What are the most common infections that trigger hives. How do chronic illnesses contribute to hive outbreaks. What are the key symptoms and treatments for hives caused by various health conditions.

Understanding Hives: An Overview of Urticaria

Hives, medically known as urticaria, are raised, itchy welts that appear on the skin as a result of an allergic reaction. These bothersome skin manifestations can be triggered by various factors, including infections and illnesses. Hives typically present as red or white bumps on the skin, often accompanied by an intense itching sensation. They can appear anywhere on the body and may vary in size and shape.

The duration of hives can be classified into two categories:

• Acute hives: Lasting from a few days up to 6 weeks
• Chronic hives: Persisting on and off for more than 6 weeks

While acute hives are often linked to specific triggers, chronic hives can be more challenging to pinpoint and may be associated with underlying health conditions.

Common Viral Infections That Can Trigger Hives

Viral infections are among the most frequent causes of hives, especially in children. In fact, approximately 80% of acute hive cases in children are attributed to viral infections. Some common viral culprits include:

The Common Cold

Can the common cold cause hives? Yes, this ubiquitous viral infection affecting the upper respiratory tract can indeed trigger hives in some individuals. The immune response to the cold virus can lead to the release of histamine, resulting in the characteristic itchy welts.

COVID-19

As we continue to learn more about the novel coronavirus, it has become evident that skin manifestations, including hives, can be a symptom of COVID-19. These hives typically last between 2 to 12 days and may appear along with other more common symptoms of the virus.

Mononucleosis

Although less common, mononucleosis, often referred to as “mono,” can occasionally cause hives. This viral infection, which primarily affects teenagers and young adults, can trigger an immune response that leads to the development of hives in rare cases.

Bacterial Infections and Their Link to Hives

While viral infections are more commonly associated with hives, certain bacterial infections can also trigger this skin reaction. One notable example is:

Urinary Tract Infections (UTIs)

How can a UTI cause hives? When bacteria invade the urinary system, the body’s immune response can sometimes lead to the development of hives. This occurrence is less common than the typical UTI symptoms like burning during urination and frequent urges to urinate, but it’s important to be aware of this potential connection.

Chronic Illnesses and Their Association with Hives

Chronic illnesses, particularly autoimmune diseases, can be underlying causes of recurring hives. These conditions often involve an overactive immune system, which can lead to various skin manifestations, including hives. Some chronic illnesses associated with hives include:

Celiac Disease

In celiac disease, consuming gluten triggers an immune response that can manifest as hives, specifically known as dermatitis herpetiformis. This skin condition affects up to 25% of individuals with celiac disease and is typically treated with oral antibiotics like Dapsone.

Diabetes

Both Type 1 and Type 2 diabetes have been linked to hives, albeit through different mechanisms. Type 1 diabetes, being an autoimmune disorder, can directly trigger hives. In Type 2 diabetes, hives may occur as a side effect of insulin or other blood sugar management medications.

Lupus

Lupus, a chronic autoimmune disease causing widespread inflammation, can lead to hives in approximately 10% of patients. It’s crucial for healthcare providers to distinguish between lupus-related hives and those caused by medication side effects or other underlying conditions.

Rheumatoid Arthritis

As an autoimmune condition, rheumatoid arthritis can trigger hives due to the overactive immune system. Additionally, some medications used to treat rheumatoid arthritis may cause localized hives at the injection site.

Thyroid Disease

The connection between thyroid disorders and skin issues is well-established. In fact, dermatologists may sometimes be the first to suspect thyroid dysfunction based on skin manifestations like hives.

Vitiligo

While primarily known for causing patches of depigmented skin, vitiligo can also be associated with hives in some cases, further highlighting the complex relationship between the immune system and skin health.

The Science Behind Illness-Induced Hives

Why do illnesses cause hives in some individuals? The mechanism behind illness-induced hives involves the activation of immune cells in the skin, specifically mast cells. When the body is fighting an infection, these mast cells can become activated and release histamine, a chemical responsible for the itching and redness associated with hives.

Interestingly, hives often appear during the recovery phase of an illness, typically about a week after the initial onset of symptoms. This timing coincides with the immune system’s efforts to clear the infection from the body.

Children and Hives: A Special Consideration

Are children more susceptible to illness-induced hives? Indeed, hives resulting from infections are particularly common in children. This increased prevalence can be attributed to several factors:

• Developing immune systems that are still learning to respond to various pathogens
• Higher frequency of infections, such as colds (6-8 per year on average)
• Constant exposure to germs in school and daycare settings

Parents and caregivers should be aware of this tendency and consult with healthcare providers if hives persist or are accompanied by other concerning symptoms.

Diagnosing and Treating Illness-Induced Hives

How are hives diagnosed and treated when caused by infections or chronic illnesses? The approach to diagnosis and treatment typically involves the following steps:

1. Medical history review: Healthcare providers will inquire about recent illnesses, medications, and any known allergies.
2. Physical examination: A thorough skin examination will be conducted to assess the characteristics of the hives.
3. Possible allergy tests: In some cases, allergy tests may be performed to rule out other potential triggers.
4. Treatment of underlying condition: If an infection or chronic illness is identified as the cause, treating the primary condition is crucial.
5. Symptomatic relief: Antihistamines are often prescribed to alleviate itching and reduce the appearance of hives.
6. Monitoring: For chronic hives, ongoing monitoring and management may be necessary.

In most cases of acute hives caused by infections, the welts will resolve on their own within a few days to weeks as the body fights off the infection.

When to Seek Immediate Medical Attention

While hives are often benign, they can sometimes be part of a more severe allergic reaction. It’s crucial to recognize the signs that warrant immediate medical attention:

• Difficulty breathing or swallowing
• Swelling of the face, tongue, or throat
• Dizziness or fainting
• Rapid pulse
• Nausea or vomiting

If any of these symptoms occur alongside hives, it could indicate anaphylaxis, a life-threatening allergic reaction requiring immediate emergency care.

Understanding the connection between infections, chronic illnesses, and hives can help individuals better manage their skin health and overall well-being. By recognizing the potential causes and seeking appropriate medical care, those affected by hives can find relief and prevent complications. As research in this area continues to evolve, we may gain even more insights into the complex relationship between our immune system, various health conditions, and skin manifestations like hives.

Illnesses That Cause Hives | Buoy

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Last updated December 23, 2022

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What are hives?

Hives are red or white raised bumps on your skin that usually itch. They are triggered by an allergic reaction. Hives can be acute, lasting a few days to up to 6 weeks, or chronic, appearing on and off for more than 6 weeks.

It’s very common for illnesses and infections to cause hives. About 80% of cases of acute hives in children are caused by viral infections like the common cold. It’s harder to pinpoint a cause for chronic hives, but they can be caused by a chronic condition like lupus or thyroid disease.

Symptoms

Hives look like raised flat bumps that appear on your skin anywhere on your body. The bumps look red or white, but the color may not be as obvious on darker skin tones. They often itch but can also burn or sting. The raised bumps can be separate or merge together into a larger patch.

The majority of hives only last a few days. If you have chronic hives, you might notice that they change size and shape or disappear and then reappear.

Hives can also be part of a larger allergic reaction, which can include dangerous symptoms like difficulty breathing or swallowing. Go to the ER or call 911 if you have these symptoms.

Why do illnesses cause hives?

When you’re sick, your immune system starts working to fight off the invader. For some people, the immune cells in your skin, called mast cells, are also activated. The mast cells release histamine, a chemical that brings on the itching and redness of hives. The hives usually appear when the immune system is clearing the infection out of your body, so it can happen a week or so after you first get sick.

Are children more likely to get hives?

Hives from illnesses are very common in children, since the infections that can cause them occur more often in younger kids. For example, children often get six to eight colds a year. It is because their immune systems are still being developed and they are constantly exposed to germs in schools and daycares.

Viruses and bacteria that cause hives

Hives may not be the first symptom you think of for these common viral and bacterial infections, but they can all potentially cause the red itchy spots.

• Common cold: This viral infection that targets your nose and upper respiratory tract can also trigger hives. Colds are usually mild and go away in 1–2 weeks.
• COVID-19: There is a lengthy list of symptoms for COVID-19, which is caused by a virus, and it includes hives, which can last 2–12 days.
• Urinary tract infection: Along with its trademark symptoms of burning while urinating and constantly feeling like you need to urinate, a UTI can also cause hives. UTIs are caused by bacteria and can be treated by antibiotics.
• Mononucleosis: Another viral infection, mono can cause hives in rare cases. It’s most common in teenagers and young adults and is very contagious.

Chronic illnesses that cause hives

There are many types of chronic illness, but autoimmune diseases are the most likely to cause hives. An autoimmune disease is when your immune system mistakenly attacks your own body. Here are some that can cause hives:

• Celiac disease: With celiac disease, your immune system reacts whenever you eat gluten (the protein found in wheat, rye, and barley). That immune reaction can trigger hives, which are called dermatitis herpetiformis when connected to celiac. It happens in up to 25% of people with celiac and is treated with an oral antibiotic (Dapsone).
• Diabetes: Type 1 diabetes is an autoimmune disorder, which is why it’s been linked to hives. And while type 2 diabetes is not an autoimmune disorder, some people may get hives from the insulin or medications they’re taking to help manage blood sugar levels.
• Lupus: Lupus is an autoimmune disease that causes chronic inflammation throughout the body. Around 10% of people who have lupus will also have hives. Your provider will want to look at your hives to make sure they aren’t a side effect of medication or a sign of a different disease.
• Rheumatoid arthritis: Caused by an overactive immune system, rheumatoid arthritis can trigger hives. Some medications for rheumatoid arthritis suppress the immune system and can also cause hives (but those hives tend to be just around the spot of the injection).
• Thyroid disease: The link between thyroid disease and skin issues is so strong that sometimes your dermatologist may be the first person to notice something is going on with your thyroid.
• Vitiligo: Vitiligo is a skin disorder that causes large discolored patches all over the body, but it can also cause hives.

Treatment

Hives caused by a viral or bacterial illness will usually go away in a week or two. An antihistamine like Benadryl can be helpful, though it does cause drowsiness.

If your itching is severe, talk to your healthcare provider about other treatment options. If the itch doesn’t improve after taking antihistamines, your provider may prescribe an oral steroid.

For hives caused by a chronic illness, a dermatologist may be able to recommend more long-term ways of managing the condition. Your provider that treats your underlying disease can also help, since managing your primary condition can improve hives.

If your hives are caused by an allergic reaction and you notice signs that you are going into anaphylaxis, which is when your throat is closing up and you can’t breathe, you need to call 911 or go to the ER immediately since that is a life-threatening condition.

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Urticaria: looking for a cause to prevent complications

Urticaria triggers

Examples of known triggers that can cause the characteristic skin rash include:

medications, including many antibiotics and nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ACE inhibitors used to treat high blood pressure, foods such as peanuts, nuts, shellfish, nutritional supplements, eggs, strawberries, and wheat products, viral infections including the flu, common cold (SARS), mononucleosis, and hepatitis B, bacterial infections, including urinary tract infections, intestinal parasites, chronic diseases such as thyroid disease or lupus extreme temperatures or changes in temperature household triggers: the epidermis of pets, dust mites, cockroaches and their waste products, latex, pollen, and some plants, in including nettles, poison ivy, insect stings, certain chemicals, exposure to sunlight, and even water left on the skin after bathing.

The exact cause of urticaria is easier to determine by contacting a doctor. Keeping a diary that takes into account the circumstances under which a skin rash develops, as well as recording its frequency, helps to quickly identify the trigger for hives.

Two types of urticaria

Acute urticaria, which occurs under the influence of an allergen, develops as follows: in response to contact with a trigger, pro-inflammatory molecules, such as histamine, are synthesized. After that, histamine and other pro-inflammatory substances cause inflammation and accumulation of fluid under the skin, which is manifested by the development of a whole range of unpleasant symptoms – redness, itching, irritation, edematous rash, etc. Chronic urticaria (rash persisting for more than six weeks) may begin as an autoimmune reaction, the cause of which is not fully established. With the development of chronic urticaria, diseases of the thyroid gland, hepatitis can be associated.

Symptomatic treatment of acute urticaria

Non-sedating antihistamines can help relieve the symptoms of acute urticaria and must be taken regularly, sometimes for several weeks. Antihistamines help by blocking histamine synthesis, thereby reducing inflammation, rashes, and stopping itching.

Some antihistamines cause drowsiness, especially if the patient also consumes alcohol while taking them. Some of these medicines are not suitable for use during pregnancy. Therefore, to choose the optimal drug, it is better to consult a doctor.

In case of emergencies

Patients with angioedema should definitely see a doctor – they will need to see an allergist, immunologist or dermatologist as this condition can cause serious breathing problems, potentially fatal.

Angioedema is characterized by severe swelling around the eyes and lips, and sometimes also in the genitals, arms and legs. It may last longer than acute urticaria, but usually resolves in less than 24 hours.

People with urticaria should be alert for warning signs that may indicate an anaphylactic reaction. An anaphylactic reaction, or anaphylaxis, is an extremely severe allergic reaction that can be fatal.

A person needs urgent medical attention if they have:

nausea and vomiting swelling of the mucous membranes of the mouth, tongue, lips and throat, difficulty breathing cold and clammy skin palpitations weakness or a sudden strong feeling of great anxiety.

If the rash is accompanied by swelling of the tongue or lips, difficulty breathing, an injection of adrenaline is required.

What about chronic idiopathic urticaria?

Chronic urticaria is also a reason to visit a doctor. The treatment in this case differs from the treatment of acute urticaria and necessarily requires the participation of medical specialists who will select the optimal medications and prevent the development of complications.

Urticaria and stress

Emotional stress has been identified as one of the causes of urticaria or a factor that may aggravate skin symptoms. It is hypothesized that chronic stress may lead to dysregulation of inflammatory mediators and exacerbate the pathophysiology of the underlying inflammatory disease. In other words, when a person is stressed, they are more susceptible to triggers and any inflammatory/allergic reactions can be more severe.

Urticaria or urticaria | Ida-Tallinna Keskaigla

The purpose of this leaflet is to provide the patient with information about the nature of urticaria, its causes and treatment options.

Urticaria is one of the most common skin diseases. During life, it is observed in about a fifth of people. Urticaria appears as bright red blisters that usually appear very quickly. As a rule, the rash is accompanied by itching. The blisters can range in size from a few millimeters to several tens of centimeters, and they can be from one to several hundred. The blisters stay in one place for a maximum of one day, usually several hours. Then they disappear, but new blisters may appear elsewhere.

Half of people with urticaria may develop edema, or angioedema . Edema develops suddenly and is usually observed on the lips, eyelids and genitals. Less commonly, swelling of the tongue and throat may occur. Edema persists from 24 to 72 hours. Angioedema involving the digestive and respiratory systems can be life-threatening.

Depending on the duration, urticaria can be divided into acute and chronic.

Urticaria is usually acute and lasts from a few days to a couple of weeks. Urticaria is called acute if it lasts less than six weeks.

Causes of acute urticaria may be as follows:

• Infections – Viral infections are the cause of the disease in more than 80% of cases of acute urticaria in children. As a rule, urticaria lasts a week or two, then recedes.

• Drugs – Urticaria can be caused by many groups of drugs, such as antibiotics and non-steroidal anti-inflammatory drugs (aspirin, ibuprofen, naproxen, etc.).

• Insect stings – Some insect stings (bees, wasps, ants) can cause urticaria in the bite area. If, after an insect bite, urticaria develops throughout the body, you should immediately consult a doctor.

• Food Allergens – Food allergies usually show up about 30 minutes after eating. The most common food allergens in children are milk, eggs, nuts, fish and wheat. In adults, food allergies are usually caused by fish, other seafood, and nuts.

• Physical factors – Urticaria can be caused by certain physical factors such as heat, cold, water chemistry, or sunlight.

Chronic blistering and/or swelling occurs daily or almost daily for six weeks or more, often for many years. Chronic urticaria is divided into spontaneous and induced forms. For spontaneous chronic urticaria blisters and/or swelling occur without a clear cause, often at night and in the morning.

In the case of inducible form , wheals or swelling may be triggered by pressure, cold water/air, exercise, sun, vibration, heat.

Chronic urticaria significantly impairs the quality of life – on the one hand, due to severe itching, on the other hand, due to edema and blisters with an unpredictable course. Sleep is often disturbed.

Chronic urticaria is more common in people with autoimmune diseases. Many patients with chronic urticaria do not have other comorbidities.

It is known about the causes of chronic urticaria that the disease is formed as a result of the release of certain substances from the mast cells of the skin and mucous membranes. The best known of these is histamine. Mast cells are activated by antibodies produced under the influence of certain factors of the immune system. The picture of the disease is often exacerbated by severe stress. In about a third of patients, a histamine-rich food (eg, avocado, cheese) or drink (eg, champagne, wine, beer) is an aggravating factor.

Treatment of chronic urticaria

The aim of the treatment of chronic urticaria is to treat the symptoms of the disease until it disappears.

• Antihistamines – when taking antihistamines, itching decreases and blisters disappear. One tablet per day is sufficient for some patients, but higher doses are often required. Spontaneous chronic urticaria requires regular long-term treatment. For best results, follow your doctor’s instructions carefully.
• Immunosuppressants – used when antihistamines do not work.