Symptoms, Diagnosis, and Treatment for Hives
Maybe you’re a dog person but you’re allergic to dogs. Maybe you love to garden but have a horrid pollen allergy. Or maybe every once in a while your body just decides to erupt in itchy, raised spots.
Either way, you are one of the many people who are no stranger to hives.
Hives are uncomfortable, and while they’re not incredibly unsightly, it can be embarrassing to constantly have to explain the red patch forming on your face or neck.
If you experience hives and are looking for answers, this article outlines the symptoms, diagnosis, and treatment for hives.
Table of Contents
What Are Hives?
Urticaria, the medical term for hives, is a skin rash triggered by an allergic reaction or other factors. Hives generally resolve within 2 to 3 hours, but may sometimes take 24 hours until you feel full relief after they occur.
Cases of multiple appearances of hives may be classified as:
- Chronic urticaria: Constant rashes of hives occurring for more than six weeks.
- Acute urticaria: A sporadic, persisting rash of hives clearing within six weeks (most cases last 24 to 48 hours. or less)
About 1 in 5 people will experience hives in their lifetime, making it a fairly common skin condition. Chronic urticaria is much rarer, affecting 1.4% of the world’s population.
Groups who are commonly affected by hives include:
- Children
- Women ages 30 to 60
- People who have allergies
What Are the Symptoms of Hives?
Raised, Red or Skin-Colored Welts
The most notable symptom of hives is their appearance. Oftentimes, hives form as a patch of raised bumps or patches in various shapes and sizes. These welts are sometimes referred to as wheals and may start as one localized area of the body before spreading to others.
Hives can look red or pink on someone with white or lighter skin. On a person with melanated skin, hives may not have any color and may appear as a raised skin-colored rash.
Itching or Burning
Itching often accompanies hives. Though the severity of the itchiness may vary from case to case, the itching and burning caused by hives can be an uncomfortable and inconvenient symptom.
Some people report that their hives burn or sting rather than itch. Due to inflammation caused by hives, the affected skin will often feel hot to the touch.
Skin issues can be uncomfortable, frustrating, and disruptive. Don’t settle for living with skin-related ailments. The professionals at Goodskin Dermatology are ready to assist you with identifying skin issues like hives so that you can live your life confidently and comfortably.
What Causes Hives?
Hives develop when white blood cells such as mast cells and basophils release histamine into the body into small blood vessels (capillaries). The capillaries expand and fluid oozes into the surrounding tissues causing a welt to form. Histamine also acts on the sensory nerves that perceive pain, which is what researchers believe causes burning and itching.
The brain instructs the cells to release histamine and the histamine signals antibodies to rid the body of foreign substances like antigens (allergens) and pathogens (like viruses and bacteria.) Think of histamines as a sort of dispatcher that labels antigens and pathogens as unwelcome visitors. Antibodies then spot them and kick them out, sort of like security guards at a club.
Environmental factors like stress may also cause hives to appear.
Allergens
If you have allergies, you are likely very familiar with hives caused by allergens like:
- Animal dander
- Food
- Insect bites
- Medications
- Pollen
Fun fact: if you’re allergic to cats, you may be surprised to find out your feline allergies may actually be caused by an enzyme in their spit instead of their dander.
Hives caused by allergies are usually a case of mistaken identity. It starts when the immune system wrongly identifies an allergen as a dangerous substance. In response, histamine is released to mark the allergen as dangerous so that the antibodies know to attack it.
If we’re using the security guard/club analogy, it’s like the immune system tells the white blood cells to label any patron wearing the color green as a threat. So when a patron (allergen) comes in wearing aqua, the immune system calls in security (antibodies and antigens) to remove them because it thinks they’re wearing green.
Illness
Contrary to public perceptions, illness is one of the most common triggers for widespread hives (patches of hives that affect larger areas of the body.).
However, this generally should be no cause to worry if you are experiencing hives. Even something as mild as a common cold might cause a case of acute urticaria.
Hives may sometimes form as your immune system fights off invading viral and bacterial infections. Respiratory infections and viruses, like bronchitis and bronchiolitis, are considered as the most related triggers of hives in all age groups and populations (roughly 40% of adults and 60% of children.) Plenty of seemingly unrelated ailments like gastrointestinal and urinary tract infections can also cause hives.
Chronic hives may sometimes be associated with autoimmune diseases, such as:
- Diabetes
- Lupus
- Celiac disease
- Hyperthyroidism and hypothyroidism
Most cases of hives are acute and when caused by a viral or bacterial infection, will go away after the illness is treated and resolved.
Emotional Stress
It isn’t uncommon that stress can trigger skin issues or exacerbate current skin conditions.
Stress can cause hormones like cortisol to increase the number of immune cells (white blood cells) in the body. This causes the immune system to be more reactive and sometimes attack itself resulting in hives.
Do you have a rash that you suspect may be hives or something else? Are you experiencing changes in your life that may be triggering unwelcome skin conditions like acne, hives, or rashes?
Acne and rashes like hives can be frustrating to deal with when you’re already having a tough time. At Goodskin Dermatology, we lead our practice with high-quality care and compassion at the forefront.
We can help you identify skin conditions, identify certain triggers like hormones or allergens, and come up with a solution. You don’t have to dismiss stress-related skin conditions as a result of life obstacles. Let our skin and healthcare professionals help you resolve your skin ailments and come up with the right treatment plan for you.
How Are Hives Diagnosed?
Hives are usually diagnosed through examination. A general practitioner or dermatologist will look at your rash and ask you questions like:
- When did the rash first appear?
- How long does the rash last?
- Does the rash continually come back?
- Are there any triggers that may be related to the rash’s appearance?
If your hives continually appear and persist, you may be referred to an allergist for allergy testing.
How Are Hives Treated?
Hive treatments may vary depending on the individual patient and what triggers their hives.
Allergy-related hives may be reduced by avoiding the trigger or taking allergy medication. Hives caused by illness will typically go away once your immune system clears your body from the virus or infection.
If your hives are a symptom of chronic illness or disease, your doctor may supplement your treatment plan with a medication or therapy that reduces them.
Antihistamines
Antihistamines, either over the counter or prescribed, are frequently recommended as a hives treatment.
Allergy medication, like antihistamines, effectively block histamine from being released and causing the skin to welt. Antihistamines like Diphenhydramine (Benadryl, Nytol, Banophen, etc.) may cause drowsiness.
Certain antihistamines that may cause drowsiness in some people, but are generally labeled non-drowsy include:
- Cetirizine (Zyrtec)
- Desloratadine (Clarinex)
- Fexofenadine (Allegra, Wal-fex, Aller-ease)
- Levocetirizine (Xyzal)
- Loratadine (Claritin)
Antihistamines are an effective and long-lasting hives treatment that also help treat other uncomfortable symptoms caused by allergens.
Topical Analgesic Creams
Topical anti-itch analgesic creams can be used to help reduce itching. It may be a good hives treatment for individuals who would not like to take allergy medicine every day to treat the rare or occasional cases of hives.
Certain anti-itch creams may contain diphenhydramine. Some healthcare professionals do not recommend mixing it with other antihistamines or diphenhydramine products. So be sure to avoid mixing topical, anti-itch creams with allergy medication.
Corticosteroids
Treatment for severe hives may call for the use of a corticosteroid such as prednisone or other steroid tablets.. Generally, a high dose of antihistamines may be prescribed before trying other treatments like corticosteroids. It’s only when the antihistamines aren’t effective that steroids will be prescribed.
Hydrocortisone cream is a topical corticosteroid that is available over the counter and can also be used to reduce the itch associated with hives.
Immune Modulator
Chronic urticaria caused by autoimmune diseases may need immune modulators to supplement their current treatment plan and reduce symptoms such as hives.
For severe cases of hives caused by immune-related diseases, antihistamines and corticosteroid therapy will be used before an immune modulator like cyclosporine is tried.
Cyclosporine may help reduce chronic hives in immunocompromised patients by downregulating the antibodies that attack the tissue and cause hives.
Goodskin Dermatology Provides High-Quality, Patient-Based Care for Hives
If you are experiencing hives, don’t panic.
The professionals at Goodskin Dermatology can help you quickly resolve your urticaria-related issues with a treatment for hives that will suit you and your lifestyle. Whether your hives are caused by allergies, stress, illness, or an autoimmune disorder, you should not have to live with the discomfort caused by them.
Our patient-centered approach to care and treatment for hives will help you take your life back from the frustration and irritation caused by skin issues. We can help you find relief from hives at any one of our Goodskin locations in Oregon.
Schedule an appointment with us to begin your hives treatment today.
The content in this blog should not be used in place of direct medical advice/treatment and is solely for informational purposes.