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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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What WE DID WELL

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Dr. Ringpfeil is wonderful. I must say i've visited various dermatologist in the past and this is the first doctor that has touched my face. Very important to me so that was big believe it or not. Also very easy to talk to and you dont feel rushed.She explains well. i'm very satisfied with my visit.

#12018-12-14

Everyone was extremely welcoming, pleasant and professional. I felt very secure with the knowledge and professional, caring treatment by both the doctor and her assistant.

#22019-06-27

The appearance and presentation of the office.

#32019-06-14

I appreciated that Dr. Ringpfeil took the time to thoroughly explain everything we spoke about. She did not simply provide a professional opinion, she provided her opinion and supplemented it with an explanation that made everything clear to me. I felt like I was listened to and interacted with, rather than just spoken at (which has often been my experience with other dermatologists). Thank you!

#42019-05-01

Ambiance and cleanliness of the office; informative, highly professional staff. Overall, this was a very pleasant experience.

#52019-03-30

The Dr. wanted to start with the simpliest treatment before jumping into medicated treatment.

#62018-12-15

The professionalism was awesome.

#72012-07-03 15:04:31

The frankness of the doctor

#82019-05-28

The dr spent a lot of time answering my questions.

#92011-10-17 16:10:34

The time the Doctor spent talking to me about my problem. She did not rush.

#102011-12-15 12:54:52

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(answers:373)

keep doing what u doing keep up the good work!!!!

#12019-05-26

I checked off compimentary consultation with aesthetician on the intake forms, but it wasn't mentioned and I forgot to ask during the examination.

#22019-06-20

So glad I came. Always liked Dr. Kern and Ann Watson. He'd be so pleased with your entire professional setup

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All fine

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nothing just keep up the good work.

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#72011-04-05 09:29:32

Information for patients to take on latest findings/research in the field

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I've never been in a medical office that was so warm and inviting. The decor and overall appearance has the feel of your living room but also reminds you that you are in a clinical environment as well. This practice surpasses my expectations in every way, from the staff, dress code, advances in technology and overall care of the patient. I was made to feel that my care is your number one priority.

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