In hives, or urticaria, itchy wheals appear on different areas of the body. When swelling occurs on the face and hands, it is referred to as angioedema. If the symptoms persist for more than six weeks, it is considered chronic hives, and we should work together to identify the underlying causes.
The symptoms are often triggered by the release of the tissue hormone histamine as part of allergic reactions. However, certain medications can also cause these symptoms. Histamine dilates small blood vessels, making them more permeable. The result is reddened skin and wheals. In addition, histamine plays a role in the development of itching.
What can cause hives?
The causes of acute hives are extremely diverse and may include infections, often in combination with medication intake (e.g. aspirin, antibiotics). Allergic reactions and intolerances can also be contributing factors.
Which examinations are useful for hives?
In addition to basic laboratory tests, we rule out allergies and, if necessary, take a skin sample. Keeping a dietary diary can be helpful. This is followed by an infection-allergy focus search, during which the patient is thoroughly examined to identify potential inflammatory triggers. Finally, an elimination diet and provocation testing may be performed; this usually requires a hospital stay.
How is hives treated?
In addition to creams for itching, possibly containing cortisone, we use antihistamines. In therapy-resistant cases, treatment with the anti-IgE antibody omalizumab (Xolair) may be considered.
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