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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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# of surveys: 3750
Last updated: 05/25/2018 9:32 AM,

PATIENT RATINGS

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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%
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What WE DID WELL

(Answers:674)

The appearance and presentation of the office.

#12017-09-28

The care, attention and kindness were remarable--thank you!

#22017-08-05

The dr spent a lot of time answering my questions.

#32011-10-17 16:10:34

Clean, bright, well appointed office

#42017-11-15

THE STAFF AND THE PAINTINGS - lINDA WAS A GOOD LISTENER AND EXPLAINED EVERYTHINF IN DETAIL - SHE DID MOT RUSH ME - I LIKE THAT - ERIN WAS PLEASANT AND VERY PROFESSIONAL . I WAS A GOOD VISIT- THNKA YOU

#52011-04-01 14:05:41

Dr Ringpfiel is clearly extremely knowledgable, and dhe took the time to listen completely to me about my condition. I really appreciated the time she took with me, and I am confident she is on the right path for treatment.

#62017-11-12

This is one of the best medical offices that I have visited. I see doctors in the Penn and Bryn Mawr systems and this is by far much better than any of those offices. The entire staff is friendly and accommodating. Both doctors are awesome! I have recommended you to family and friends. Keep up the great work!

#72012-12-03 17:05:27

LIKE THE WAY WAY THE EXPLAIN THE PROCEDURE ,AND ALSO LIKE THE STAFF PATIENT INTERACTION.

#82012-10-09 10:22:11

The doctor made me feel very comfortable when I was asking questions.

#92017-06-11

The doctor made me feel very comfortable when I was asking questions.

#102018-01-01

What can we do better?

(answers:373)

do not change a thing

#12017-12-22

Excellent experience Can't think of anything I would change

#22011-04-04 11:16:27

just continue listening which is so important

#32017-08-21

Your rain spouts put water into the driveway to the back parking lot. As it gets colder, it will freeze and create a dangerous pathway for clients

#42010-12-13 11:23:03

I would have liked to pay in cash but the receptionist had no change.

#52017-07-14

it's a little thing, but when you enter an office and ask the receptionist attending to you how are you, she say fine, but does not inquire how you are, and is not engaging, I just think its rude.

#62017-05-30

It's a little warm in the office.

#72017-10-29

NO COMMENT AT THIS TIME.

#82017-12-08

no suggestions, you are doing a good job

#92017-12-18

I am new here, so I don't have any suggestions at this time

#102017-12-31
Customer Rating : 4.1

Based on 36 ratings