Hives

Disease	Injury	Nutrition	Poison

Special Topic	Surgery	Symptoms	Test

Hives (urticaria) - close-up

Hives

Food allergies

Hives (urticaria) on the arm

Hives (urticaria) on the chest

Hives (urticaria) - close-up

Hives (urticaria) on the trunk

Hives (urticaria) on the back and buttocks

Hives (urticaria) on the back

Hives (urticaria) on the chest

Hives

Definition:

Hives are raised red welts of various size on the surface of the skin, often itchy, which come and go.

Alternative Names:

Urticaria

Causes, incidence, and risk factors:

Hives are very common, especially in people who have experienced other allergic reactions, including hay fever and angioedema. The welts occur on the surface of the skin, usually in batches. Release of histamine and other chemicals into the bloodstream, associated with the allergic response, causes the itching, localized swelling, and other symptoms.

Many substances, called allergens, can trigger an allergic response resulting in hives. Common allergens include:

Medications
Foods (such as berries, shellfish, fish, nuts, eggs, milk, and others)
Pollen
Animal dander (especially cats)
Insect bites

Hives may also develop after infections or illness (including autoimmune diseases, leukemia, and others). There seems to be a hereditary tendency toward the development of hives.

Some less common causes of hives include:

Cold urticaria
Lupus erythematosus (SLE)
Echinococcus infection (dog tapeworm)
Hereditary angioedema
Mononucleosis
Hepatitis
Mastocytosis

Symptoms:

Itching (pruritus)
Swelling of the surface of the skin into red or skin colored welts (wheals) with clearly defined edges
- Sudden onset
- Rapid resolution
- Welts blanch to touch

Welts enlarge, spread, or join together to form large flat raised areas
Welts change shape, disappear and reappear within minutes or hours

Signs and tests:

The diagnosis is primarily based on the appearance of the skin, and is confirmed by a history of exposure to an allergen. Occasionally, skin or blood tests may be performed.

Treatment:

Hives in the throat may obstruct the airway, so any swelling in the throat or difficulty breathing with hives are emergency symptoms. Call your local emergency medical services or visit the emergency room immediately.

Treatment may not be needed if hives are mild, and they may disappear spontaneously.

Antihistamines, adrenaline (epinephrine), corticosteroids (prednisone), sedatives, or tranquilizers may reduce the inflammation, itching, and swelling.

Self care:
Cool compresses or soaks to the area may reduce swelling and pain. Avoid irritation of the area, and don't wear tight clothing (which may trigger a new outbreak). Avoid known allergens to prevent recurrence of hives.

Expectations (prognosis):

Hives may be uncomfortable, but they generally are harmless and disappear on their own. In most cases, the exact cause of hives can not be identified.

Complications:

Anaphylaxis
Life-threatening airway obstruction, if swelling occurs in the throat

Calling your health care provider:

Call your health care provider if urticaria is severe and does not respond to treatment.

Call your health care provider or go to the emergency room if there is difficulty breathing, severe wheezing, or if fainting occurs.

Prevention:

Avoid exposure to substances that are a known allergen for you.
Take only prescribed medications.
Avoid hot baths or showers after an episode of urticaria to prevent recurrence.

Review Date: 10/28/2001
Reviewed By: Michael Lehrer, M.D., Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

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