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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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SKIN

# of surveys: 3749
Last updated: 05/18/2017 4:45 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)

I was very impressed that Dr. Ringpfeil took the time out to talk to me and treat me like an individual. I am completely comfotable here and I will be coming here for my treatment.

#12011-05-04 14:47:50

everyone was very friendly and didn't make me feel self conscious.

#22011-06-01 18:06:14

Cute babes that worked in the office.

#32017-01-09

friendly, laid-back style yet factual and to-the-point feedback

#42017-05-27

I enjoyed how friendly everyone was.

#52017-09-22

the atmosphere alomg with the professionalism of the staff.

#62017-07-17

The Dr. was very kind, compassionate and respectful as well as knowlegeable of alternative ways. She is a real doll. Happy to have her as my doc and would recommed her to clients at Arrowroot Health Food Store.

#72017-02-19

Excellent service; thanks for not making me wait to be seen, like I do in every other doctor's office!

#82011-06-08 09:39:58

I liked how the doctor gave me the prices of procedures that we discussed. Every doctor should do that!!

#92017-06-08

the personalized acne regiment.

#102017-09-11

What can we do better?

(answers:373)

no complaints. everything was fine.

#12017-05-06

I'm speechless!! I make a living at answering this very question but I can't recommend anything you can do to provide better service. You deserve a high score in all aspects of the practice. One minor detail - I have not yet seen the aesthetician and I have limited experience with you. Maybe patients could complete a survey after they've had a couple of appointments and contact with others. Some valuable feedback may be provided. Oops....I just heard an administrator use the word "cancellation" with a patient. May I suggest other terms like "change in the schedule" or "we'll make time for you". Wouldn't want to give patients the idea that it's ok to cancel. :-) Can you recommend a vascular specialist closer to the area than in Center City?

#22011-06-02 14:18:32

Nothing, Thank you so much.

#32011-03-04 10:10:02

just keep giving me good news and no cancer.

#42017-11-15

Try to get enrolled as a provider in Tricare Prime!

#52016-12-16

Cannot think of anyway to improve things, unless you want to serve hot tea and cappachino!

#62011-02-22 11:25:39

No room for improvement

#72017-02-26

Hard to say, this was a short visit and the service and treatment, as far as I can tell, were excellent

#82017-08-04

So far so good!

#92011-01-04 10:23:13

Keep up the thinks you are doing....

#102017-06-11
Customer Rating : 4.3

Based on 33 ratings