HIVES

(Urticaria; Giant Urticaria)

 Basic information

description

Hives is an allergic reaction that involves the skin. Hives may occur anywhere on the body, but the arms, legs, and trunk are most often affected. Urticaria is the medical name for hives. Hives are very common and can affect any age group.

FREQUENT SIGNS & SYMPTOMS

• Raised, irregular, red areas on the skin. They may be referred to as wheals or welts. They usually itch, but they may also burn or sting. The size may range from small spots to the size of a dinner plate. They can sometimes cause the whole lip or eyelid to swell.
• Wheals can join together quickly and form large, flat plaques. These are raised, skin-colored areas.
• Wheals and plaques change shape, go away, and come back in minutes or hours.

causes

Release of histamines. These are chemicals in the cells of the human body that are released during an allergic reaction. They may be released due to a specific reaction or in some cases for unknown reasons.

risk increases with

• Drugs. Nearly all drugs cause hives in some persons.
• Insect bites; viral infections; some chronic medical disorders.
• Exposure to cold, heat, water, or sunlight.
• Exposure to animals, especially cats.
• Eating eggs, fruits, nuts, and shellfish. Other foods sometimes cause hives in infants but not in adults.
• Food dyes and preservatives (possibly).
• Infection (bacterial, viral, fungal).
• Cancer, especially leukemia.
• Other factors include: physical and emotional stress, other allergies, or a family history of allergies.

PREVENTIVE MEASURES

• There are no specific preventive measures to stop the first outbreak of hives. Once you have had hives and know the cause, you need to avoid it in the future.
• Your health care provider may advise you to keep an emergency kit handy if you have had severe reactions.

expected outcomes

Hives usually clear up within hours or days (even if the cause is unknown). They can be uncomfortable, but normally they cause no complications. A few cases become chronic and may last for weeks.

possible complications

• Other allergic reactions may occur with hives:
  • Angioedema (face, throat, and tongue swelling).
  • Anaphylaxis (severe reaction that causes shock and difficulty in breathing).

 diagnosis & treatment

general measures

• Most persons will treat hives at home. Try to identify the cause of the hives. See your health care provider if the hives are more severe or cause concern. Your health care provider will do a physical exam of the affected skin. Questions will be asked to help identify the cause. Medical tests are usually not needed.
• Treatment usually involves antihistamines, stopping the cause of the hives when known (such as a drug, cosmetic, or soap), and self-care measures. If the reaction is severe, hospital care may be needed.
• Don't wear tight underwear or foundation garments. Any skin irritation may trigger new outbreaks.
• Don't take hot baths or showers.
• Apply cold-water compresses or soaks.
• Try to relax and not become over-stressed.

medications

• Use nonprescription antihistamines for the itching.
• Prescription antihistamines, steroids, or other drugs to relieve itching and rash may be prescribed.
• Epinephrine by injection for severe symptoms.

activity

Decrease activities until several days after hives disappear. Avoid getting hot, sweaty, or overly excited.

diet

• If foods are suspected as a cause, keep a food diary to help identify the offending food.
• Avoid alcohol and coffee (or other caffeine-containing drinks) if they appear to trigger outbreaks.

 notify our office if

• You or a family member has hives that aren't helped by self-care or last for more than 2 days.
• The following occur during an episode of hives:
  • Swollen lips, tongue, or face.
  • Shortness of breath or wheezing.
  • Stomach pain, vomiting, or diarrhea.
  • Any feeling of weakness or faintness.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.

Special Notes: