Overview
Hives — also called urticaria (ur-tih-KAR-e-uh) — is a skin reaction that causes itchy welts. Chronic hives are welts that last for more than six weeks and return often over months or years. Often, the cause of chronic hives isn't clear.
The welts often start as itchy patches that turn into swollen welts that vary in size. These welts appear and fade at random as the reaction runs its course.
Chronic hives can be very uncomfortable and interfere with sleep and daily activities. For many people, anti-itch medications (antihistamines) provide relief.
Types of Chronic Hives
- Acute Urticaria: This type of hives lasts for less than six weeks and is often triggered by allergens or physical factors.
- Chronic Urticaria: Chronic hives persist for more than six weeks and may have various underlying causes.
Causes of Chronic Hives
Hives can develop due to several factors:
- Allergens: Exposure to allergens triggers an allergic reaction, leading to histamine release and capillary leakage. Common allergens include certain foods (nuts, eggs, seafood), medications (antibiotics, aspirin), and latex.
- Physical Triggers: Hives can result from physical factors such as sunlight exposure, scratching, pressure (tight clothing), extreme temperatures, or exercise-induced adrenalin release.
- Underlying Health Conditions: Viral or bacterial infections, autoimmune disorders, and inflammation of blood vessels can contribute to chronic hives.
Risk Factors of Chronic Hives
- Age: Hives can affect people of all ages.
- Gender: Women are more prone to chronic hives.
- Family History: A family history of hives or other allergic conditions increases the risk.
- Stress: Emotional stress can exacerbate hives.
Symptoms of Chronic Hives
The Symptoms of Hives (Urticaria) are :1. Raised Welts (Wheals): The hallmark symptom of hives is the appearance of raised, red or pink welts on the skin.
These welts can vary in size and shape, from small pinpricks to larger patches.
They are often intensely itchy and may cause discomfort.
2. Itching (Pruritus): Itching is a common complaint among individuals with hives.
The urge to scratch the affected areas can be overwhelming.
Scratching can worsen the condition and lead to further inflammation.
3. Transient Nature: Hives typically come and go rapidly.
Individual welts may last for a few hours to a day before fading away.
New welts may appear elsewhere on the body during this time.
4. Blanching: When pressure is applied to a hive welt, it blanches (turns white).
This blanching occurs due to the release of histamine and other inflammatory mediators.
5. Variable Distribution: Hives can occur anywhere on the body, including the face, trunk, limbs, and even the palms and soles.
The distribution is often random and unpredictable.
6. Angioedema (Swelling): Angioedema is a related condition that affects deeper layers of the skin.
It causes swelling, especially around the eyes, lips, and sometimes the throat.
Unlike hives, angioedema is not always itchy.
7. Triggers and Patterns: Some people notice specific triggers for their hives, such as certain foods, medications, or insect stings.
Others experience hives without an identifiable cause.
Chronic hives may follow a recurring pattern, with flare-ups and remissions.
8. Aggravation by Heat or Cold: Exposure to extreme temperatures (hot or cold) can worsen hives.
Hot showers, saunas, or cold weather may provoke symptoms.
9. Stress-Induced Hives: Emotional stress can exacerbate hives.
Stress management techniques may help reduce symptoms.
10. Systemic Symptoms (Rare): In severe cases, individuals may experience systemic symptoms such as fatigue, malaise, or fever.
These are more common in chronic urticaria.
Preventions of Chronic Hives
- Identify and avoid triggers (allergens, physical factors).
- Maintain good skin hygiene.
- Manage stress effectively.
Diagnosis of Chronic Hives
- A thorough medical history and physical examination.
- Allergy testing if allergens are suspected.
- Blood tests to rule out underlying conditions.
Treatment for Chronic Hives
- Antihistamines: First-line treatment to relieve itching and reduce hives.
- Avoid Triggers: Eliminate exposure to known triggers.
- Corticosteroids: Used for severe cases.
- Epinephrine (for anaphylaxis): Emergency treatment.
- Lifestyle Modifications: Stress management, cool showers, loose clothing.
When to seek medical attention ?
- If hives persist for more than six weeks (chronic hives).
- If symptoms worsen or include angioedema or difficulty breathing.
