Hives can be very uncomfortable and inconvenient, especially when you break out in a rash unexpectedly. Hives can be triggered by various circumstances and environments so let’s take a look at the causes and symptoms of hives and how to treat this condition effectively.
Hives (also known as urticaria) are red itchy welts that are caused by a skin reaction. They vary in size and can appear and fade at different times and when pressing the centre of the hive it usually turns white. If the welts appear for more than six weeks at a time or occur and re-appear over a period of months and years, then it is considered chronic. Chronic hives can be very uncomfortable and can interfere with sleep and other activities.
There are various signs and symptoms of chronic hives which include the following:
- Batches of red or coloured welts which can appear anywhere on the body
- Welts that vary in size, change shape and appear and fade repeatedly as the reaction runs its course
- Itching, which may be severe
- Painful swelling of the lips, eyelids and inside the throat, hands or feet (also known as angioedema)
- Symptoms get worse due to heat, stress and exercise
- Symptoms reappear frequently and unpredictably
The welts associated with hives occur when certain cells release histamine and other chemicals into your bloodstream. It is also very difficult for doctors to find the underlying reason for the hives but it can be triggered by the following:
- Pain medication
- Insects or parasites
- Heat or cold
- Alcohol or food
- Pressure on the skin, such as tight clothing or waistbands
- Certain foods such as peanuts, eggs, nuts and shellfish
- Blood transfusions
- Bacterial infections such as urinary tract infections and strep throat
- Certain plants
- In some cases hives may be causes by thyroid disease
In order to diagnose the problem the doctor might ask you to keep track of the following:
- Your activities
- Any medications or supplements that you take
- What you eat and drink
- Where the welts appear and how long it takes for them to fade
- Whether the hives come with painful swelling
After the physical exam and providing answers to questions regarding the points above, the doctor might feel that the hives are being caused by another underlying condition and thus send you for further blood tests or skin tests.
In certain cases, it is very easy to determine the cause such as simple allergy to nuts, however, in other cases it takes a lot of time and patience to identify the problem and sometimes the answer is never found. This is known as chronic idiopathic urticaria which means ‘unknown’.
If the tests do not provide an answer then the doctor will usually first suggest cool compresses or lotions to relieve itching and over the counter antihistamines to treat the symptoms, however, if these do not seem to work then other combinations of prescription medication such as anti-inflammatories are usually prescribed. Severe cases of urticaria might require temporary treatment using prednisone which can reduce the severity of the symptoms.
Some doctors might recommend that you see a skin specialist or allergist for more specialised medication. They are trained specifically in performing skin tests and thus might be able to identify the problem quickly and provide stronger and more specialised combinations of medications to assist in clearing up or controlling the hives more effectively.
If the hives are found to be caused by physical circumstances then this means that the hives will be triggered by the following situations:
- Rubbing or scratching – hives appear within minutes in the area that was rubbed or scratched.
- Constrictive clothing such as belts or shoes – hives appear on the midsection or the soles of the feet (as that part of the foot is under constant pressure). In these situations, red swelling can appear within 6-8 hours after applying pressure.
- Changes in temperature – for example, exposure to low temperatures followed by re-warming, which can be severe and life-threatening if there is general body cooling such as jumping into a swimming pool.
- Higher body temperature – as a result of sweating, exercise, hot showers or anxiety, known as cholinergic urticaria.
- Sun exposure – known as solar urticaria, may occur within minutes after being exposed to the sun.
Here are a few home remedies and tips to help relieve symptoms of hives as sometimes (as mentioned previously) it is hard to pinpoint what the trigger is:
- Try wearing loose-fitting and light clothing so as not to put any pressure on any parts of the body.
- Avoid scratching or using any harsh soaps as this can make the hives feel worse.
- Soothe the affected area with a bath, fan or cool cloth, lotion or anti-itch cream.
- Keep a diary of the food and beverages you eat and drink every day, the activities you perform and the products you use on your body which could assist the doctor in finding out the cause of the hives.
- Make a note of the time of day that the hives occur and if this is related to any activities or food consumed.
- Avoid things that you know might trigger the hives.
- Apply sunscreen before going out.
If you or anyone you know is struggling with hives, please contact a doctor so that you can get the necessary treatment and relief from what can be a very painful and uncomfortable condition. The right doctor and the right medication can assist in identifying the cause, treating the problem and preventing future episodes from occurring. If the doctor cannot find the cause then at least you know that he/she will be able to help you manage the urticaria so that you can go back to leading a healthy and happy lifestyle!