What Are Hives Or Urticaria
Hives or urticaria are a type of rash consisting of itchy, swollen, red welts. The itching may be mild or severe. Foods, medications, infections, exercise, scratching, alcoholic beverages, emotional stress and many other factors may worsen hives. The condition affects an estimated 20 percent of the population at one time or another in their lives.
Finding Relief: Treatment Options
The first step in getting treatment is to figure out if you actually have hives. In most cases, your doctor will be able to determine if you have hives from a physical exam. Your skin will show signs of the welts that are associated with hives. Your doctor may also perform blood tests or skin tests to determine what may have caused your hives especially if they were the result of an allergic reaction.
You may not need prescription treatment if youre experiencing a mild case of hives not related to allergies or other health conditions. In these circumstances, your doctor might suggest that you seek temporary relief by:
- taking antihistamines, such as diphenhydramine or cetirizine
- avoiding irritating the area
- avoiding hot water, which may aggravate the hives
- taking a cool or lukewarm bath with colloidal oatmeal or baking soda
Anaphylaxis is a medical emergency that needs to be treated immediately by a physician.
Can You Combine A Queenless Hive
The number of worker bees may be severely reduced if the colony has been without a queen for two weeks or more.
These bees may not have the ability nor the time to raise a new queen if a brood frame is introduced. Therefore, an alternative approach to save the remaining bees is combining them with an existing one.
This process must be done carefully to reduce fighting among the bees. However, the procedure is relatively simple and has reasonable success rates if the combination method is followed correctly.
You will need the following equipment.
- Your bee smoker.
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How Are They Treated
The most important treatment is avoiding the things that cause your hives, if your doctor finds out what is causing them. Your doctor may have you take medicines called antihistamines, if needed. Many of these are available without a prescription. Sometimes your doctor may have you take more than the normal dose, but this should only be done under his or her supervision. Sometimes other prescription medicines also are used to treat hives.
When Should I Call My Healthcare Provider About Hives
Hives can get better without treatment. Call your healthcare provider if you have:
- Hives or swelling that lasts more than a week.
- Infected-looking bumps .
- Recurring hives .
- Severe itching that might even keep you from sleeping.
- Signs of anaphylaxis, including wheezing, shortness of breath or vomiting.
- Swollen lips or face.
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About Hives Or Urticaria
Hives or urticaria are raised spots that form a very itchy rash. Theyre usually harmless.
Hives develop when the body releases histamines. The histamine makes small blood vessels in the skin open up and leak fluid, which forms raised patches on the skin surface.
Hives can have several causes.
They might be caused by an allergic reaction.
Viral infections like those that cause colds or diarrhoea can also cause hives in children.
Your child might also develop hives because of heat, or tight-fitting or scratchy clothing, particularly if your child has eczema.
Some children develop hives for no obvious reason.
Hives are very common but not contagious.
Stress Can Contribute To Hives Too
Stress can be a factor in hives, but its usually not an independent risk factor.
Stress usually isnt the direct cause, and primarily affects only individuals who are susceptible to hives, Friedman says. Both chronic and acute hives can be made worse by stress, especially in people more likely to get hives, such as women and people with autoimmune disorders.
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How Is It Diagnosed
Your healthcare provider will look at the hives and ask about your history of sensitivity to such things as:
- plants and pollens
- animals, such as an allergy to cats
- insect bites or stings
- exposure to heat, cold, or sunshine
To find the cause of your hives, the healthcare provider may suggest that you:
- Keep a detailed diary of everything you eat, drink, take as medicine, or are exposed to for 2 to 4 weeks.
- Avoid foods, one at a time, to which you may be allergic.
It is easiest to identify drugs, foods, or plants that may cause you to have hives because the response usually occurs within an hour. Identifying triggers such as emotional stress or multiple allergies may take more time. Identifying multiple allergies may require skin tests or other types of allergy tests.
Should I Handle Hives At Home Or Seek Treatment
If your child has a small patch of hives and is showing no other symptoms the hives are probably an allergic reaction to something like plant pollen, pet saliva or a minor chemical irritant. Wash your childs skin, and offer ice cubes or a cold pack to ease itching. The hives should subside within a few hours.If the hives are more widespread or very itchy as long as theyre not accompanied by other symptoms and your child is over the age of 1 give your child a dose of Benadryl every four to six hours until the hives have subsided.
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When To Seek Medical Advice
Urticaria on its own is not a serious condition. However, urticaria can occur in a severe allergic reaction called anaphylaxis .
If you have symptoms of anaphylaxis this is a medical emergency.
If you have urticaria, without the symptoms of anaphylaxis, visit your GP if your symptoms don’t go away within 48 hours.
You should also contact your GP if your symptoms are:
- infection such as a cold
- certain medications check the patient information leaflet with your medication to see if urticaria is a usual side effect or if you need advice speak to your pharmacist or GP
In many cases of urticaria, no obvious cause can be found.
Some cases of long-term urticaria may be caused by the immune system mistakenly attacking healthy tissue. This can be difficult to treat, and your GP may refer you to a specialist for tests and treatment.
Certain triggers may also make the symptoms worse. These include:
- drinking alcohol or caffeine
- warm temperature
Rashes On Amoxicillin: When Is It A True Allergy
May 18, 2018
Rash while taking Amoxicillin or Augmentin is common 5-10% of children taking Amoxicillin or Augmentin will develop a skin rash at some point during the course of the medication. The majority of these are not a true allergic reaction, and most are caused by viruses. So, how can you tell the difference?
A non-allergic rash occurring while taking Amoxicillin or Augmentin will:
- Look like small widespread pink spots in a symmetrical pattern or slightly raised pink bumps.
- Usually appear on day 5-7 from the start of the Amoxicillin or Augmentin, but can occur at any time during the course of the medication. It always appears on the chest, abdomen, or back and usually involves the face, arms, and legs.
- Differ from hives in appearance .
- Usually go away in 3 days, but can last from 1-6 days.
- Your child probably wont develop it the next time she takes amoxicillin.
- The best part? Its not contagious, so he/she can go back to school!
How is an amoxicillin rash treated?
No treatment is necessary. The rash will disappear just a quickly whether or not you continue the medication.
Even if you know its not an allergic reaction, it may still feel wrong to continue giving the medication. There are several reasons why it is better to finish the course of Amoxicillin than stop or change to a different antibiotic:
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What Might Be Causing Your Unexpected Hives
Hives are a very common skin reaction that can come from some unexpected sources. Some causes you might not have thought of include:
- Colds and other viral infections. Sometimes hives can be caused by your immune system fighting colds and other viral infections. These hives often appear near the end of your cold or virus as youre starting to feel better. Theyre most common in children but can happen to anyone.
- Bacterial infections. Bacterial infections such as strep throat or urinary tract infections can also sometimes trigger hives as your body reacts to the bacteria. These hives will fade as the antibiotics help your body fight the infection. They might peel before healing completely.
- Chronic conditions such as lupus. Hives that last for longer than 6 weeks might be a sign of an autoimmune condition such as lupus, type 1 diabetes, thyroid disease, or rheumatoid arthritis. These hives wont go away on their own. Its a good idea to make a medical appointment to get this type of hive checked out and see if a chronic condition is the cause.
- Stress. Stress can raise your internal body temperature and release adrenalin and other chemicals that might trigger hives. Stress hives tend to be located on the face, neck, chest, and arms. Theyre common in people with eczema, allergies, or sensitive skin.
How Does The Testing Work
Skin testing for a penicillin allergy is commonly performed and can be done safely even in patients who are critically ill or who have had serious reactions to penicillin, Dr. Lang says.
1.Validating the test
To ensure that your skin reacts normally, a nurse will apply both a saline solution and a histamine solution. If your skin reacts to the saline, that means your skin is too sensitive and the test cannot be interpreted.
The histamine solution should cause a red, raised, itchy area, similar to a mosquito bite. If there is no reaction, your skin test may not show an allergy even if you have one, and for this reason the test cannot be interpreted.
If your skin does not react to the saline, but reacts to the histamine, this validates the skin test: Your skin has the capacity to react to a potential allergen.
2. Testing for penicillin allergy
At the same time, a nurse places liquid drops of penicillin on your skin and scratches through the liquid so that it gets underneath the top layer of your skin. A reaction that is similar to a mosquito bite should occur in minutes if you are allergic to penicillin.
If your skin does not react to penicillin, an intradermal test is the next step, which involves a nurse injecting a small amount of penicillin liquids into your skin. After 15 minutes, the skin test is examined for signs of an allergic reaction.
3. Applying a challenge dose
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How Doctors Diagnose Hives
Expect to undergo a thorough physical exam. The dermatologist or allergist will also likely ask you to review your hives experience in detail, including when the hives started, if you suspect anything in particular triggered your hives, what medications youve tried, and what type of response youve gotten. Come prepared with this information.
Doctors will also verify that the bump is hives, often circling the spot on your skin to see if it disappears the next day .
Once theyve confirmed that it is hives, theyll work to determine the trigger. Rossi says: Figuring out the cause can be the most frustrating part of it, especially if the tests arent helpful.
You may require additional testing. If an allergy is suspected, you may need to undergo allergy testing. If you are diagnosed with a severe allergy, the doctor may prescribe an epinephrine auto-injector in case youre accidentally exposed to your allergen.
And because chronic hives can signal autoimmune disorders, you may need to have a blood draw in which doctors will look for a common antibody found in many autoimmune disorders. In rare cases when a bout of hives doesnt disappear within 24 hours, your doctor may do a skin biopsy to see if theres inflammation of the blood vessels, Rossi adds.
Favorite Tool To Virtually Identify An Allergy
Sometimes hives can be part of an allergic reaction. This interactive tool from AAAAI can help pinpoint the issue. Just click through a series of questions and mark where on the body the allergy is occurring and the symptoms youre experiencing, and youll be presented with possible issues.
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What Are The Symptoms Of Hives
The common symptoms include itchy, raised red or skin-coloured bumps or welts on the skin. The raised areas of skin are known as wheals, which often fade after a few hours but can sometimes reappear elsewhere on the body.
The hives rash can last for a few minutes to hours, and usually disappears within 24 hours.
Sometimes people get hives on most days. This is called chronic urticaria. See your doctor if you have hives that keep coming back.
Case 1 Immediate Reaction
A healthy 8-year-old white girl was receiving a standard dose of oral amoxicillin for an uncomplicated pneumonia. On the seventh day of treatment, 15 minutes following her morning dose of amoxicillin, she developed pruritic erythematous plaques that progressed all over her body over the course of the day. There were no systemic signs of anaphylaxis. Amoxicillin was discontinued the same day. The rash resolved after 7 days. It is not known whether this was her first exposure to amoxicillin. She has avoided amoxicillin since then. An intradermal test with Pre-Pen® was negative. Three months later, she underwent an oral challenge for amoxicillin at our allergy clinic. The oral challenge was positive as she developed hives 20 minutes following ingestion of the full dose . No other symptoms occurred and the hives resolved after a few hours with no treatment. She was diagnosed with immediate allergy to amoxicillin and advised to avoid amoxicillin and all penicillin family antibiotics.
Hives developed on mid-back and right forearm 20 minutes following ingestion of full dose of amoxicillin
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If You Had A Severe Allergic Reaction To A Covid
Anyone who has had a severe allergic reaction after receiving a particular type of COVID-19 vaccine should not get another dose of that type of vaccine. The vaccines made by Pfizer-BioNTech and Moderna are considered one type of COVID-19 vaccine. The COVID-19 vaccine made by Johnson & Johnson/Janssen is considered another type .
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How Common Are Hives In Children And What Causes Them
Urticaria, also known as hives, are very common in children affecting up to 25 percent of kids at least once. When a child is exposed to a specific trigger an allergen, infection, extreme temperature or a period of high stress mast cells release histamine, which causes fluid to leak from small blood vessels under his or her skin. This results in red or pink patches and itching. If youre not sure whether your child has these or a different type of rash, you can see a picture of hives here.
Here are some common hive triggers:
- Bug bites or stings
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Other Ways To Get Relief From Hives
No matter the treatment course, avoid the urge to scratch the hives. You risk breaking the skin and getting an infection, Friedman says.
One of the best ways to relieve an itch is by using cold therapy . Use ice packs, a cool cloth, or a frozen bag of veggies like peas, or take a cool shower. Even better, stick a moisturizer in the fridge to cool it down, which will have a double-whammy effect against that itch, Rossi says.
How Do Dermatologists Treat Hives
When treating hives, the goals are to:
-
Control the itch
-
Prevent new hives
-
Avoid whats causing the hives
Your treatment plan will be tailored to your needs and may include one or more of the following:
To improve your outcome, your dermatologist may give you self-care tips to follow. To see what dermatologists frequently recommend, go to: Hives: Self-care.
Related AAD resources
Image 1: Used with permission of DermNet NZImage 2: Getty Images
ReferencesAntia C, Baquerizo K, et al. Urticaria: A comprehensive review: Epidemiology, diagnosis, and work-up. J Am Acad Dermatol. 2018 79:599-614.
Antia C, Baquerizo K, et al. Urticaria: A comprehensive review: Treatment of chronic urticaria, special populations, and disease outcomes. J Am Acad Dermatol. 2018 79:617-33.
Grattan CEH, Saini SS. Urticaria and angioedema. In: Bolognia JL, et al. Dermatology. . Mosby Elsevier, China, 2018:304-19.
Hide M, Takahagi S, et al. Urticaria and angioedema. In: Kang S, et al. Fitzpatricks Dermatology. McGraw Hill Education, United States of America, 2019:684-785.
Wong HK. Urticaria. In: Medscape Last updated 9/16/2020. Last accessed 8/1/2021.
Yosipovitch G and Kwatra SG. Chronic urticaria. In: Living with itch: A patients guide. The Johns Hopkins University Press. United States, 2013: 56-9.
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When To Call A Professional
Symptoms of an acute severe allergic reaction such as rapid pulse, labored breathing and facial swelling require an immediate visit to an emergency care facility. Other reactions should be reported promptly to your physician so that your treatment can be evaluated and you can avoid the medication that caused the reaction.