What Is Urticaria?
It is a red, raised, itchy skin rash that is sometimes triggered by something that produces an allergic reaction - an allergen. When there is an allergic reaction the body releases a protein called histamine. When histamine is released our capillaries (tiny blood vessels) leak fluid. The fluid accumulates in the skin and causes a rash.
Urticaria can be triggered by:
- Certain foods.
- Insect bites and stings.
- Contact with an irritant, such as nettles, chemicals or latex.
- Certain medications
- Extremes of temperatures.
- Water on the skin.
What are the symptoms of urticaria (hives)?
Swellings, known as wheals, appear on the skin as a rash. They are usually pink or red and have an oval or round shape, and range from a few millimeters in diameter to a several inches. They can be extremely itchy. The wheals may be surrounded by a red flare.
The wheals usually occur in batches, and frequently appear on the face or the extremities (arms, hands, fingers, legs, feet, and toes).
How is urticaria diagnosed?
A GP (general practitioner, primary care physician) can easily diagnose acute urticaria by examining the rash on the skin. The doctor will attempt to find out what the trigger was, as this may help the patient prevent recurrences. Typically, the doctor will ask the patient the following questions:
When the episode began.
Where the episode began.
Whether the patient lives or works in a place where potential triggers may exist, such as latex gloves, chemicals, or animals.
What medications the patient has been taking, including herbal supplements.
The patient's medical history.
Whether the patient had been bitten by an insect.
Whether any close relatives also have/had urticaria.
In half of all cases the doctor and patient will never find out what the trigger was. However, most cases will resolve themselves within a few days and never recur.
If a doctor believes there may be a trigger which is causing an allergic reaction the patient may be referred to an allergy clinic (UK). Allergy clinics test the patient's blood and skin to find out whether there is an allergy to specific substances, such as chemicals, dust mites, or some food.
What is the treatment for urticaria?
Allergic skin disorders, such as urticaria, can cause much discomfort and have an impact on quality of life, and can sometimes cause serious complications. Like other allergic conditions, these disorders can often be effectively treated, according to the American College of Allergy, Asthma and Immunology.
Acute urticaria treatment
Generally, no treatment is needed for acute urticaria because symptoms are usually mild and the condition is short-lived and rarely recurs.
Antihistamines - However, if symptoms are more severe, or if the condition persists the patient may be given antihistamines. Antihistamines block the effects of histamines and reduce the rash and stop the itching.
Current antihistamines do not make most patients drowsy. Unfortunately, some patients may be affected and should check how they react to the antihistamine before operating heavy machinery or driving a car. Antihistamines often cause drowsiness if the patient has alcohol in his/her system.
Some patients may benefit from antihistamines that do cause drowsiness, especially if the itchiness is causing sleep problems.
Pregnant women should not take antihistamines, unless the GP prescribes it. Very occasionally GPs may prescribe an antihistamine called chlorphenamine for pregnant women if it is felt the benefits are greater than the risks. In the UK thousands of pregnant women have taken chlorphenamine, and so far there have been no reports of any harmful effects to the unborn baby.
Corticosteroids - If symptoms are very severe the doctor may prescribe a short course of high-dose oral corticosteroids, which suppress the immune system which usually results in either eliminating or reducing the symptoms of urticaria. Corticosteroids should not be taken for more than 5 days. The longer a patient takes Corticosteroids the greater his risks are of getting an infection.
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