Understanding Urticaria

Urticaria, more commonly known as hives, appears as red, itchy welts or raised patches on the skin that can vary in size and shape. For some, urticaria may last only a few hours, while for others, it may persist for weeks or even months.

While hives may seem like a minor skin irritation, they can significantly impact daily life due to discomfort and the unpredictability of flare-ups. In severe cases, urticaria may also signal an underlying health issue or trigger life-threatening allergic reactions, making proper diagnosis and management essential.

This blog explores urticaria in detail — from its causes, symptoms, and types to diagnostic tests, treatments, home remedies, and prevention strategies.

What is Urticaria?

Urticaria is a skin reaction that causes raised, red, and itchy welts on the surface of the skin. These welts, also called hives, are caused by the release of histamine and other chemicals from skin cells in response to a trigger.

Hives may appear suddenly and can move from one part of the body to another. They typically fade within 24 hours but may recur. When the condition persists for more than six weeks, it is classified as chronic urticaria.

Causes of Urticaria

The image above highlights some common causes of urticaria. Let’s explore them in more detail:

1. Allergies

One of the most common triggers. Allergens may include:

• Certain foods (nuts, shellfish, eggs, milk, soy)

• Animal dander

• Latex

• Mold

2. Medications

Some drugs can cause allergic reactions or histamine release, leading to hives. Examples include:

• Antibiotics (penicillin, sulfa drugs)

• Aspirin

• Nonsteroidal anti-inflammatory drugs (NSAIDs)

• Blood pressure medications

3. Exercise

Physical exertion may trigger a condition known as exercise-induced urticaria, often linked with increased body heat and sweating.

4. Sunlight (Solar Urticaria)

In rare cases, exposure to direct sunlight can cause hives to develop within minutes.

5. Pollen

Seasonal allergies triggered by pollen from trees, grass, or flowers can result in skin reactions such as hives.

6. Dust Mites

Microscopic dust mites that thrive in bedding, carpets, and upholstered furniture can cause allergic reactions.

7. Insect Bites or Stings

Mosquitoes, bees, ants, and other insect bites can lead to sudden hives, especially in allergic individuals.

8. Excessive Sweating (Cholinergic Urticaria)

Heat, emotional stress, or sweating may trigger hives in sensitive individuals.

9. Other Factors

• Stress and anxiety

• Viral or bacterial infections

• Hormonal changes

• Contact with chemicals or irritants

Symptoms of Urticaria

The hallmark symptom of urticaria is itchy, red welts on the skin. Other symptoms include:

• Raised patches that vary in size and shape

• Red, pink, or skin-colored bumps

• Welts that may appear, fade, and reappear in different locations

• Burning or stinging sensation

• Swelling of lips, eyelids, or throat (angioedema) in severe cases

Types of Urticaria

Urticaria can be categorized based on duration and triggers:

1. Acute Urticaria

   • Lasts less than six weeks

   • Often caused by allergies, infections, or medications

2. Chronic Urticaria

   • Persists longer than six weeks

   • Cause may be difficult to identify

   • Sometimes linked with autoimmune disorders

3. Physical Urticaria

   • Triggered by external factors such as heat, cold, sunlight, pressure, or vibration

4. Cholinergic Urticaria

   • Triggered by sweating, exercise, or hot showers

5. Dermatographism

   • Hives appear when the skin is scratched or rubbed

Risk Factors

You may be at higher risk of developing urticaria if you:

• Have a personal or family history of allergies

• Take medications known to cause allergic reactions

• Have autoimmune disorders

• Are frequently exposed to pollen, dust, or insects

• Experience high levels of stress

Complications

While most cases of urticaria are mild, complications may include:

• Angioedema: Deep swelling of the skin and tissues

• Anaphylaxis: A severe, life-threatening allergic reaction requiring emergency treatment

• Sleep disturbances due to intense itching

• Emotional distress from recurring symptoms

Diagnosis of Urticaria

Doctors typically diagnose urticaria through:

• Medical history and physical examination

• Allergy testing (skin prick or blood test)

• Blood tests to rule out autoimmune or thyroid issues

• Elimination diets if food allergies are suspected

Treatment of Urticaria

1. Medications

• Antihistamines (Cetirizine, Loratadine, Fexofenadine) – to reduce itching and swelling

• Corticosteroids – for severe flare-ups (short-term use only)

• Leukotriene inhibitors – used in some chronic cases

• Immunosuppressants or biologics (like omalizumab) – for chronic urticaria unresponsive to other treatments

2. Home Remedies and Lifestyle Changes

• Applying cold compresses

• Wearing loose cotton clothing

• Avoiding hot showers

• Staying away from known triggers

• Practicing relaxation techniques for stress-induced urticaria

3. Dietary Adjustments

Some patients benefit from a low-histamine diet, avoiding foods such as:

• Aged cheese

• Processed meats

• Alcohol

• Fermented foods

Prevention Tips

• Keep a diary to identify and avoid triggers

• Maintain good indoor hygiene to reduce dust mites

• Use sunscreen if sensitive to sunlight

• Stay hydrated and avoid overheating

• Consult your doctor before taking over-the-counter medications if you have a history of allergies

When to See a Doctor

Seek immediate medical help if you experience:

• Swelling of lips, tongue, or throat

• Difficulty breathing or swallowing

• Severe, recurring hives that don’t respond to medication

Living with Chronic Urticaria

Chronic urticaria can be frustrating, but with the right treatment plan, most patients can manage symptoms effectively. Regular follow-ups with a dermatologist or allergist are essential to adjust medications and monitor progress.

Frequently Asked Questions (FAQ)

1. What is the main cause of hives?
The most common causes include allergies (to foods, pollen, or medications), infections, insect bites, and stress. In many chronic cases, the exact cause may remain unknown.

2. Can hives be cured permanently?
While acute urticaria often resolves within weeks, chronic urticaria may persist for months or years. Proper treatment can control symptoms, but there may not always be a permanent cure.

3. Are hives contagious?
No, urticaria is not contagious. You cannot catch it from another person.

4. What foods should be avoided in hives?
Foods high in histamine such as shellfish, nuts, alcohol, aged cheese, and processed meats may worsen symptoms in some patients.

5. Can stress cause hives?
Yes, stress can trigger or worsen hives by affecting the immune system and increasing histamine release.

6. How long does hives last?
Acute hives typically last a few days to weeks, while chronic urticaria persists for six weeks or longer.

7. Is hives a sign of a serious disease?
Not always. However, in some cases, chronic urticaria may be linked to autoimmune disorders or thyroid problems.

8. Which doctor should I consult for hives?
You can consult a dermatologist or an allergist for diagnosis and treatment.

Urticaria, or hives, is a common skin condition that can be triggered by a wide variety of factors including allergies, medications, stress, and environmental exposures. While most cases are mild and temporary, persistent or severe urticaria requires medical attention.

At Sparsh Diagnostic Centre, expert healthcare professionals can help diagnose the underlying cause of urticaria and recommend effective treatments. If you or a loved one is struggling with recurring hives, don’t ignore the symptoms — book a consultation today.