Description

Urticaria — also known as urticaria (ur-tih-KAR-e-uh) — is a skin reaction that causes itchy welts, which vary in size from small spots to large blotches. Hives can be caused by many situations and substances, including certain foods and medicines.

Angioedema can occur with hives or alone. This causes swelling in the deeper layers of the skin, often around your face and lips. Short-term (acute) urticaria and angioedema are common. Most of the times, are harmless, of course within a day and don't leave any lasting marks, even without treatment. Hives lasting more than six weeks is called chronic urticaria.

Urticaria and angioedema are usually treated with antihistamine medication. Angioedema can be life-threatening if the swelling of the tongue or in the throat blocks the airway.

Symptoms

The hives

The welts associated with urticaria can be:

  • The color of the skin, red skin, white, or purple on black and brown skin
  • The itching, ranging from mild to severe
  • Round, oval or worm-shaped
  • As small as a pea or as large as a dinner plate

Most of the welts quickly appear and disappear within 24 hours. This is known as urticaria acute. Chronic hives can last for months or years.

Angioedema

Angioedema is a reaction that is similar to hives that affects the deeper layers of the skin. May appear with hives, or alone. Signs and symptoms include:

  • Welts that form in a matter of minutes to hours
  • Swelling, especially around the eyes, cheeks or lips
  • Mild pain and heat in the affected areas

When to see a doctor

Usually, you can treat mild cases of hives or angioedema at home. Consult your health care professional if your symptoms continue for more than a few days.

If you think that your hives or angioedema was caused by a food allergy or a medication, the symptoms may be an early sign of an anaphylactic reaction. Seek emergency medical attention if you feel your tongue, lips, mouth, or throat swelling, or if you are having trouble breathing.

Causes

To the majority of people who suffer from acute urticaria and angioedema, the exact cause cannot be identified. The conditions are sometimes caused by:

  • Food. Many foods can cause reactions in people with sensitivities. Shellfish, fish, peanuts, nuts, soy, eggs and milk are frequent offenders.
  • Drugs. Many medications can cause urticaria or angioedema, such as penicillin, aspirin, ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve), and blood pressure medications.
  • Allergens in the air. Pollen and other allergens that are inhaled can cause hives, sometimes accompanied by the upper and lower respiratory tract symptoms.
  • Insect bites and infections. Other causes of acute urticaria and angioedema are the bites of insects and infections.

Risk factors

Urticaria and angioedema are common. You may be at increased risk of urticaria and angioedema if:

  • Have had hives or angioedema before
  • You have had allergic reactions
  • Have a family history of urticaria, angioedema or angioedema

Complications

Serious angioedema can be life-threatening if the swelling of the tongue or in the throat blocks the airway.

Prevention

To reduce your chance of suffering from urticaria or angioedema, take the following precautions:

  • Avoid known triggers. If you know what has triggered the hives, try to avoid the substance.
  • Take a bath and change your clothes. If the pollen, or contact with animals, has triggered the hives in the past, taking a bath or a shower and change of clothes if you are exposed to pollen or animals.

Diagnosis

For the diagnosis of urticaria or angioedema, your doctor will probably watch your hives or areas of inflammation and ask about your medical history. You may also need blood tests or allergy skin test.

Treatment

If your symptoms are mild, you may not need treatment. Hives and angioedema often go away on their own. But the treatment can offer a relief from the intense itching, severe discomfort or symptoms persist.

Drugs

Treatments for urticaria and angioedema may include prescription drugs:

  • Anti-itch drugs. The standard treatment for hives and angioedema is antihistamines that won't make you drowsy. These medications reduce the itching, swelling and other allergy symptoms. They are available in nonprescription and prescription formulations.
  • Medications that suppress the immune system. If antihistamines are not effective, your doctor may prescribe a medication that can calm an overactive immune system.
  • Drugs for hereditary angioedema. If you have the type of angioedema that runs in families, you can take medicines to relieve the symptoms and maintain the levels of certain proteins in the blood at levels that do not cause symptoms.
  • Anti-inflammatory medications. For severe cases of hives or angioedema, doctors may prescribe a short course of oral corticosteroid drugs such as prednisone — to reduce swelling, inflammation and itching.

Emergency situations

For a severe attack of hives or angioedema, you may need a trip to the emergency room and an emergency injection of epinephrine — a type of adrenaline. If you have had a severe attack, or their repeated attacks, despite treatment, your doctor may have you take a penlike device that will allow you to self-inject epinephrine in emergency situations.

Lifestyle and home remedies

If you are experiencing a mild urticaria or angioedema, these tips may help relieve your symptoms:

  • To avoid the triggers. These may include food, medication, pollen, pet dander, latex and insect stings. If you think that a medicine has caused your rash, discontinue use and contact your primary care provider. Some studies suggest that stress or fatigue can cause hives.
  • The use of an anti-itching of medicines available without a prescription. Over-the-counter oral antihistamine such as loratadine (Alavert, Claritin, and others), cetirizine (Zyrtec Allergy, others) or diphenhydramine (Benadryl Allergy, others) may help relieve the itching. Consider whether you might prefer a type that does not cause drowsiness. Ask your pharmacist about the options.
  • Apply cold. Cover the affected area with a cold washcloth or rub an ice cube on it for a couple of minutes can help to soothe the skin and prevent scratching.
  • Take a comfortable bath of cold water. Find relief from the itching in a cold shower or a bath. Some people may also benefit from a bath in cool water sprinkled with baking soda or oatmeal powder (Aveeno, others), but this is not a solution for long-term control of chronic itching.
  • Wear, smooth-textured cotton clothing. Avoid wearing rough clothing, tight, scratchy or wool.
  • Protect your skin from the sun. Apply sunscreen generously over a half an hour before going outdoors. When you are outdoors, seek shade to help relieve the discomfort.

Preparing for your appointment

It is likely to start by seeing your primary care physician. In some cases, when you call to schedule an appointment, you may be referred immediately to a specialist in skin diseases (dermatologist) or a specialist in allergies.

What you can do

Here are some tips to help you prepare for your appointment.

  • List of signs and symptoms, when they occurred, and how long they lasted.
  • List of all the medications you are taking, including vitamins, herbs, and supplements. Better yet, take the original bottles, and a list of the dose and directions.
  • List of questions to ask your doctor.

For urticaria and angioedema, questions to ask include:

  • What is likely causing my symptoms?
  • Do I need any tests to confirm the diagnosis?
  • What are other possible causes of the symptoms?
  • Is my condition likely temporary or chronic?
  • What is the best course of action?
  • What are the alternatives to the primary approach you're suggesting?
  • Do I need prescription medication, or can I use over the counter medications to treat the disease?
  • What results can I expect?
  • Can't wait to see if the condition goes away on its own?

What to expect from your doctor

Your doctor may ask you a series of questions, such as:

  • When did you first begin experiencing symptoms?
  • What made his reaction in the skin to look like when it appeared for the first time?
  • The symptoms changed over time?
  • Have you noticed anything that makes your symptoms worse or better?
  • Make your injuries in the skin, primarily itch or burn or sting?
  • The skin lesions disappear completely, without leaving a bruise or a mark?
  • Do you have any known allergies?
  • Have you ever had a similar reaction of the skin before?
  • Have you tried a new food for the first time, changed the cleaning products or adopting a new pet?
  • What prescription drugs, over the counter medications and supplements you are taking?
  • Have you started taking any new medication or start a new course of medication that you have taken before?
  • Has your health in general changed recently? Have you had a fever or have lost weight?
  • Has anyone else in your family ever had this type of reaction in the skin? What other family members have any known allergies?
  • What at-home treatments have you used?
Symptoms and treatment of Urticaria and angioedema