Itching, stinging, and burning is what most people with hives complain about. These blotchy patches of red elevated skin can be intensely uncomfortable, interfering with school or work, and can even keep a person from sleeping.Few doctors are surprised by the misery experienced by patients with hives. Although the condition is usually not life-threatening, it is not unusual for people with hives to end up exhausted and desperate for relief from the intense, persistent itching. It may be a small consolation, however, to realize that hives affect many people sometime in their lives—15 to 20 percent is the estimate.
Hives Move Around
The medical term for hives is urticaria, and it can be caused by a number of factors. Whatever the cause, the condition widens blood vessels in the skin so that they leak fluid into the surrounding areas. This leads to the formation of red, elevated, bumps or wheals, often with a clear center and a flat top. The color of these wheals can vary from light pink to dark red, and their size can range from a fraction of an inch to several inches. These wheals are generally circular, although unusual patterns sometimes develop. A wheal that has enlarged and spread outwards is known as a plaque.
Hives are well known to appear, change shape, disappear, and reappear in another location in a matter of minutes. This has been demonstrated by tracing the outline of a hive with a pen and watching what happens to it over time. Characteristically, the original hives disappear and new hives appear in another place on the skin. Emotions are known to play a large role in the onset of hives because outbreaks are frequently associated with a stressful experience.
Although hives are quite distressing, an outbreak is not life-threatening unless it develops quickly in association with a severe allergic reaction known as anaphylaxis. When that happens, there may be swelling of the tongue or throat and you should see a physician immediately for treatment. Also, a physician should be consulted if hive plaques persist in one area for more than 24 hours.
Hives most often occur on the body trunk, although the palms of the hands and soles of the feet are frequently affected. An outbreak of hives may be an acute (last six weeks or less) or chronic (longer-lasting). Acute outbreaks are most often caused by medications, less often by a food, and even less often by something that has been inhaled. In the summer months, insect bites become a common cause. Penicillins, sulfonamides, aspirin, and non-steroidal anti-inflammatory agents are well-known medication offenders. When consulting a physician, be sure to provide a listing of all medications you take, including over-the-counter products and food supplements. Foods, such as chocolate, shellfish, nuts, peanut butter, citrus fruits, berries, cheese, tomatoes, garlic, onion and spices, often cause hives. Food additives such as yeast, MSG, tartrazine, azo dyes and benzoic acid derivatives can be the culprit in both acute and chronic conditions.
Allergies develop after repeated exposure, and you should not be surprised if a food that has never caused a problem before suddenly gives you hives. Also, if you have asthma or allergies, you are more likely to have an outbreak of hives. After the cause has been determined, your body can eliminate the offender, but in the meantime your physician will probably prescribe regular doses of antihistamines. Cool soaks of the itchy areas will help. Dip a thin material (such as a pillowcase) into ice water, apply to the affected areas, and allow the moisture to evaporate. Try to stay as cool as possible because heat will makes hives worse.
When hives are chronic (last longer than six weeks), the search for the cause can be frustrating. Your doctor will try to determine if you have an infection somewhere in your body, possibly in your throat, teeth, sinuses, chest, ears, or joints, and will also check to see if you may have gallbladder disease. He or she will also want to know if you have been experiencing chronic fatigue or unintended weight loss. Less often, hives can be caused by physical factors, such as pressure from sitting or standing for long periods or from wearing tight clothes. Exercise, exposure to cold, heat, or sun can also be responsible.
Treatment for Relief
Treatment of hives is aimed at stopping the reaction that brings on the outbreak. The typical outbreak involves an allergic reaction in your body that results in the release of histamine near the skin. The first-generation antihistamines, such as Benadryl or Atarax, help the skin reaction but cause drowsiness and dryness of the mouth. Topical application of calamine usually does not help hives, but topical corticosteroids prescribed by your doctor can decrease the itching and inflammation.
Newer, second-generation antihistamines do not usually cause sleepiness or dryness but can cause abnormal heart rhythm when taken together with certain other medications, including the antibiotic, erythromycin, and medications that treats fungal infections. Claritin is a newly available antihistamine, taken only once a day, that acts very fast, stopping itching in one to three hours. Claritin can be safely taken with most medications without the risk of heart rhythm abnormalities. With the treatments available today, your physician can do much to relieve the misery of hives while the search for identifying and eliminating the underlying cause is taking place.