Check If You Have Hives
DR P. MARAZZI/SCIENCE PHOTO LIBRARY https://www.sciencephoto.com/media/694159/view
This image shows white skin with the hives rash. The rash is on a child’s leg and hand. Their groin, in the top left of the photo, is not affected by the rash.
The skin on most of their thigh is pink, raised and bumpy. At the side of their thigh are deep creases in the skin.
Their hand is pink with some red patches between their thumb and finger and at their fingertips.
Elizabeth Nunn / Alamy Stock Photo https://www.alamy.com/stock-photo-an-urticarial-rash-caused-by-an-allergic-reaction-to-penicillin-111762116.html?pv=1& stamp=2& imageid=261CE1C1-DA64-4EAE-8D55-1794DA842BD3& p=278658& n=0& orientation=0& pn=1& searchtype=0& IsFromSearch=1& srch=foo%3dbar%26st%3d0%26pn%3d1%26ps%3d100%26sortby%3d2%26resultview%3dsortbyPopular%26npgs%3d0%26qt%3dGDR5M4%26qt_raw%3dGDR5M4%26lic%3d3%26mr%3d0%26pr%3d0%26ot%3d0%26creative%3d%26ag%3d0%26hc%3d0%26pc%3d%26blackwhite%3d%26cutout%3d%26tbar%3d1%26et%3d0x000000000000000000000%26vp%3d0%26loc%3d0%26imgt%3d0%26dtfr%3d%26dtto%3d%26size%3d0xFF%26archive%3d1%26groupid%3d%26pseudoid%3d%26a%3d%26cdid%3d%26cdsrt%3d%26name%3d%26qn%3d%26apalib%3d%26apalic%3d%26lightbox%3d%26gname%3d%26gtype%3d%26xstx%3d0%26simid%3d%26saveQry%3d%26editorial%3d1%26nu%3d%26t%3d%26edoptin%3d%26customgeoip%3d%26cap%3d1%26cbstore%3d1%26vd%3d0%26lb%3d%26fi%3d2%26edrf%3d0%26ispremium%3d1%26flip%3d0%26pl%3d
This image shows light brown skin with the hives rash.
Conditions Related To Hives
Hives can sometimes be a symptom of or be mistaken for other skin problems. Similarly, certain conditions and other things can trigger hives. The following are related to hives for at least one of these reasons:
More than 50 percent of cases of chronic hives are believed to occur alongside an autoimmune disease. The following autoimmune diseases can trigger chronic hives:
- Type 1 Diabetes Long-lasting chronic hives could be an early indicator of type 1 diabetes.
- Lupus Its not very likely, but lupus can cause hives, possibly because of the existence of certain antibodies, sunlight, or response to some medications. Hives typically will go away within 24 hours, but if they last longer, it could be a condition called urticarial vasculitis.
If Hives Do Not Respond To Treatment Your Healthcare Provider May Recommend One Of These Therapies
Urticaria is the clinical term for hivesred, raised, itchy welts that form on the surface of the skin. Hives are classified as either acute or chronic, depending on how long symptoms last. Hives are categorized as acute when symptoms resolve within six weeks, and chronic when symptoms persist for six weeks or longer. Only a very small percentage of the total population experience chronic urticaria, but for some, symptoms last for months or even years, and can be difficult to treat.
The initial steps for treating hives are avoiding triggers and taking medications called antihistamines. However, these steps are not always effective for every person. The majority of cases of chronic hives are categorized as chronic spontaneous urticaria . With this type, the cause of the hives is unknown, and is not associated with any identifiable allergen or trigger.
Antihistamines work by blocking inflammatory chemicals called histamines. If symptoms do not respond to treatment with antihistamines, a healthcare provider may recommend a stronger-dose antihistamine, a different type of antihistamine, or another type of treatment. Other treatment options for chronic hives include corticosteroids, immunosuppressive drugs, a biologic therapy, and therapies for other conditions that may have a therapeutic benefit for chronic hives.
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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 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.
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.
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What Are Chronic Hives Treatments
Treatments for chronic hives include:
- Allergy medications: Daily over-the-counter or prescription allergy medications like antihistamines relieve itching and reduce or prevent allergic reactions.
- Allergy shots: A monthly injection of a drug called omalizumab blocks your bodys production of immunoglobin E . People with severe allergies can make too much IgE, leading to problems like chronic hives and asthma.
- Steroids: Corticosteroids like prednisone can ease symptoms that dont respond to allergy medicines.
- Hydroxychloroquine: A study found that 8 in 10 people with autoimmune disease-induced chronic hives got symptom relief after taking hydroxychloroquine , an antimalarial drug, for three or more months.
- Cyclosporine: This immunosuppressant is highly effective at clearing up severe chronic hives. But it can cause serious side effects when taken for too long.
Common Questions & Answers
Whats important to know is that hives can affect anyone. While some people may carry a higher risk for hives, you can get them no matter your age or gender. Heres what you should know about the common condition, including why you get hives, how to deal with them if you do, and how to prevent them from coming again .
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How Are Hives Treated
The best treatment for hives is to find and remove the trigger, but this is not an easy task. Antihistamines are usually prescribed by your doctor to provide relief from symptoms. Antihistamines work best if taken on a regular schedule to prevent hives from forming in the first place.
Chronic hives may be treated with antihistamines or a combination of medications. When antihistamines don’t provide relief, oral steroids may be prescribed. A biologic drug, omalizumab , is also approved to treat chronic hives in people at least 12 years old.
Reasons Why You Might Be Breaking Out In Hives
Your workout may be to blame.
Hives are confusing AF: The oddly-shaped reddish spots can disappear and reappear faster than an ex-BF. As it turns out, these transient little buggers are actually quite commonthey affect about 20 percent of people at some point, says Whitney Bowe, M.D., a New York-based dermatologist. So, theres a decent chance you may experience hives in your lifetime .
Although the cause is sometimes obvious , oftentimes it can be difficult to figure out why, exactly, you have hives. The good news is that, for the most part, they don’t last more than 24 hours and are easily treated with antihistamines, according to the American College of Allergy, Asthma, and Immunology.
Here are a few reasons why you might find yourself covered in splotches:
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1. You Take Certain MedicationsNon-steroidal anti-inflammatories , opioids , and antibiotics , can all make you break out in hives, says Bruce Brod, M.D., clinical professor of dermatology at the Perleman School of Medicine at the University of Pennsylvania. According to the American Academy of Allergy, Asthma, and Immunology, hives will usually develop within an hour of popping the pill.
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Is It Hives Or Angioedema
Angioedema swelling of tissue beneath the surface of the skin can be mistaken for, or associated with hives. It can be caused by allergic reactions, medications or a hereditary deficiency of some enzymes. The following symptoms may indicate angioedema:
- Swelling in the eyes or mouth
- Swelling of the hands, feet or throat
- Difficulty breathing, stomach cramps or swelling of the lining of the eyes
The best way to identify your symptoms is to talk to an allergist who can diagnose and treat both hives and angioedema.
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.
An Adverse Reaction To Exercise And Environment
Although a daily dose of thirty minutes of exercise is highly recommended, it may also be causing an individual to break out in hives. The body produces a chemical that can inhibit cell breakdown as cause rashes, known as acetylcholine, during exercise as a natural bodily response. Sweating is also known to cause a breakout of hives in those who are already prone to the condition. The sweat itself is not causing the hives, but the excess warmth of the skin can irritate the area concerned. Managing the inhabited environment, exercise, and what is consumed is paramount if hives are affecting an individual on a regular basis. There are also many environmental occurrences that can cause hives to break out such as excess heat, powerful winds, bug bites, and some plants are known to cause a breakout. If environmental concerns are worrisome, talk to a health professional about taking an antihistamine to reduce skin irritability.
There Are Two Types Of Urticaria:
- Acute urticaria are hives that last six weeks or less
- Chronic urticaria happens when hives last or recur for more than six weeks
Acute urticaria in a child can be caused by infections, foods, medications, insect bites or blood transfusions. When a child develops acute hives, the first thing that usually comes to mind is, What did she or he eat that caused this rash? However, most cases of childhood hives are a result of infections. Some infections that can cause hives in children include respiratory viruses , strep throat, urinary tract infections, hepatitis, infectious mononucleosis and many other viral infections.
In an infant or a toddler who is being introduced to new foods, think about food allergy as a possible cause of the hives, especially peanuts, tree nuts, eggs, cows milk, and fish or shellfish. If your child develops hives while or shortly after playing outdoors, look at their skin for any signs of insect bites, especially fire ants in our area. When a child develops hives while taking a medication, the hives could have been caused by the medication, but this gets tricky if the child is taking an antibiotic, since the hives could also have been caused by the initial infection for which she was taking that antibiotic.
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When Should I Call The Doctor
Hives and swelling typically get better without treatment. Call your healthcare provider if you have:
- Hives or swelling that last more than a week.
- Infected-looking bumps .
- Recurring hives that come back every few months.
- Severe itching.
- Signs of anaphylaxis, including wheezing, shortness of breath or vomiting.
- Swollen lips or eyes.
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2. Youre StressedAnother reason to take a deep breath: Intense emotions can prompt hives. That’s because stress causes your immune system to falter, making you more susceptible to skin issues. Typically, stress hives are short-lived though, says Brod.
3. You Got Really SweatyAccording to the World Allergy Organization, heat-induced hives , generally start on the neck and upper chest and spread to the face, back, and extremities. If this happens to you regularly, Bowe suggests consulting your doc, who can put you on an antihistamine regimen.
4. You Came Into Contact with an Allergen in the EnvironmentSummertime and the livin is itchy. Environmental factors that can spark an outbreak include sunlight, heat, cold, grass, pollen, and dust mites, says Lauren Ploch, M.D., a dermatologist in Augusta, Georgia.
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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.
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.
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When To Call Your Dermatologist
You should schedule an appointment with your dermatologist whenever youre concerned about your skin. And hives are no exception. However, there are a few hives symptoms that always warrant a call to your dermatologist.
Book a dermatology appointment if your hives last for six weeks or longer. Hives that persist for this long are considered chronic hives. You should also note whether your hives appear with other symptoms. For example, if you have allergic reaction hives, you might have difficulty breathing or a swollen tongue after eating as well. Your dermatologist may refer you to an allergist or other health professional to diagnose any underlying conditions, but they may prescribe antihistamines and topical creams for treatment.
If youre experiencing frequent hives outbreaks, the team at Pacific Dermatology Specialists can recommend next steps. We offer hives treatment among our medical dermatology services. With locations in Redondo Beach, CA and other communities in the Greater Los Angeles area, we also provide cosmetic and surgical services to support your skin needs. Contact us today to schedule an appointment.
Seeking Emergency Medical Care
Call 911, especially if youre having trouble breathing. If you dont have an EpiPen, the ambulance will have epinephrine that paramedics can use to provide immediate treatment and will likely reach you much faster than having someone drive you to a hospital. Paramedics can get you to the hospital quickly and monitor your condition the entire time.
Never attempt to drive yourself to the hospital during anaphylaxis. Even if it is a very short drive, its not safe to attempt. You can lose consciousness rapidly.
If possible, after you call 911, keep someone with you until paramedics arrive.
If you are experiencing any of these symptoms, call 911.
A doctor may prescribe you an epinephrine injector, such as an EpiPen, for future allergic reactions. Theyll teach you how to use it and answer any questions you might have. Youll keep your epinephrine injector on hand and use it if you develop hives in the future.
Youll still need to visit the emergency room after you use your epinephrine injector, but it can stop anaphylaxis from becoming deadly.
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