Hives (Urticaria)

Urticaria or hives is an itchy and reddish or dark area on the skin. It is usually the result of a reaction to food (e.g. chocolate and eggs), medicines, cosmetics or insect bites.
These patches may appear on any part of the body, including the face, throat, ears, and lips. Hives are not contagious. But sometimes, the itching site may be infected with a microorganism that can spread from person to person.

Most patients will complain of:

• Itchy patches of reddish or dark coloured skin in the area affected.
• Painful swelling of the eyelids, lips and inside the throat.
• It may worsen with exercise or when at work, especially when you sweat.
• In most patients, the itching is uncomfortable enough to disrupt work or leisure.

There are two types of hives- acute and chronic. Acute hives last less than six weeks, while chronic hives last longer.

The following symptoms indicate acute hives:

• Red or skin colour marks.
• Itching of the skin.
• Painful swelling of the lip or eyelids.

Symptoms of chronic hives may include:

• Shortness of breath.
• Muscle soreness.
• Vomiting and diarrhoea.

Hives are caused by an allergic reaction to something you have eaten or have been in contact with within your immediate environment. This allergic process leads to the release of chemicals that your body uses to protect itself from infections. This can lead to swelling, itching and other symptoms associated with hives.

The following are risk factors for developing hives:

• Allergies and existing skin sensitivities.
• Infections of the skin.
• Existing skin sensitivities.
• Stress.
• Prior history or family history of skin rash.

See your healthcare provider if:

• Your entire skin is severely itchy and covered with dark spots.
• The symptoms don’t resolve in a week or less.
• The itching and spots make you uncomfortable or affect your ability to work.
• Self-care does not resolve the symptom within 2 to 3 days.
• You may have difficulty breathing.

You can prevent hives by avoiding the allergen that causes it. Your healthcare provider can help you identify your allergens. Your healthcare provider may recommend some allergy medicines that you can take before an allergy flare-up happens (like anti-histamines, such as loratadine).

Self-Care Tips

You can do the following to relieve your symptoms:

• Apply a cool compress or wet cloths to the affected area.
• Try to work and sleep in a cool room.
• Wear loose-fitting clothes.
• Avoiding bathing with hot water as it may worsen the hives.
• Avoid scratching the dark spots. Prevent breaking the skin as this can lead to an infection.

Medical treatment

• If you have acute hives, you may not need medication. In serious discomfort, your doctor may prescribe ointments and creams to relieve the itching.
• Your doctor may prescribe antihistamines like chlorpheniramine (Piriton) to help with the allergic reaction.
• In a case of chronic hives, you may need an injection of adrenaline, antibiotics, or cortisone medication.

Hives can be painful and cause scarring of the skin if not properly managed. The reoccurrence of hives is common and is nothing to worry about. The management is mostly targeted at relieving the symptoms and avoiding the trigger. In most cases, urticaria will resolve on its own once the cause has been removed.