Chronic Urticaria Is Defined When Hives Occur Most Days For More Than Six Weeks
Symptoms of chronic urticaria usually resolve, although this can take months or several years. Most people with chronic urticaria manage with appropriate doses of non-drowsy antihistamines. People with severe symptoms interfering with quality of life may be referred to a clinical immunology/allergy specialist or dermatologist for assessment and consideration of additional medications.
Stress Rash Woes: What To Expect
Howlong can you expect to stay polka-dotted? Sorry to say it, but this gets worsebefore it gets better.
Itstotally normal for new hives to bubble up just as the firstwelts are fading. They will typically subside within a day or two, and you cantreat them with over-the-counter antihistamines.
Nowbrace yourself for this last bit of bad news: Even after they subside, hivesmay not be through with you yet. Hive breakouts often come and go in waves andcan flare up on and off for weeks.
Ifhives last longer than a few days, a doctor can help you figure out whatsgoing on.
Hives usually arent medical emergencies, though they can feel like a major disruption to your regularly scheduled programming. However, get medical attention post-haste if you have symptoms like fever or swelling of the mouth, tongue or lips, since those are signs of a more serious allergic reaction.
Causes And Risk Factors Of Hives
Although hives can have many causes, they all get their start when immune cells in your body called mast cells are activated. In many cases, those mast cells release a chemical called histamine that can cause swelling, itching, and redness. Although not all hives are the result of histamine being released, the vast majority are, Dr. Elmariah says. Heres the real question, though: Whats causing those mast cells to react in the first place?
Thats a relatively easy question to answer if you have acute hives. We can generally identify about 50 percent of the triggers after taking a good history of the patient and getting the full story behind the incident, Dr. Friedman says.
Chronic hives, however, often have different outcomes, and unfortunately, although about 50 percent of hive cases will be resolved within a year of entering the chronic phase, some people will have hives their entire life. With chronic hives, we can rarely identify why theyre happening, and the longer somebody has hives, the less likely it is that theyll go away, says Friedman, adding that 20 percent can continue for longer than 10 years.
Nonallergic causes consist of bacterial and viral infections exercise stress pressure on or scratching the skin chemical contact exposure to sun, heat, or cold and autoimmune disorders like thyroid diseases and lupus, especially in the case of chronic hives.
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Solutions For Common Skin Problems
Hives can be quite itchy, not to mention irritating. While they bring an obvious physical burden, they can hinder emotional well-being too, often isolating individuals socially and affecting performance at work and school, especially if a person has been struggling with hives for a long time, says Sarina Elmariah, MD, PhD, a board-certified dermatologist at Massachusetts General Hospital in Boston.
As you may suspect, hives are easily confused with other conditions, but there are a few characteristics that distinguish them. Although many conditions can look like hives, they often dont behave like hives, says Adam Friedman, MD, professor of dermatology at the George Washington University School of Medicine and Health Sciences in Washington, D.C.
Namely, how long they last and how much they move can help you determine if a rash or skin condition is hives. Common symptoms of hives are:
- Red or skin-colored bumps or welts with clear edges that typically clear up within 24 hours, but may reappear in another spot
- Bumps or welts that show up either alone or clumped together, covering a larger area
- Itchiness around the bumps or welts
- Swelling around the bumps or welts
- Sometimes pain or stinging at the site of the bumps or welts
If hives last for six weeks or longer, you may be dealing with chronic hives, which can be a sign that something else is going on.
Hives Are Rarely Due To A Serious Underlying Disease
Whilst a clear cause of hives in not obvious in many cases, causes may include:
- Infection from a virus is the most common cause of hives in children, especially if they last for more than 24 hours.
- Contact allergy to plants or animals may cause localized hives.
- Allergic reactions to food, medicines or insect stings can appear as hives. They usually occur within one to two hours of exposure and disappear in most cases within six to eight hours.
An allergic cause for hives should be suspected if episodes are rare, short-lived and occur under specific circumstances, for example:
- Only when exercising.
- Always within two hours of a meal.
- When symptoms involving other organs occur around the same time, such as stomach pain, vomiting, difficulty breathing or dizziness.
- If hives occur with swelling of the tongue or throat, difficulty breathing or low blood pressure, anaphylaxis should be suspected. Urgent administration of adrenaline and medical assessment is required. Information about anaphylaxis is available on the ASCIA website.
Ongoing hives lasting days at a time are almost never allergic in origin, with the exception of some cases of allergy to medicines. Stress is a very rarely the cause of hives but may make the symptoms worse.
In some people hives are caused by physical triggers, including cold , heat, sunlight , vibration, rubbing or scratching of the skin , and delayed pressure , stress, alcohol, spicy food or coffee may cause symptoms.
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What Are Hives Symptoms Causes Diagnosis Treatment And Prevention
If youve never experienced a bout of hives, consider yourself lucky. Roughly 20 percent of people do get hives at some point in their lives, making it a very common ailment. Hives can be a source of physical and mental anguish, especially if they appear frequently and continue happening for months or years.
Favorite Resource To Find An Allergist
Generally, youll visit a primary care doctor first, but he or she may recommend you schedule an appointment with an allergist. The AAAAIs Find an Allergist tool can help you find an allergist or immunologist close to where you live.
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What Are The Complications Of Hives And Swelling
Anyone who has a severe allergic reaction could have life-threatening swelling of the airways your throat and lungs. This condition is known as anaphylaxis. It can potentially close off the airways, resulting in death.
Anaphylaxis is often triggered by a severe allergic reaction to a certain food, like peanuts and tree nuts, or a bee sting. People having anaphylaxis need an immediate shot of epinephrine, such as injectable epinephrine . Epinephrine opens airways, raises blood pressure and reduces hives and swelling. If epinephrine is used outside of the medical setting, a trip to the ER is warranted, since symptoms can return if epinephrine wears off.
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5. Youre Wearing Too-Tight ClothesSome people will develop hives in areas where there is more pressure on the skin, such as on the bottom of their feet and underneath tightly-fitting clothing or underwear, says Brod. He recommends resisting the urge to scratchand wearing loose-fitting clothing.
6. You Have an Autoimmune DiseaseIf you still have hives after an extended period of time , an autoimmune disease may be to blame. Lupus or thyroid disease can cause hives, says Ploch, who adds that type 1 diabetes, Sjogren’s syndrome, and celiac disease could also be to blame. Attributing hives to an autoimmune disease is often a process of elimination, though, she says, so its important to check in with your doctor.
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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.
If You Experience Hives Often Or They’re Severe You Need To Deal With Them Asap
One way to address the underlying cause of hives is to review the last few days. “If hives happen, I recommend going back through the past 48 hours and writing down everything you did and ate,” said Blake. Even if you don’t find a cause, Blake said that the next time it happens, there’s a better chance that a doctor can find a cause.
NYC Dermatologist, Dr. Hadley King, MD, also told INSIDER that taking an oral antihistamine regularly on a daily basis for a period of time can treat current hives as well as prevent new ones.
So, how do you know when your hives are beyond OTC treatment? “Anyone with chronic hives absolutely needs to be evaluated by a physician, because causes of hives can be serious,” explained Blake. The most concerning, said Blake, are certain cancers, autoimmune diseases, lupus being the most common, and infections, especially parasites or hepatitis, and vasculitis, where the blood vessels of the body are being attacked, so it’s worth seeing a doctor to try and determine a cause as soon as you can.
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Due To Physical Cause Like Dermatographia:
There are also certain physical causes which affect the skin causing hives. Dermatographia, which translates to skin writing, is the most common type of physical urticaria, that manifests as development of a hive, when the skin is scratched. These hives frequently occur in young adults and they are harmless and go away in about 1-2 hours.
Is It Hives Or Something Else
Hives is a skin rash that breaks out when you have an allergic reason to something. Known in the medical field as urticaria, hives outbreaks may be brought on by consuming certain foods, being stung by certain insects, by taking certain medications, or just by being around certain chemicals. In some cases, extreme temperatures can even result in a hives outbreak. Hives can appear anywhere on the body, and may vary in severity. Some hives outbreaks only last hours or a day, while chronic hives can last for over 6 weeks.
While its important to be wary of hives outbreaks, it is also important not to jump to the conclusion that you have hives every time you break out into a rash. Make sure to know what symptoms to look out for, so you can tell if what you are experiencing is hives or something else.
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What Is The Prognosis For People With Hives And Swelling
For most people, hives dont cause serious problems. Children often outgrow allergies that cause hives.
For some people, angioedema can cause anaphylaxis severe swelling of the airways and lungs. People with this life-threatening condition should carry injectable epinephrine to treat severe allergic reactions.
When You Have Flare
Make an appointment to see a board-certified dermatologist, allergist, or primary care doctor. Most people who have hives are otherwise healthy, but its still helpful to see a doctor.A thorough medical exam can help rule out possible causes, such as an infection or medication, which could be causing your hives.Its also possible for a disease, such as a thyroid condition, rheumatoid arthritis, or diabetes to cause hives. If signs indicate that this may be the cause, medical testing can find or rule out these causes.While medications and medical conditions can cause hives, there are many other causes, including foods, insect bites, and pressure on the skin. Sometimes, its not possible to find the cause. If that happens, your dermatologist can still recommend lifestyle changes and prescribe medication that can help reduce your flare-ups.
Take photos of your hives. When your see your dermatologist, you may not have hives. Taking pictures can help your dermatologist make sure you have hives. Other skin conditions can look like hives.
Relieve the itch at home. Itch is common in people who have chronic hives. Here are some ways to get temporary relief:
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Hives At Night: Alpha
For the past five nights, including tonight, I have been experiencing a reaction of some sort. I assume that they are hives. The weird thing is that it only happens, well 95% of the time, the breakout starts in the evening. I know it’s not from a bite or something because they are in different spots each night I have had an allergy test ..that was done a few years back and it came back negative. Not allergic to anything. I know that can change, but I just find it odd that this only happens at night. During the day, I am fine just anxious know what’s to come after sundown. Another thing I noticed is that they are usually in straight lines.. not always, sometimes they are blotchy but a lot of the time they are in lines. I have taken benadryl every night for the past few nights didn’t work. Tonight I got a little bit of relief but I can already feel my body getting itchy. Hydrocortisone creams do nothing. I think I just apply them for piece of mind. I called my primary’s after hours answering service and spoke with my doc. I have an appt with her in the morning and she is going to do bloodwork and give me steroid shots, but I just wanted to see if anyone else has experienced anything like this before or know someone who has.
They usually last for the night. When I can finally get myself to sleep at night.. in the morning i am fine. They dont leave any markings or anything. They are just red and raised and extremely itchy.
Mast Cells And Histamines
Underneath the lining of the skin, gut, lungs, nose and eyes are mast cells. These are designed to kill worms and parasites.
Mast cells contain chemicals including histamine. When these are released into the skin in small amounts, they cause itching and irritation. When large amounts are released into the skin, fluid leaks out of blood vessels, resulting in swelling of the skin .
Occasionally, hives produce swelling without an itch.
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Potentially Serious Causes Of Hives
- Food allergies: Some common foods that can cause allergic reactions include nuts, milk, eggs, sesame, and seafood. These reactions can sometimes be severe and cause anaphylaxis, a serious condition requiring immediate medical treatment. Anaphylaxis can cause chest tightness, hives, difficulty breathing, vomiting, and rapid heartbeat.
- Medication allergies: Antibiotics such as penicillin and sulfa drugs can cause hives, itching, wheezing, and swelling. Other common medications that can cause allergies include aspirin and ibuprofen. If the allergy is severe, it can cause anaphylaxis.
- Insect stings or bites: Insect bites can cause itching and bumps on your skin. Some stings, such as bee stings, can cause an allergic reaction that can be more serious. If you are allergic to bee venom, you may need to carry an epinephrine pen. An epinephrine pen can help decrease your symptoms if you are stung and potentially avoid an anaphylactic reaction.
- Blood transfusions: Receiving a blood transfusion can trigger an allergic reaction. If this happens, you may break out in itchy hives along with an elevated temperature, chills, and trouble breathing.
Complications Of Hives: Chronic Hives And Others
Have you struggled with hives that come and go for six weeks or more? Youve got what experts call chronic hives, and they can be exhausting especially because they can cause changes in your sleep, performance at work or school, and social life. The impact chronic hives can have on somebodys quality of life is well studied, Friedman says.
While many of the triggers are the same as acute hives , chronic hives have several different causes, including autoimmune issues and long-standing infections. In some cases, you might have to undergo extra testing to determine the cause and unfortunately in many cases, a definitive cause will not be identified.
The good news is that while treatment generally starts in the same manner as for acute hives, doctors do have additional medications and, in some cases, tests they can use to help diagnose and treat chronic hives. Youll just have to make sure you put patience on your side, as it can often take several years for improvements to happen.
Other potential complications of either acute or chronic hives can include:
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What Are The Signs & Symptoms Of Hives
The hallmark red raised welts are the main sign of hives. The welts can:
- have a pale center
- change shape and location in a matter of hours
- be tiny or as big as a dinner plate
- itch, sting, or cause a burning sensation
Someone who also has angioedema might have puffiness, blotchy redness, swelling, or large bumps around the eyes, lips, hands, feet, genitals, or throat. Other symptoms can include nausea, vomiting, or belly pain.
Rarely, a person with hives and angioedema can also get anaphylactic shock. Signs of anaphylactic shock include breathing trouble, a drop in blood pressure, dizziness, or a loss of consciousness .