an external physical trigger such as heat, cold, pressure or exercise (also called Inducible Urticaria). While Urticarial Vasculitis is a rare condition associated with underlying auto-immune connective tissue diseases which requires specialist referral.
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. 
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.
The “chronic” in CIU means that symptoms last six weeks or more. CIU is an unpredictable form of chronic hives that can appear at any time with no identifiable cause. These hives may not go away for many months—or even years. CIU can be difficult to diagnose.
After a run of Californian live shows and the two weekends at the Coachella Valley Music and Arts Festival (April 15 and April 22), the band performed on Jimmy Kimmel Live! on 23 April 2012.[21] The music video for “Go Right Ahead” was released on 9 May 2012.
Foods that are fermented such as cheese, vinegar and alcoholic beverages also produce histamine and should be cut out of your daily diet. Some people may be allergic to additives and artificial colorings so over-processed and junk foods need to be avoided as well.
The rash appears rapidly, usually within a few minutes of sweating, and can last from 30 minutes to an hour or more before fading away. The mean duration is around 80 minutes. Typical signs and symptoms of the rash include:
Each weal usually lasts less than 24 hours. However, as some fade away, others may appear. It can then seem as if the rash is moving around the body. The rash may appear quite dramatic if many areas of skin are suddenly affected.
Idiopathic cold urticaria is characterized by the rapid onset of pruritus, erythema, and swelling after exposure to a cold stimulus. The location of the swelling is confined to those parts of the body that have been exposed. When suspected, an ice-cube test can be performed in which an ice cube is placed on the subject’s forearm for 4-5 minutes. A positive reaction leads to formation of a hive in the shape of the ice cube within 10 minutes after the stimulus is removed (click for picture). The time course of this reaction (i.e., cold challenge followed by hive formation as the area returns to body temperature) demonstrates that a two-step reaction has occurred in which exposure to cold is a prerequisite, but hive formation actually occurs as the temperature increases.
Chizzola maculae is a very specific skin lesion due to fluoride exposure. The size of a coin, these lesions may resemble small blue bruises or be wholly pink. Doctors George Waldbott and V. A. Cecilioni named the lesions after a town in Italy, where they were common in young women and children.[17] According to Waldbott, chizzola maculae are early symptoms of fluoride intoxication.[18][19]
Benadryl (diphenhydramine) is the most commonly used drug for hives, and is available without a prescription. The main side effect of this drug is drowsiness in some people. Other antihistamines (for example, store brands of any drug for hay fever) will also help. When you give Benadryl, give it 3 to 4 times a day until the hives are gone for 12 hours. Use the dosage given on the product.
i am Harry Wayn i have been with my girlfriend since June 2011 ..I just found out this past month that she is HIV positive I knew he was on med of all kinds wasn’t exactly positive for what though…I finally sat Her down and talked to her and asked her to please tell me what the pills were for…she finally admitted in 95 she was told she was HIV positive …she was afraid to tell me…she has been in the hospital twice near death …that part I knew just didn’t know the why…I love her with all my heart and can’t leave her..but I am scared we have never practiced safe sex the whole time we have been together…I have been tested twice and am HIV free so far …He appears to me to be in denial of her disease..she takes her med because i give them to her each day…I cant leave her i need her he needs me…we never talk about his disease..how can i make things more in the open with him? He has told me if i discuss this with anyone I will have to leave no if and or buts about it…so I haven’t talked with anyone till now about it…also I know I am going to hear leave her immediately and I cant and won’t do that.. but i.just had a good friendly ear who told me how doctor Okhihie help her cure her HIV virus she gave me the email address okhihiespelltemple@gmail.com i really contacted him he told me to get some items which he will use to prepare the herbal medicine, though i could not found those items over here he said i should send him the little money so that he can help me buy the item and proceed with the herbal medicine i was very happy i gladly send him the little money he prepare the herbal medicine and send it to me i gave it to my love she drank it for just three weeks every thing about her was fully okay then we both went to hospital for check up my love was found negative. so i want to use this great privilege to thank doctor Okhihie for my love because me and my love are living happily today.i will advice any body that is passing through such problem to contact him on his email okhihiespelltemple@gmail.com
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.
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.
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.
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.
Angioedema is a reaction similar to hives that affects deeper layers of your skin. It most commonly appears around your eyes, cheeks or lips. Angioedema and hives can occur separately or at the same time.
Biopsy of urticaria can be non-specific and difficult to interpret. The pathology shows oedema in the dermis and dilated blood vessels, with variable mixed inflammatory infiltrate. Vessel-wall damage indicates urticarial vasculitis.
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 is one cause that acute and chronic hives share. You may not feel particularly stressed, but your body may, especially if you are very busy. Keep in mind that life stressors may be either positive or negative. Your approaching wedding day may be as much to blame as trouble at work, for instance.

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The most well tolerated initial treatment are the non-sedating antihistamines like fexofenadine, loratidine, and cetirizine. If these don’t eliminate the hives, a sedating-type of antihistamine (diphenhydramine, hydroxyzine, cyproheptadine or doxepin) is added at night. High doses may be needed and this will cause sedation. Fortunately, most patients will become less affected by sedation after they have taken the drug regularly for a while.
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.
^ Jump up to: a b Zuberbier, Torsten; Grattan, Clive; Maurer, Marcus (2010). Urticaria and Angioedema. Springer Science & Business Media. p. 38. ISBN 9783540790488. Archived from the original on 2016-08-21.
Diet plays a very important role in the treatment of urticaria, especially in the case of a food allergy. The first step in planning your diet for urticaria is to avoid the food that is causing the reaction. If you are unsure as to what food caused your reaction, you would need to make a list of all the foods that you have consumed in the last 24 hours and avoid all of them if possible. Try to recall if your diet in the last 48 hours included foods that you do not usually consume. Take away food, especially Chinese food is often associated with food allergies due to the spices and condiments that are used to prepare them. 
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
If hives are making it difficult to sleep, then it may be necessary to see a physician. This would be especially important if you are taking nonprescription antihistamines. If your hives last longer than two months, it is also likely you will benefit from visiting a physician.
28. Federman DG, Kirsner RS, Moriarty JP, Concato J. The effect of antibiotic therapy for patients infected with Helicobacter pylori who have chronic urticaria. J Am Acad Dermatol. 2003;49:861–4. [PubMed]
Many parents wait to give the antihistamine until new hives have appeared. This means your child will become itchy again. The purpose of the medicine is to keep your child comfortable until the hives go away. Therefore, give the medicine regularly until you are sure the hives are completely gone.
Jump up ^ Sharma, M; Bennett, C; Cohen, SN; Carter, B (14 November 2014). “H1-antihistamines for chronic spontaneous urticaria”. The Cochrane Database of Systematic Reviews (11): CD006137. doi:10.1002/14651858.CD006137.pub2. PMID 25397904.
Vicki Lawrence is no stranger to being quick on her feet and playing off improv lines on stage. But when she was diagnosed with this form of chronic hives without a known cause, she was caught off-guard.
4. Rockwell WJ. Reactions to molds in foods. In: Chiaramonte LT, Schneider AT, Lifshitz F, editors. Food allergy: a practical approach to diagnosis and management. New York: Marcel Dekker; 1988. pp. 153–70.
Angioedema – swelling of tissue beneath the surface of the skin – can be mistaken for or associated with hives. It can be caused by allergic reactions, medications or a hereditary deficiency of some enzymes. The following symptoms may indicate angioedema:
The presence of systemic symptoms could mean the urticarial rash is not ordinary urticaria,” he said, suggesting that Schitzler’s syndrome, adult-onset Still’s disease, an autoinflammatory syndrome, or urticarial dermatitis could be at play.
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.
In many cases, a single attack of hives is due to an infection or virus and these go away within a few days to a few weeks. Some people get repeated attacks that occur as an allergic reaction to a variety of things (foods, most commonly nuts, chocolate, fish, tomatoes, eggs, fresh berries and milk, insect stings, and medications). In this case, they usually break out within a few hours of the exposure. Usually, the patients figure out the cause by themselves, and they never bother coming to a doctor.
Your allergist may want to conduct skin tests, blood tests and urine tests to identify the cause of your hives. If a specific food is the suspected trigger, your allergist may do a skin-prick test or a blood test to confirm the diagnosis; once the trigger is identified, you’ll likely be advised to avoid that food and products made from it. In rare instances, the allergist may recommend an oral food challenge – a carefully monitored test in which you’ll eat a measured amount of the suspected trigger to see if hives develop. If a medication is suspected as the trigger, your allergist can conduct similar tests, and a cautious drug challenge – similar to an oral food challenge, but with medications – may also be needed to confirm the diagnosis. Because of the possibility of anaphylaxis, a life-threatening allergic reaction, these challenge tests should be done only under strict medical supervision, with emergency medication and equipment at hand.
Acute urticaria may develop in relation to a particular stressful event and it is recognized that financial, personal or professional stress may all worsen chronic urticaria. The condition itself may be very debilitating and it reduces quality of life [36].
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]
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].
Acute urticaria may rarely progress to life-threatening angioedema or anaphylactic shock in a very short period, although anaphylactic shock is usually of rapid onset with no urticaria or angioedema. [5] Prehospital measures may include the following when there is concern for anaphylactic shock:
Hives appear when histamine and other compounds are released from cells called mast cells, which are normally found in the skin. Histamine causes fluid to leak from the local blood vessels, leading to swelling in the skin.
urticaria pigmentosa, juvenile urticaria pigmentosa present at birth or in the first few weeks of life, usually disappearing before puberty, taking the form of a single nodule or tumor or of a disseminated eruption of yellowish brown to yellowish red macules, plaques, or bullae.
Antihistamine medications are a mainstay in the treatment of hives, as they block the action of histamine, the chemical responsible for hives. Non-drowsy antihistamines are available over the counter or your doctor may recommend a daily antihistamine so that the cumulative effects of the drug can manage symptoms of allergies, like hives, before they appear. 
When an individual is stressed, his or her body releases hormones such as adrenaline and cortisol. The sudden release of those hormones creates a hormonal imbalance that can cause hives in sensitive individuals.
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)
As far as the physical symptoms, you’ll see red bumps and swelling of the skin. They can develop anywhere on your body and be any size. Some people get breakouts as small as a penny, others get stress hives the size of a dinner plate or larger. Urticaria also has a tendency to spread around your body when you leave it untreated which is why you shouldn’t ignore it.

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Some doctors suggest that medications should be continued for long periods – perhaps even a month after the hives have disappeared. Again, the exception to this is the cortisone/steroid-type medications, which should only be used for short periods initially to quiet down the urticaria. Remember that one must work closely with their doctor to find a medication regimen that suppresses the hives until they resolve on their own.
This corticosteroid is taken orally. You should only use it for a short period of time as directed by your doctor. Corticosteroids can have side effects, especially if taken for extended periods of time. Side effects can include:
The real secret behind stress is the social programming we have gotten since Day 1 of our existence. It’s not your fault. We were raised to go to school and have a job, make a family and have kids and then raise them to do the same. If you fail in one of these steps, you get stressed. You become depressed and anxious whenever you deal with the need for social approval, when you’re about to face a challenge that might change you or change your social status.
Certain soaps may dry your skin and cause more itching when you have hives. Make sure to use a soap that’s marketed for sensitive skin. Find a great selection here. These typically omit fragrance and other irritating chemicals.
The main treatment of all forms of urticaria in adults and in children is with an oral second-generation antihistamine chosen from the list below. If the standard dose (eg 10 mg for cetirizine) is not effective, the dose can be increased up to fourfold (eg 40 mg cetirizine daily). They are stopped when the acute urticaria has settled down. There is not thought to be any benefit from adding a second antihistamine.
Many people have a sensitivity to latex which causes a contact dermatitis. The foods listed in the second table above contain chemicals that are similar enough to those found in latex that eating them can cause an allergic reaction. If you have a latex allergy, cross these foods off your shopping list.
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]
“This subset — about 30 percent of patients who have been diagnosed with idiopathic urticaria — is the group in which we most often look to psychological factors for an explanation,” she says. “Many dermatologists will agree that it is not uncommon to see chronic idiopathic urticaria arising after a major life stressor, or for patients who are most impaired by urticaria to be those with more limited stress management skills.”
If you suffer with allergy symptoms, you know all about the stress of having a chronic condition. Not only is it difficult to breathe with allergy symptoms, but poor sleep can lead to fatigue and problems concentrating. Allergy medicines can cause appetite changes, low energy, and even irritability. All you want is relief: from the stress, the symptoms, all of it.
Fortunately, it’s easy to find out whether cold is one of your triggers: Your doctor can administer a simple test that involves placing an ice cube on your skin for five minutes to see if a reaction occurs. If it turns out that cold is a trigger for you, your doctor will recommend that you protect your skin from the cold and take your medications as prescribed.
papular urticaria (urticaria papulo´sa) an allergic reaction to the bite of various insects, with appearance of lesions that evolve into inflammatory, increasingly hard, red or brownish, persistent papules.
The diseases listed above are rare causes of hives, with the exception of thyroid disease. People with chronic urticaria have a higher incidence of thyroid problems compared to the general population.
Pressure hives produces deep and painful local swelling. The swelling can occur immediately or several hours later. This type of urticaria can be triggered by prolonged sitting. It is also triggered but the wearing of tight clothing and consequently is seen in areas such as the waist/belt line, under elastic bands such as panties, socks or wristbands. Choosing appropriate clothing and/or taking regular breaks from sitting, usually controls pressure urticaria. If medication is needed, steroids are usually administered for a short time.
Your provider may suggest that you take an antihistamine such as diphenhydramine (Benadryl) or cetirizine (Zyrtec). Follow your provider’s instructions or the package instructions about how to take the medicine.
Evidence of systemic autoimmune disease, including hypothyroidism or hyperthyroidism (autoimmune thyroiditis); hepatitis, renal failure, and polyarthritis (cryoglobulinemia); malar rash, serositis, and polyarthritis (SLE); dry eyes and dry mouth (Sjögren syndrome); cutaneous ulcers or hypopigmented lesions after resolution of urticaria (urticarial vasculitis)
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.
Angioedema is similar to hives,[34] but in angioedema, the swelling occurs in a lower layer of the dermis than in hives,[35] as well as in the subcutis. This swelling can occur around the mouth, eyes, in the throat, in the abdomen, or in other locations. Hives and angioedema sometimes occur together in response to an allergen, and is a concern in severe cases, as angioedema of the throat can be fatal.
The pathophysiology of urticarial vasculitis is similar to other forms of cutaneous small vessel leukocytoclastic vasculitis. Urticarial vasculitis is a type III hypersensitivity reaction in which antigen-antibody complexes are deposited in the vascular lumina. This reaction results in complement activation and chemotaxis of neutrophils. These cells release various proteolytic enzymes, such as collagenase and elastase, resulting in damage to the vascular lumina. Some authors have speculated that eosinophils may be involved in the early stages of the vasculitic lesions. Patients with hypocomplementemic urticarial vasculitis are more likely to show autoantibodies to C1q and vascular endothelial cells.[6, 7] The presence of antineutrophilic cytoplasmic antibodies is rare. Many patients ultimately prove to have SLE. Other etiologies include drug reactions and parasitic infections.[8]
One proposal to explain this phenomenon is that patients have an IgE autoantibody to a cold-induced skin antigen. Passive transfer (PK-testing) has been reported. Thus, sensitization might occur in the cold, and release of mediators proceeds as the cells warm. Studies to test this hypothesis have thus far been negative. High levels of IgM and IgG antibodies directed against the Fc portion of IgE have been found in patients with cold urticaria, although the clinical significance of such autoantibodies is questionable.
We thank Dr Helen Griffiths (Royal Surrey County Hospital, Egerton Road, Guildford, Surrey, UK) for the use of Fig. 1, and Dr M. Yousuf Karim (Frimley Park Hospital, Portsmouth Road, Frimley, Camberley, Surrey, UK) for the use of Fig. 3.
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.
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When a person has had hives for over six weeks, they are 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.
Arora A, Wetter DA, Gonzalez-Santiago TM, Davis MD, Lohse CM. Incidence of leukocytoclastic vasculitis, 1996 to 2010: a population-based study in Olmsted County, Minnesota. Mayo Clin Proc. 2014 Nov. 89 (11):1515-24. [View Abstract]
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.
urticaria pigmento´sa  the most common form of mastocytosis, characterized by small, reddish brown macules or papules that occur mainly on the trunk and tend to urtication upon mild mechanical trauma or chemical irritation.
Darius Mehregan, MD, Associate Professor, Hermann Pinkus Chairman of Dermatology, Department of Dermatology, Wayne State University School of Medicine; Clinical Associate Professor of Pathology, University of Toledo College of Medicine; Dermatopathologist, Pinkus Dermatopathology Laboratory; Consulting Staff, Department of Dermatology, J Dingell Veterans Affairs Medical Center
A drug used for psoriasis and kidney transplants, cyclosporin, is almost always effective in clearing even the most severe cases of chronic hives at low doses. However, it causes significant side effects if taken for a long time.
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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 a doctor should be consulted.
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.

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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.
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.
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Urticaria may be classified on the basis of underlying aetiology (see Table 1) or by a clinical classification. In most cases of chronic urticaria it will not be possible to identify the underlying cause, i.e. the rash is idiopathic; however, when seeing a patient, it is helpful to use a clinical classification, as this guides history-taking and ensures that in any one individual all possible triggers for the urticaria are identified. In some patients several factors may cause/worsen the rash.
If non-sedating antihistamines are not effective, a 4 to 5-day course of oral prednisone (prednisolone) may be warranted in severe acute urticaria, particularly if there is angioedema. Systemic steroids do not speed up resolution of symptoms.
Hives usually cause itching, but may also burn or sting. They can appear anywhere on the body, including the face, lips, tongue, throat, or ears. Hives vary in size (from a pencil eraser to a dinner plate), and may join together to form larger areas known as plaques. They can last for hours, or up to one day before fading.
Check CH50, C3, C4, Clq, and antibodies to Clq in urticarial vasculitis patients. If these test results are positive, evaluate renal function and urinalysis to check for the effects of vasculitis on the kidneys.
42. Sabroe RA, Grattan CE, Francis DM, Barr RM, Kobza BA, Greaves MW. The autologous serum skin test: a screening test for autoantibodies in chronic idiopathic urticaria. Br J Dermatol. 1999;140:446–52. [PubMed]
Hormonal causes via endocrine tumors or ovarian pathology are rare. Oral contraceptive use or changes in the menstrual cycle have been reported as a possible cause of urticaria: patients commonly report worsening of hives with the menstrual cycle. This may be hormonally mediated, and the cyclical use of analgesics should also be considered as a possible etiology.
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.
Acute viral illnesses in children can be associated with urticarial eruptions which last a few weeks and then spontaneously subside. This typically accompanies symptoms of viral rhinitis, pharyngitis, or bronchitis. When such patients are given an antibiotic, the cause of the hives becomes less clear because a drug reaction becomes an alternative possibility. If penicillin or related antibiotics have been given it is worth performing skin testing for penicillin and/or cephalosporin allergy, rather than making an unsubstantiated assumption that the child is “penicillin allergic.” Hepatitis B, infectious mononucleosis (EB virus) and a large number of helminthic parasites may be associated with hives all age groups.
Hives Dermatology A condition characterized by pruritic raised red welts on the skin, associated with allergic reactions and histamine release or defects in the complement or kinin systems Risk factors Prior allergic reactions–eg, hay fever and angioedema Triggers Medications; foods–eg, berries, shellfish, fish, nuts, eggs, milk; pollen; animal dander–especially cats; insect bites; mechanical stimulants–eg, water, sunlight, cold or heat; emotional stress; post-infection; linked to other disease–eg, autoimmune diseases SLE, leukemia, etc; may be partially hereditary, dermographism, cold urticaria, echinococcus infection–dog tapeworm, hereditary angioedema, Henoch-Scho¨nlein purpura, mononucleosis, hepatitis, mastocytosis
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]
Acute – if it develops suddenly and lasts less than six weeks. Most cases last 24-48 hours. In some cases the rash only lasts a few hours. About 1 in 6 people will have at least one bout of hives in their lives. It can affect anyone at any age. Some people have recurring bouts of acute hives.
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]
If a specific urticarial trigger can be found, then avoiding that trigger is the most sensible course of action, but most often no underlying cause is ever found.  The main focus of treatment is trying to alleviate symptoms while the urticaria slowly “burns” itself out and eventually clears – a process that may take many months or even some years.
If hives occur with swelling of the tongue or throat, difficulty breathing or low blood pressure, anaphylaxis should be suspected. Urgent administration of adrenaline and medical assessment is required. Information about anaphylaxis is available on the ASCIA website www.allergy.org.au/anaphylaxis
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.
There is just not enough evidence to support using antihistamines and playing roulette with your patient’s health,” he said, noting that the degree of disability, both socially and occupationally, that accompanies chronic urticaria is on par with that of a patient awaiting triple coronary bypass.
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.
“My hope is that we will be able to move towards a more integrated approach to treating patients which incorporates attention to the multifactorial nature of so many dermatologic conditions, both in their etiology as well as the experience of living with these conditions, whether it is chronic urticaria, psoriasis, acne or delusions of parasitosis,” she says.
Biopsy of urticaria can be non-specific and difficult to interpret. The pathology shows oedema in the dermis and dilated blood vessels, with variable mixed inflammatory infiltrate. Vessel-wall damage indicates urticarial vasculitis.
Aloe vera gel can also be applied over the affected area to reduce inflammation. Aloe vera gel is know to have a cooling effect and this will help provide relief, especially if you have the urge to scratch the inflamed area.
Making a paste of baking soda and water can help to calm hives and also prevent new ones from popping up. Baking soda is known as nahcolite, which is part of the natural mineral natron. Natron contains large amounts of sodium bicarbonate. It has been used since ancient times as a soother and cleanser. Mix a teaspoon of baking soda with some cold water to create a paste and then rub it on the affected area. Let it dry completely before washing it off. You can do this a few times a day, if needed. Relief is typically immediate from this easy hives treatment.
If you have chronic hives, or urticaria, you probably already know that when you are under stress, your symptoms either appear or worsen. Doctors have increasingly looked to study the relationship between emotional stress and skin conditions. One study, which appeared in Dermatology Times, examined the relationship between stress and chronic hives. Josie Howard, M.D., a psychiatrist in private practice and clinical instructor of psychiatry and dermatology at the University of California, stated that, “external stressors plus cognitive, behavioral and social stressors have been shown to play a significant role in the intensity of itch.” She also explains that it is not unusual for hives to appear after a major life stressor and that those with chronic hives have “limited stress management skills.”
Mallory Shiver, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, Arkansas Foundation for Skin Cancer, Christian Medical and Dental Associations
a vascular reaction of the skin that is commonly immunologically based or may be due to direct exposure to a chemical. Marked by transient appearance of slightly elevated patches (wheals) which are redder or paler than the surrounding skin and often attended by severe itching; called also hives. The wheals may be in very large numbers, mostly over the body, 0.5 to 2 inches in diameter and there is no discontinuity of the epithelium. Called also nettle rash.
Sulfone antibiotics are used for infectious diseases (eg, leprosy); however, sulfones are effective in inflammatory diseases. The mechanism of action may involve inhibiting free radical formation by neutrophils. In most case reports, these medications are effective only in purely cutaneous forms of urticarial vasculitis.
You can also buy ointment and sprays like OxyHives and Gold Bond Anti-Itch Cream to help with the itching and burning. You can get both of these without a prescription.Try to avoid wearing tight clothing on the affected area because it can cause further irritation. So if you get outbreaks on your legs, skip the skinny jeans.
Chronic cases are much more likely to be related to autoimmune causes than allergies. In the autoimmune form of urticaria and angioedema, a person makes antibodies against a component of their mast cells, triggering the release of histamine and causing symptoms.