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Philadelphia and Mainline Center of Dermatology and Cosmetic Surgery

Written by Dr. Ringpfeil

Hives - Urticaria

Hives are extremely itchy raised bumps that appear on the skin. They can resemble mosquito bites or have an oddly shaped appearance. They are often called wheals. The official name for hives is urticaria. A wheal typically last less than 24 hours. Urticaria can be acute or chronic. Urticaria is considered chronic if it lasts more than six weeks. There are many causes for urticaria. Acute urticaria can be caused by insect bites, food, infection or medication/supplements. Chronic urticaria can also be caused by infections or medication but can also be caused by many other factors including physical triggers such as stroking the skin, pressure, cold, water, sun and exercise.

Diagnosis

The diagnosis of hives can usually be made with a thorough history and physical examination although sometimes a skin biopsy may be necessary. It is important that you inform your treating physician of all over the counter medications, vitamins and herbal supplements as well as prescription medications you have taken. It is also important to reveal all current and previous medical diagnoses. For chronic urticaria, blood work is often ordered to rule out infection, autoimmune disease or other metabolic causes. An X-ray of the chest, sinuses or teeth may also be used to look for occult infection.

Management

Hives occur because of release of histamine from cells within the skin. Therefore, the mainstay of management of the intense itch associated with most hives is oral antihistamines. Antihistamines include H1 blockers such as diphenhydramine (Benadryl), loratidine (Claritin), zytrizine (Zyrtec) and h3 blockers such as cimetidine (Tagamet) and ranitidine (Zantac). High doses and a mix of several antihistamines is often required to control itching. Other oral agents called leukotriene receptor antagonists may also be used. Important treatment, however, is soothing the skin with the use of anti-itch lotions based on camphor, menthol or phenol such as Sarna and Calamine lotion. The use of oral steroids is rarely necessary.

Coping

Living with hives can be very challenging because of the intense itch. Following recommendations regarding use of oral antihistamines and topical skin soothing agents will help. The majority of hives are transient and resolve within a few days or weeks. For those episodes of longer duration, laboratory tests can provide reassurance that there is no underlying infection or illness. If a medication is suspected as the cause, the medication may need to be stopped under the guidance of the prescribing physician. Even if the offending agent is removed the hives generally do not stop immediately but may take weeks to vanish depending how long it will take for the offending agent to "wash out" of your body.

Prevention

Prevention of acute episodes of hives is rarely possible especially when the underlying cause is unknown. For chronic urticaria caused by physical stimuli, avoidance of these physical factors such as cold, pressure, water and sun can reduce flares. Continuing use of oral antihistamines can also be preventative.

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# of surveys: 3853
Last updated: 2/11/2021 4:23 PM

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The doctor explained treatment options

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Front desk performance

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Office comfort

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What WE DID WELL

(Answers:674)

Woderful atmosphere and service

#12020-07-26

The doctor was very thorough and pleasant. Having Melissa take notes was an excellent strategy for covering so much information in a short amount of time.

#22020-10-27

Everyone was so pleasant,and nice.

#32020-03-19

Bravo!! I am very impressed with the doctor, staff, facility, everything right down to the current magazines available in the reception room(that I didn't even get to read!). I can highly recommend you with trust and confidence.

#42011-06-02 14:18:32

The treatments that are on display in the lobby. Also, the fact that the dermatologist told me the truth about commercial face cleansers.

#52020-09-15

I really liike the office space . I get a good feeling when i first cam in here. I alos like the doctor , shes seem very intelligent.

#62020-05-11

IN ADDITION TO THE EXCELLENT ENVIRONMENT AND STAFF AND DOCTOR, THE MUSIC WAS ALSO EXCELLENT AND SOOTHING. sOME OFFICES HAVE AWFUL MUSIC STREAMING.

#72010-11-11 15:36:56

I was particularly impressed with the doctor and her exam...more thorough than I had previously experienced elsewhere.

#82020-11-15

all people very nice.

#92020-08-14

The atmosphere was pleasent and during appointment, didnt feel judged about skin.

#102021-01-16

What can we do better?

(answers:373)

I can't think of anything.

#12010-08-25 14:18:06

Everything was great!

#22020-08-01

i was completely satisfies with everything and everyone. Even my lateness was not held against me.

#32020-03-14

service was excellent

#42020-11-23

I was more than pleased with my first visit; a very warm and professional office

#52011-03-09 09:12:38

Maybe some more magazines for the guys. I`ll bring a few in...

#62020-04-09

Not a lot to improve on service is already top notch.

#72010-09-30 11:25:20

You often have a long wait time in the room for the doctor. When she does come in it is not for a very long time.

#82010-08-23 17:00:56

You often have a long wait time in the room for the doctor. When she does come in it is not for a very long time.

#92010-08-23 17:00:56

Cookies and Milk! Seriously, I love coming in and being seen promptly. More importantly, I like the fact that the doctor was not distracted and there was not a single interruption.

#102020-03-31
Customer Rating : 4.5

Based on 178 ratings
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