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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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# of surveys: 3870
Last updated: 5/3/2021 12:54 PM

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Overall doctor performance

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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

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Office comfort

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What WE DID WELL

(Answers:674)

the doctor was very nice and all the staff was very nice and answered all my questions i had.

#12020-05-26

start to finish it was a perfect experience, i found the reception area very heplful and understanding,

#22020-09-16

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.

#32020-06-15

The frankness of the doctor

#42020-09-06

Friendliness

#52021-01-08

Very well organized! Dr. Ringpfeil was very professional and thorough!

#62020-09-03

I have al;ways liked the Doctor and the satff

#72010-11-17 15:23:04

everyone was very pleasant and made me feel comfortable about my situation as well as gave me the hope for relief I was hoping for.

#82020-05-08

The doctor was very nice and seemed to care about the patient. She asked me many questions. Office is very clean and professional looking.

#92020-09-06

everyone seemed genuinely friendly.

#102020-10-30

What can we do better?

(answers:373)

Evening hours

#12020-12-25

this computer system doesnt show the full anser in some cases. and some required tabs shouldnt be required, like cell phone and work phone.

#22021-05-06

before prescribing a very expensive treatment, inform the patient you are doing so.

#32020-12-18

everything was great

#42021-01-27

When making a first appointment ask who ther person would like to see. Doctor vs Aesthetician

#52020-10-07

Everything was excellent.

#62021-01-04

Complimentary BMW with first visit

#72020-07-06

I had problems with my insurance. Since you took my insurance information over the phone it might have been nice to know that before I came in so I could have fixed it.

#82011-05-19 10:14:50

Overall excellent service. Friendly front desk staff. A very small suggestion would be to have someone immediately identify themselves as the person to register a new patient and direct where to go when someone enters the waiting room. With a big waiting room and three people at the front desk, it is a lot to take in and not know to whom to speak. Having had negative experiences with doctors' receptionists where all three of the three people at the front desk have ignored me until I called out and forced a response, I am sensitive to the issue and imagine others have had this experience as well.

#92011-01-31 10:42:48

Keep doing what you are doing now..make sure no one slips, then I will make sure I write about it.

#102020-08-16
Customer Rating : 4.5

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