Book
Appt
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 hive typically lasts less than 24 hours. Urticaria can be acute or chronic.

It is considered chronic if it lasts more than six weeks. There are many causes of hives. 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 the 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), loratadine (Claritin), cetirizine (Zyrtec), and h3 blockers such as cimetidine (Tagamet) and ranitidine (Zantac).

High doses and a mix of several antihistamines are often required to control itching. Other oral agents called leukotriene receptor antagonists may also be used. An 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 the 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 on 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.

How can we help you?

SKIN

# of surveys: 3952
Last updated: 6/16/2022 2:45 PM

PATIENT RATINGS

Would you recommend us?

definitely
93.1%
probably
6.16%
maybe
0.58%
not likely
0.08%
no
0.02%

Compare our service to other similar practices

excellent
87.9%
very good
10.1%
good
1.8%
poor
0.06%
very poor
0%

Overall doctor performance

excellent
94.2%
very good
4.89%
good
0.80%
poor
0.03%
very poor
0%

The doctor listened to you attentively

excellent
93.9%
very good
4.97%
good
1.05%
poor
0.05%
very poor
0%

The doctor took time to answer your questions

excellent
94.0%
very good
4.66%
good
1.27%
poor
0.02%
very poor
0%

The doctor explained treatment options

excellent
94.3%
very good
4.16%
good
1.25%
poor
0.14%
very poor
0.02%

The doctor explained treatment options

excellent
92.0%
very good
5.69%
good
2.18%
poor
0.11%
very poor
0.0%

Front desk performance

excellent
85.6%
very good
10.2%
good
3.66%
poor
0.31%
very poor
0.08%

Aesthetician performance

excellent
88.6%
very good
7.61%
good
3.39%
poor
0.24%
very poor
0.08%

Office comfort

excellent
90.9%
very good
6.93%
good
2.08%
poor
0.05%
very poor
0.05%

Parking

excellent
66.4%
very good
14.4%
good
15.7%
poor
2.49%
very poor
0.9%

Friendliness of the staff during appointment

excellent
90.9%
very good
7.23%
good
1.85%
poor
0.05%
very poor
0%

What WE DID WELL

(Answers:674)

The attention Dr. Abraham gave to me.

#12012-07-24 12:29:37

Attention by all staff.

#22022-06-14

The unhurried time spent by everyone

#32010-11-30 10:51:14

All was excellent

#42011-05-03 10:51:30

Everyone was incredibly kind, informative and helpful. It was one of the best doctor office experiences I've ever had.

#52022-05-25

professional staff

#62010-12-02 11:39:52

It was a very good experience in all - see you next year!

#72021-07-04

I have been to many dermatologists and the service here was exceptional.

#82022-02-06

Dr. Ringpfeil took her time and was attentive to my concerns. Writing all options on paper was very helpful and will help me when I start my regimen

#92021-09-11

cleanliness of office, layout of facility, short wait time to see physician, communication skills of physician and medical asst.

#102022-01-20

What can we do better?

(answers:373)

I think everything was wonderful. Keep up the good work!

#12011-02-22 09:25:17

Keep doing what you are doing!

#22022-06-22

My advice would be to continue doing exactly what you are presently doing. I had a very good first impression of Dr. Ringpfeil and the practice. Thank you.

#32011-02-07 10:50:14

Provide some written information for questions asked. I can't remember everything said.

#42022-05-22

I cannot think of a thing that would make the visit any better.

#52010-11-03 15:36:43

frankly, everything was excellent

#62011-08-01 16:26:25

Keep doing what you're doing.

#72022-05-06

I think that you should just mkae the vists a little bit quicker, and thats all.

#82010-10-27 08:46:34

Everything was good

#92011-03-08 15:22:54

I recommended this practice to a family member but they showed up 15 mins late to their first appt. due to traffic and were turned away (after traveling over an hour to get here). I would suggest on the first visit to allow more leeway for late appointments (try to fit them in) and then explain the late policy for all appointments moving forward.

#102011-09-21 14:47:49

Customer Rating : 4.6

Based on 351 ratings
Send us a message!

Enter your information, and we will text you shortly.