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Urticaria - Hives

Urticaria is commonly known as hives. First the skin itches, then it erupts into red welts. The itching may be severe, keeping people from working or sleeping. It's a distressing disorder which affects an estimated 20 percent of the population at one time or another in their lives.

Most cases of urticaria are acute, lasting from a few hours to less than six weeks. Some cases are chronic, lasting more than six weeks. The welts may appear in one place, disappear after a short time, then erupt at another spot, then another. They are made worse by scratching.

Bouts of urticaria have been traced to such triggers as certain foods and additives, infections, drugs (including aspirin), cold, sun exposure, insect stings, alcohol, exercise, endocrine disorders and emotional stress. In some people, pressure caused by belts and constricting clothing causes eruption. Urticaria may be a response to infection including the common cold, strep throat and infectious mononucleosis. In the urticaria-prone person, these triggers cause the body to release chemical mediators, including histamine, from cells. Histamine (which causes itchy, runny noses and watery eyes in hay fever sufferers) dilates the walls of blood vessels, allowing fluids to leak out into the surrounding tissues. Swelling and itching are the result.

How is urticaria treated?

Your allergist first will alleviate the discomfort with medications, such as antihistamines. Severe attacks of urticaria can be temporarily relieved by injections of epinephrine; rarely in these cases, corticosteroids may be prescribed for a short period. Other drugs may be required for specific types of urticaria. If the cause can be identified, the best course of treatment is avoidance of the substance that triggers urticaria. If a problem with a specific food is strongly suspected, then it should be avoided. This may require a careful reading of packaged food labels and inquiry about ingredient in restaurant meals. Loose-fitting clothing will help relieve pressure urticaria. Avoid harsh soaps and frequent bathing to reduce the problem of dry skin, which can cause itching and scratching that can aggravate urticaria. Vigorous toweling after a bath may precipitate hives. Although success of identifying the cause of chronic urticaria varies from clinic to clinic according to patient populations, it usually is no higher than 20 percent of cases. It may last for months or for years and burn itself out, never to bother the sufferer again.