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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.

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Last updated: 6/27/2023 11:10 AM

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What WE DID WELL

(Answers:674)

Technologically advanced office made it much easier to register all information as a new patient.

#12023-08-12

colors and plants

#22010-12-13 11:23:03

The friendlyness

#32023-01-20

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!

#42023-05-27

Everyone was very attentive and I didn't feel rushed. Soothing atmosphere and even the temperature in the office and waiting room was perfect! The doctor exceeded my expectations - wonderful experience!

#52011-06-02 11:41:01

I was impressed that the doctor really listened to me and that she thoroughly answered my questions. Instead of telling me not to worry about things, she explained the nature of the condition and why it wasn't a concern. She also thoroughly explained my treatment options so I could make an informed decision.

#62023-01-31

the doctor and assistant were very nice and the doctor very inormative and clear

#72023-06-17

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.

#82023-03-02

THE ATMOSPHERE IS LOVELY AND DR. RINGPFEIL IS VERY THOROUGH AND I HAVE CONFIDENCE IN HER.

#92023-09-24

Everything was great. Very prompt, attentive service. Thank you.

#102023-06-05

What can we do better?

(answers:373)

Everything was great thanks!

#12011-02-25 11:46:15

I can't think of a single thing to make it better!

#22023-05-27

everything was great

#32023-05-13

So far so good!

#42011-01-04 10:23:13

No comments, everything is great.

#52011-02-21 13:37:17

I have no suggestions. I am very pleased with ever aspect of my care

#62010-10-18 16:25:51

nothing just keep up the good work.

#72023-07-26

Thank you

#82011-02-23 17:11:29

Please consider offering more appointments after 5pm since it can be a challenge to take time off from work.

#92022-12-23

music in office was just okay

#102022-12-29

Customer Rating : 4.6

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