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Home > Health Hub > Article > Urticaria (Hives)- Symptoms, Causes and Treatment

Urticaria (Hives)- Symptoms, Causes and Treatment

Medikoe Health Expert

Medikoe Health Expert

  Koramangala, bengaluru, karnataka, india, Bengaluru     Sep 30, 2020

   6 min     



Urticaria (hives) are a red, raised, and itchy skin rash, a skin reaction that is sometimes triggered by an allergen. An allergen is something that introduces an allergic reaction.

It is also identified as urticaria, weals, welts, or nettle rash. The welts or urticaria differ in size and appearance and frequently fade as the reaction runs its course.

When an allergic effect appears, the body emancipates a protein called histamine. When histamine is released, the tiny blood vessels known as capillaries leak fluid are also released from under the surface of the skin. This fluid gathers in the skin and causes a rash.

The condition is regarded as chronic hives if the welts arise for more than six weeks and frequently reappear over months or years. Often, the reason for developing chronic hives is not clear.

Chronic hives can be very annoying and hinder with sleep and daily activities. For a lot of people, antihistamines and anti-itch medications give relief. 

The urticaria or hives affect approximately 20 per cent of people at some time in their life. 

It is not communicable.

Causes of Urticaria

Urticaria appears when the body responds to an allergen and liberates histamine and other chemicals from beneath the surface of the skin.

The histamine and chemicals begin inflammation and fluid to accumulate beneath the skin, causing welts or wheals.

Examples of identified triggers include:

  • medications, including some non-steroidal anti-inflammatory drugs (NSAIDs) and antibiotics, such as ACE inhibitors and aspirin, used for high blood pressure

  • foods, such as eggs, nuts, shellfish, strawberries, food additives, and wheat products

  • infections, including influenzaglandular fever, the common cold, and hepatitis B

  • bacterial infections, including UTI or urinary tract infections and strep throat

  • high body temperature

  • extreme temperatures or changes in temperature

  • scratching

  • water on the skin

  • pet wrath from cats, dogs, horses, and so on

  • dust mites

  • cockroaches and cockroach waste

  • intestinal parasites

  • insect bites and pricks

  • latex

  • pollen

  • some plants, including poison ivy, nettles, and poison oak

  • a few chemicals

  • chronic ailments, such as thyroid disease or lupus

  • sunlight vulnerability

  • exercise

In over half of all cases, people never discover the accurate cause.

Chronic urticaria may begin as an autoimmune response, but why it appears is unclear.

Symptoms of Urticaria

Signs and symptoms of chronic urticaria (hives) include:

  • Bunches of red or skin-coloured welts (wheals), which can develop anywhere on the body

  • Itching, which may be critical

  • Welts that vary in size, change its shape and appear and repeatedly fade as the reaction runs its course

  • Painful inflammation (angioedema) of the lips, eyelids and inside the throat

  • An inclination for signs and symptoms to widen with triggers such as stress, heat and exercise

  • A tendency for signs and symptoms to continue for more than six weeks and to reappear frequently and unpredictably, sometimes for months or years

Short-term or acute hives arise suddenly and disappear on its own within a few weeks. 

Complications of Urticaria 

Chronic hives don't place you at any unexpected risk of a severe allergic reaction (like anaphylaxis). But if you do encounter urticaria or hives as part of critical allergic response, inquire for emergency care. 

Signs and symptoms of anaphylaxis include dizziness, difficulty in breathing, and swelling of your lips, tongue and eyelids.

Diagnosis of Urticaria

Your specialist will do a physical exam and inquire you a number of questions to try to comprehend what might be beginning your signs and symptoms. He or she may also ask you to maintain a diary to keep track of:

  • Your activities

  • What you eat and drink

  • Any medications, herbal remedies or supplements if any you take

  • Where hives occur and how long it needs a welt to disappear

  • Whether your hives come with painful inflammation

If your physical exam and medical records imply your hives are caused by an underlying problem, your doctor may have you undergo a few testing, such as blood tests or skin tests. 

Treatment of Urticaria

Your doctor will possibly advise you to treat your symptoms with home remedies, for example, over-the-counter antihistamines. If self-care measures don't benefit, confer with your doctor about getting the prescription medication or combination of drugs that goes best for you. Commonly, adequate treatment can be found.


Taking non-drowsy antihistamine medicines daily supports to block the symptom-producing outflow of histamine. They have several side effects. Examples include:

  • Cetirizine (Zyrtec)
  • Loratadine (Claritin)
  • Desloratadine (Clarinex)
  • Fexofenadine (Allegra)

If the non-drowsy antihistamines don't benefit you, your physician may raise the dosage or have you undertake the type that directs to make people lazy or drowsy and is taken at bedtime. Examples include doxepin (Zonalon) and hydroxyzine pamoate (Vistaril).

Verify with your doctor before using any of these medications if you are pregnant or breast-feeding, have a serious or chronic medical condition, or are already under other medications.

Other medications

If antihistamines alone don't alleviate your symptoms, other drugs may help. For example:

  • Histamine (H-2) blockers. These medications, also called H-2 receptor antagonists, are either injected or taken orally. Examples include famotidine (Pepcid) and cimetidine (Tagamet HB).
  • Antidepressants. The tricyclic antidepressant doxepin (Zonalon), used in emulsion or creamy form, can help reduce itching. This drug may make you feel dizzy and drowsy.
  • Anti-inflammatory medications. Oral corticosteroids, such as prednisone, can assist in reducing swelling, redness and itching. These are usually for short-term prescription of severe hives or angioedema because they can begin serious side effects if exercised for a long time.
  • Asthma drugs with antihistamines. Medications that intervene with the action of leukotriene modifiers may be effective when taken with antihistamines. Examples are zafirlukast (Accolate) and montelukast (Singulair).
  • Immune-suppressing drugs. Options include tacrolimus (Astagraf XL, Prograf, Protopic) and cyclosporine (Gengraf, Neoral, others).
  • Man-made (monoclonal) antibodies. The drug omalizumab (Xolair) is very useful against a kind of difficult-to-treat chronic hives. It's an injectable drug that's habitually given once a month.

Lifestyle Changes and Home Remedies for Urticaria

Chronic hives can disappear for months and years. They can hinder your sleep, work and other activities. The following precautions may help deter or mitigate the recurring skin reactions of chronic hives:

  • Avoid scratching or using harsh soaps.

  • Soothe the troubled area with a bath, cool cloth, fan, lotion or anti-itch cream.

  • Wear loose, light clothing.

  • Maintain a diary of when and where hives occur, what were your activities, what you were eating, and so on. This may aid you, and your doctor to identify triggers.

  • Avoid obvious triggers.

  • Apply sunscreen before you are going outside.

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Tags:  General health ,Skin,Skin conditions,healthy skin,itchy skin, skin rash, allergic reaction, skin reaction

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