Hives, what you see and what you can do
Hives are a skin reaction that cause red, itchy welts, ranging from small spots to large blotches. There are two types of hives (also known as urticaria): Acute urticaria (temporary in nature) and chronic urticaria (hives lasting longer than 6 to 8 weeks). Hives can appear anywhere on the skin, including the face and even the lips, eyes, tongue, and throat. While the itch can be intense, the skin is not usually scabbed or broken. In some people, the hives burn or sting. Each individual hive can last several hours before fading, but new hives can appear as the older ones fade.
Dermatographia is a condition in which scratching the skin results in the formation of itchy hives. The name dermatographia, which means "skin writing", comes from the fact that one can literally scratch the skin in such a way as to make the hives appear in the form of a word. Dermatographia sometimes also occurs along with other forms of hives.
Dermatographia is a chronic condition which affects about 4 percent of the normal population. A temporary form of the condition is found in about 25 percent of people who develop allergic hives. Some cases of dermatographia will clear up spontaneously, while other cases may persist for years.
The treatment for dermatographia is antihistamines. Most people have excellent results with antihistamines. Unfortunately, most antihistamines are somewhat sedating. There are many types of antihistamines, and while one type may be sedating for you, another type may not be. There are newer antihistamines which are non-sedating, any of which may be effective. Another possibility would be an antihistamine which is taken only at bedtime.
Hives are generally an allergic reaction to medication, foods, insect stings or sunlight exposure, and toiletries. Some of the most common foods that can cause hives are nuts, chocolate, fish/seafood, citrus, eggs, fresh berries, and tomatoes. Fresh food causes hives more often than cooked.
Temperature changes can also cause hives. Some people develop hives in reaction to anything that makes them hot or sweaty, such as sunlight, exercise, hot baths, blushing, or anger, which may result in tiny, intensely itchy hives with big red blotches around them (cholinergic urticaria). Occasionally, people react to the cold, as well.
Pressure urticaria is a deep welt in an area of prolonged pressure.
Often, the cause of chronic urticaria cannot be determined by the patient or the doctor. In the overwhelming majority of cases, the cause is idiopathic.
Antihistamines are the most common first line of treatment for hives. Topical creams and sprays may provide symptomatic relief. The application of cool, wet compresses and/or taking a cool bath may help soothe the skin and prevent scratching. For chronic hives, adherence to a daily medication regimen is important to prevent recurrent breakouts. A short course of cortisone (steroids) may also be used to treat hives.
Seeing a physician is recommended to determine if any underlying disease is present. The physician will obtain a detailed history and physical. Blood and urine tests, as well as a skin biopsy, can also be performed, if necessary, to aid in diagnosis.
For the majority of people, hives are not serious. However, if you have trouble breathing or experience difficulty swallowing, you should seek emergency care immediately.
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