Urticaria
Created: 03.08.2023
Updated: 22.12.2023
Approved by: General Practitioner, Dr Binita Parmar
Urticaria presents as raised swellings in the skin surrounded by a reddish inflammation, and it causes itching. The challenge with urticaria is that it is often difficult to identify the cause. It can be triggered by an allergen, but it doesn't have to be. Some individuals seem to experience hives more frequently than others. It may be associated with atopic dermatitis.
What is urticaria?
Urticaria, also known as hives, is a skin reaction that can occur due to infection, allergies, physical irritants, heat, cold, insect bites, medications, or certain foods. The rash can appear on small areas of the skin or spread all over the body. It develops quickly, causes intense itching, and often moves around.
Urticaria, or hives, is classified into acute urticaria, which lasts for less than 6 weeks, and chronic urticaria, characterised by at least two outbreaks per week for more than 6 weeks. Approximately 8-10% of the population will experience urticaria at some point in their lives, most commonly before the age of 30.
Symptoms
The symptoms vary from person to person and from episode to episode. Generally, the following can be experienced:
- intense itching
- rash appearing anywhere on the body, characterised by raised areas with slight redness
- the rash often moves from one part of the body to another
- the duration of the rash can range from a few hours to several weeks, but each individual raised area on the skin lasts no more than 24 hours before moving
- some individuals may experience fever
- In severe cases, swelling may occur in the mouth and throat, genital area, abdomen, and the bowels.
Treatment
The most common treatment for hives is to make sure that you identify and avoid the medication, food or anything else causing the outbreak. After this, antihistamines are given. There are different types of antihistamine and the doctor will advise on the appropriate choice.
For severe or recurrent hives, especially if it causes a deeper inflammation called angioedema, there is more powerful medicine. You can ask your doctor about immunosuppressive drugs or newer biological drugs.
Examination
If you experience a rash as described above, it is advisable to consult a doctor for an examination. The doctor will conduct a thorough interview with you to try to determine the underlying cause of the rash. This can be challenging, and the cause of urticaria is not always found.
The doctor will also examine the rash, and in most cases, this is sufficient to make a diagnosis. Additional tests are rarely necessary for the examination of urticaria. If it seems that the rash was caused by an allergic reaction, there may be an indication to undergo allergy testing, including a blood test and a skin prick test, to determine what you reacted to.
In the case of chronic urticaria, further blood tests may be conducted to investigate if there is another underlying condition triggering the skin reaction.
FAQs about hives (urticaria)
Are hives dangerous and a sign of a serious illness?
Generally, hives (urticaria) are not dangerous. They are simply a reaction in the top layer of the skin to something that irritated the body at that moment. The itching can be extremely bothersome, but it is not dangerous.
However, in some cases, swelling of the mucous membranes in the mouth, throat, genital area, abdomen, and intestines may occur. This can potentially be dangerous if it causes airway obstruction. This is very rare. If this happens, it is important to call emergency services immediately (999) for prompt assistance.
I had hives once, can I get them again?
Yes, it is possible to get hives again if you have had them before. It is often triggered by the same cause, so if you had hives after eating apples, being bitten by a mosquito, or having a streptococcal throat infection, for example, it is likely that you may develop a rash if exposed to the same trigger again. Therefore, it is advisable to try to avoid it if possible.
Can hives go away on their own without treatment, or do I need to see a doctor for medication?
In most cases, hives resolve on their own, but the intense itching leads people to seek medical help to find relief.
Are hives hereditary?
A person who has had hives often has slightly more sensitive skin, which can be inherited. However, just because a parent has had hives does not necessarily mean their child will have the same condition.
