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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 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: 4187
Last updated: 1/02/2024 11:10 AM

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Compare our service to other similar practices

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Overall doctor performance

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The doctor listened to you attentively

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The doctor took time to answer your questions

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The doctor explained treatment options

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The doctor explained treatment options

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Front desk performance

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Aesthetician performance

excellent
88.6%
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Office comfort

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Parking

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Friendliness of the staff during appointment

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What WE DID WELL

(Answers:674)

ENVIRONMENTALLY CONVENIENT AND EVERYONE WAS EXTREMELY FRIENDLY. ALSO IMPORTANT WAS YOU SERVE YOUR PATIENTS RIGHT ON TIME WITH NO DELAYS WHICH IS ALWAYS A PLUS!

#12012-06-14 10:23:51

The neatness of the clinic and the efficency of the staff and the doctor. Dr. Ring fieil was wonderful and knows her fireld, i have been to several dermatologists and finally I found the one who knows what she is talking about.

#22024-04-25

Everyone seem to be knowing what they are doing and loving to take the time to assure you that they care and can assit you..

#32011-04-19 09:23:01

I particularly like the assertiveness that the office provided. Being in and out is a best for me.

#42024-02-19

I think the doctor is very thorough in her evaluations and explanations and the staff is extremely professional and friendly. Definitely 5 star service!

#52011-09-22 13:13:46

Minimal waiting time. So friendly and professional!!

#62012-10-01 11:08:39

doctor

#72024-05-31

I found the office pleasant and staff, medical assistant, and doctor very friendly, yet very efficient, well-informed, professional, and knowledgeable. A very satisfying experience!

#82024-04-13

Staff professionalism,crisp action,friendly engagement,and a well designed entry area.

#92011-09-21 17:08:06

the stafff and doctor were extremely friendly

#102024-02-27

What can we do better?

(answers:373)

Nothing more than today's appintment.

#12010-11-10 08:24:10

No room for improvement. You have a first-rate, exceptional staff Dr. Ringpfeil! Everyone especially Linda Heckman is so professional. Jessie makes a great first impression and is an asset to your team!

#22010-12-15 19:35:32

You guys did great. This was a great experience for me

#32010-09-22 12:31:41

service wonderful!

#42011-01-03 11:45:01

It would be helpful to have some later evening hours, but the early morning hours work for me too!

#52024-08-07

While I totally understand the late policy, unfortunately my daughter and I drove 1.5 hrs to the facility and given the weather and errorous directions, we ended up being 7 mins late. I immediately called the office while on route to explain that we were lost and sought correct directions. The receptionist was very curt, short and condesending. Upon our arrival, there was no warm greeting and very limited eye contact. Again,as a heath care provider myself, I appreciate the need to follow a schedule, however, our appointments were in direct succession and I do not think it would have had a significant impact on the work schedule, given our special circumstance.

#62011-03-24 10:10:11

Service was fantastic. No suggestions.

#72011-11-29 13:58:45

No changes recommended at this time.

#82024-11-25

Everything was great.

#92024-03-05

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

#102010-11-03 15:36:43

Customer Rating : 4.7

Based on 637 ratings
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