Hives (Urticaria)

HIVES (urticaria) is a medical condition, in which a skin reaction is characterized by pale or reddened small swellings (wheals). A condition called angioedema, which involves larger region and dipper tissues beneath the person’s skin is related to and sometimes coexists with hives. Angioedema and hives are anaphylactic-type reactions that are limited to underlying tissues and skin. Hives and angioedema may be caused by allergens or other agents, or their causes can be unknown.

Common allergens include drugs, fruits, insect stings, nuts, shellfish, eggs, and allergy shots. In some cases, hives start abruptly after people have eaten even an extremely tiny food amount. Sometimes, hives appear only after eating large food amount (for instance, strawberries). Hives also may be caused by German measles, infectious mononucleosis, and viral infections, such as hepatitis. Hives that repeat over months or weeks are freqently hard to explain; the true cause may never be discovered. Hives

Hives are rarely caused by allergy, although, drugs, unwitting prolonged food additive use, and other chemical factors can be responsible; for instance: dyes, preservatives and other food additives; certain nonprescription drugs; and penicillin minute traces in milk (used by farmers to treat cow infection). Hives also may be resulted from psychologic problems, but they are rarely identified.

Specific medications including aspirin can aggravate hive symptoms. An individual with hives due to aspirin, can similary react to other anti-inflammatory medications including Ibuprofen or to yellow dye , called tartrazine used to color some  drugs and foods. Angioedema that repeats with no ordinary hives symptom usually itches, promptly followed by wheals-slightly elevated, smooth regions that are paler or redder than the surrounding skin and commonly remain small (fewer than half inch across). When the wheal is larger (up to eight inches across), the central regions can be clear, producing rings.

Usually, hives crops come and go; 1 spot can persist for few hours, then disappear, only reappearing in another body areas. In angioedema, the swelling frequently extends deep beneath the person’s skin and covering large areas. Angioedema can involve all or part of genitals, hands, lips, eyelids, or feet, or even airways, throat, mouth linings, causing difficulty breathing.  If hives appear abruptly and disappear fast without a recurrence, a medical evaluation generally is not required;  it rarely shows the cause.  But when hives or angioedema repeat without reason, a medical examination is usually recommended. If the hives cause is unknown, an individual must discontinue all nonessential medications until the reactions relieve.

Using antihistamines, including hydroxyzine, chlorpheniramine, or diphenhydramine reduces the swelling and subsides an itching. In more severe itching and swelling, using a corticosteroid such as Prednisone, for few days can relieve itching and swelling. Any person who has difficulty of breathing or swallowing, or collapses, must immediately seek medical help. Injection of adrenaline (epinephrine) combined with antihistamines, must be given as soon as possible in this situation and treatments are best continued in an emergency room where the individual’s treatment may be adjusted as needed and carefully monitored. Antihistamines can also be relieved by antihistamines. In some adults, antidepressant called Doxepin, may be effective. Because corticosteroid used for more three or four weeks result in many adverse reactions, it is given only when all other treatments fail or for severe symptoms and is given for a short time.

About 50% of chronic untreated hive cases cases typically disappear after 2 years. Keeping stress under control helps decrease severity and frequency of hives attacks.

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