What are hives?

Hives (medically known as urticaria) are red, itchy, raised bumps or wheals that can appear on any part of the skin. They can be pea sized like mosquito bites or join to cover broad areas of the body. In most cases, hives are not due to an allergy. Angioedema is deeper swelling of tissue beneath the surface of the skin. It sometimes occurs with hives.

How do hives occur?

Acute hives usually go away spontaneously within six weeks. Causes may include:

• Infection (especially viral)
• Spontaneous (no trigger/cause)
• Contact allergy to plants, animals and chemicals
• Allergic reactions to food or drugs

Chronic hives recur or persist continuously beyond six weeks, often almost daily for months to years. Most of the time, the cause cannot be identified. This condition is called chronic spontaneous urticaria (occurring naturally without trigger).

Physical stimuli like scratching, pressure, cold, heat, physical exercises, sun exposure or stress may aggravate the hives.

Symptoms include:

• Swelling around the eyes or mouth
• Swelling of the face, hands, feet, throat or genitals
  

Causes of angioedema associated with hives are similar to those causing hives.

Although hives and angioedema can be uncomfortable and cosmetically embarrassing, they are not harmful.

Rarely, angioedema (in the absence of hives) can be associated with breathing difficulty or severe stomach cramps. This may be related to a rare genetic condition and requires immediate medical attention.

Management of hives

• Eliminate or avoid identifiable triggers. 
• Non-sedating antihistamines are prescribed to manage hives and to reduce itch.

A higher dose of antihistamine or a combination of medications for a prolonged course may be needed for chronic hives. Tests are seldom necessary.

Majority of patients with chronic hives will clear between one to five years. A very small number may experience these hives for more than 20 years. About half will have another episode of chronic hives in their lifetime.

See your allergist/dermatologist

Whenever you have an unusual rash, please consult your doctor to determine if any underlying disease is present. Most importantly, your physician and other healthcare providers can offer a support system and assist you in managing your skin condition.