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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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Last updated: 12/03/2019 4:34 PM

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What WE DID WELL

(Answers:674)

Ability to use computer to fill in info

#12019-05-06

The knowledge, helpfulness, and friendliness of every person in this office has made me decide to have my daughter and me be seen here instead of by a doctor in the area in which we live (more than half an hour away). Thank you.

#22018-12-15

The dr spent a lot of time answering my questions.

#32011-10-17 16:10:34

Friendliness

#42011-01-03 09:55:52

Everything was good. I like this place.

#52019-09-14

The professionalism of the staff and doctor. Everyone was easy to talk to and my questions were answered.

#62019-08-24

I thought the doctor was very thorough in explaining the procedures I need to take care of my skin problem

#72019-11-05

I loved how friendly and nice everyone was. It was the greatest doctore visit I have ever had.

#82019-02-11

THE DOCTOR WAS GREAT. REALLY EXPLAINED THINGS WELL AND LISTENED TO MY CONCERNS.

#92019-06-03

The prfessionalism of the staff and the attentiveness of the physician. Also the timliness of the staff.

#102011-01-26 08:55:26

What can we do better?

(answers:373)

It's a little warm in the office.

#12018-12-25

Good the way it is.

#22019-08-28

Coffee, Tea? only kidding. Hope I gave the reader a smile today.

#32011-02-21 10:56:55

just keep giving me good news and no cancer.

#42018-12-22

not sure yet

#52019-08-19

The restroom could be cleaner.

#62011-01-19 08:56:51

keep up the good work. you have an excellent service and your office is great

#72019-08-04

my visit was great

#82019-03-25

sometimes I feel the phone staff is not as helpful as it could be, but that is not reflected in the quality of services. Front office is very professional overall.

#92010-11-04 13:29:14

No major suggestions. I got all the answers I needed.

#102019-06-19
Customer Rating : 4.5

Based on 110 ratings