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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: 1/02/2024 11:10 AM

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What WE DID WELL

(Answers:674)

I liked the fact that I could enter my information on a computer and I was not asked to provide the same more than once on the informational forms!

#12023-11-28

The service was great!

#22023-10-12

I go away feeling like my concerns have been heard and taken seriously. I liked the music too. Good choices!

#32023-11-13

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

#42023-09-04

Clear information about treatment options which had not been offered in the past. It is possible that these treatment options are new, but it is also possible that the physician is especially knowledgeable.

#52023-11-06

I have been extremly impressed with this practice.

#62011-04-13 12:25:11

I like that you can schedule and access info by computer. The office is beautiful, very relaxing and staff is wonderful. The nicest doctors office I have ever been too

#72011-10-19 12:56:42

I liked that Dr. Ringpfoil was very through and caring.

#82023-08-24

The atmosphere was relaxed and pleasant. I especially liked having a nice big clock in the waiting room.

#92024-03-28

the Dr

#102023-11-15

What can we do better?

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Parking was a little tight.

#12011-06-09 15:52:46

If you continue the same level of care that I received today, I will be thrilled.

#22023-07-06

Magazines in the examining room to read while I waited for the doctor (I get bored easily).

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all good

#42010-10-14 12:21:49

A follow up, even if its an email, after the apt. could help!

#52010-08-23 16:38:55

Can't think of anything staff were very helpful

#62024-04-11

More upbeat music! The warm temperature and the John Mayer-esque music made me feel as if it were bedtime =)

#72011-09-16 11:42:32

NOPE; COULD NOT IMPROVE ON YOUR ARTISTRY IN HEALING ATMOSPHERE AND MEDICAL ATTENTIVENESS.

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Everything was great

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do not change a thing

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