Urticaria (Hives)

What is urticaria?

Urticaria, or hives, is a condition in which red, itchy, and swollen raised areas appear on the skin.  Sometimes this is due to an allergic reaction from eating certain foods or taking certain medicines; however, in many cases the cause remains unknown.  Hives can vary in size from one-half inch to several inches in size.  Hives can appear all over the body or be limited to one part of the body.

Which foods commonly cause hives?

• Nuts
• Peanuts
• Eggs
• Fish and Shellfish
• Milk
• Alcohol

Which medicines commonly cause hives?

• Antibiotics, especially penicillin and sulfa-based drugs 
• Pain killers, such as opioids and NSAIDs (examples: ibuprofen, naproxen, or aspirin)
• Anticonvulsant drugs or anti-seizure drugs 
• Chemotherapies

Other causes of hives

• Dermatographism. Hives caused by scratching the skin or wearing tight-fitting clothes that rub the skin.
• Cold-induced. Hives caused by exposure to cold air or water.
• Cholinergic urticaria. Hives caused by an increase in the core body temperature. >
• Solar hives. Hives caused by exposure to sunlight or artificial lighting.
• Exercise-induced urticaria. Allergic symptoms brought on by physical activity.
• Chronic urticaria. Recurrent hives that have been continuously or intermittently present for at least 6 weeks. Most cases of chronic urticaria do not have an identifiable cause.

What is angioedema?

Angioedema is swelling in the deeper layers of the skin and can last a few hours to a few days.  It most commonly occurs on the hands, feet, and face (lips, tongue, and eyes).

Treatment

Treatment of acute urticaria and angioedema involves antihistamines (examples are diphenhydramine, cetirizine, and loratadine) and sometimes systemic steroids, such as prednisone.  Management of chronic urticaria consists of symptom control with regular use of antihistamines as first line treatment and avoidance of triggers.  There may be other appropriate treatment options available that can be discussed with your doctor.