What are the most common infections that lead to hives. How do chronic illnesses contribute to hive outbreaks. Why do children seem more prone to developing hives from infections. What treatments are available for hives caused by various health conditions.

Understanding Hives: Symptoms and Triggers

Hives, medically known as urticaria, are a common skin condition characterized by raised, itchy welts on the skin. These welts can appear anywhere on the body and vary in size and shape. But what exactly causes these uncomfortable and often unsightly skin reactions?

Hives are typically triggered by an allergic reaction, with the immune system releasing histamine and other chemicals into the bloodstream. This reaction causes small blood vessels to leak, leading to swelling in the skin. While many associate hives with external allergens like foods or medications, it’s important to note that infections and illnesses can also be culprits.

Key Characteristics of Hives

• Appearance: Red or white raised bumps on the skin
• Sensation: Often itchy, but can also burn or sting
• Duration: Can be acute (lasting up to 6 weeks) or chronic (recurring for more than 6 weeks)
• Location: Can appear anywhere on the body
• Pattern: May change in size, shape, or location over time

Do hives always indicate a serious condition? Not necessarily. While hives can be uncomfortable and concerning, they often resolve on their own within a few days to weeks. However, if hives are accompanied by difficulty breathing or swallowing, it’s crucial to seek immediate medical attention as this could indicate a severe allergic reaction.

The Link Between Infections and Hives

Infections are a common trigger for hives, especially in children. In fact, approximately 80% of acute hive cases in children are attributed to viral infections. But how exactly do infections lead to hives?

When the body is fighting an infection, the immune system kicks into high gear. For some individuals, this immune response can activate mast cells in the skin. These mast cells release histamine, which is responsible for the itching and redness associated with hives. Interestingly, hives often appear as the body is clearing the infection, which may be a week or more after the initial onset of illness.

Common Infections That Can Cause Hives

1. Common Cold: This viral infection of the upper respiratory tract can trigger hives in some individuals.
2. COVID-19: Among its many symptoms, COVID-19 has been known to cause hives lasting 2-12 days in some patients.
3. Urinary Tract Infections (UTIs): These bacterial infections can sometimes lead to hives alongside more typical symptoms.
4. Mononucleosis: While rare, this viral infection can cause hives, particularly in teenagers and young adults.

Are certain age groups more susceptible to infection-induced hives? Yes, children are more likely to develop hives from infections. This is primarily due to their developing immune systems and frequent exposure to germs in schools and daycare settings. Children typically experience six to eight colds per year, increasing their chances of developing hives as a secondary symptom.

Chronic Illnesses and Their Connection to Hives

While acute infections are a common cause of short-term hives, chronic illnesses can lead to recurring or persistent hive outbreaks. Autoimmune diseases, in particular, are frequently associated with chronic hives. In these conditions, the immune system mistakenly attacks the body’s own tissues, which can manifest as skin reactions like hives.

Autoimmune Conditions Linked to Hives

• Celiac Disease: Up to 25% of celiac patients may experience a specific type of hives called dermatitis herpetiformis.
• Lupus: Approximately 10% of lupus patients may develop hives as part of their symptom profile.
• Rheumatoid Arthritis: The overactive immune response in RA can trigger hives in some individuals.
• Thyroid Disease: There’s a strong connection between thyroid disorders and various skin issues, including hives.
• Vitiligo: While primarily known for causing patches of depigmented skin, vitiligo can also lead to hive outbreaks.

Can non-autoimmune chronic conditions cause hives? Yes, conditions like diabetes can indirectly lead to hives. In type 1 diabetes, which is autoimmune in nature, hives may occur due to the underlying immune dysfunction. In type 2 diabetes, hives might develop as a side effect of insulin or other blood sugar management medications.

Diagnosing the Cause of Hives

Given the wide range of potential triggers for hives, determining the underlying cause can be challenging. Healthcare providers typically start with a thorough medical history and physical examination. They may ask about recent illnesses, changes in diet or medication, and any known allergies.

Diagnostic Approaches for Hives

1. Blood Tests: To check for infections, autoimmune markers, or thyroid function
2. Skin Prick Tests: To identify potential allergens
3. Skin Biopsy: In cases of chronic hives to rule out other skin conditions
4. Elimination Diets: To identify potential food triggers
5. Provocation Tests: Controlled exposure to potential triggers in a medical setting

Is it always possible to identify the specific cause of hives? Unfortunately, no. In many cases of chronic hives, the exact trigger remains elusive. These cases are referred to as chronic idiopathic urticaria. However, even without identifying a specific cause, effective treatments are available to manage symptoms and improve quality of life.

Treatment Options for Infection-Related Hives

The treatment approach for hives caused by infections often involves addressing both the underlying infection and the hive symptoms. The primary goal is to relieve itching and reduce inflammation while the body fights off the infection.

Common Treatments for Hives

• Antihistamines: Over-the-counter options like cetirizine or loratadine can help reduce itching and swelling
• Corticosteroids: For severe cases, short-term use of oral or topical corticosteroids may be prescribed
• Cool Compresses: Applying cool, damp cloths to affected areas can provide relief
• Oatmeal Baths: Colloidal oatmeal baths can soothe itchy skin
• Avoiding Triggers: Identifying and avoiding known triggers can prevent future outbreaks

How long does it typically take for hives to resolve with treatment? In most cases of acute hives, symptoms improve within a few days to weeks with appropriate treatment. However, chronic hives may require ongoing management and can persist for months or even years.

Managing Chronic Hives from Ongoing Health Conditions

For individuals with chronic illnesses that contribute to recurrent hives, management often involves a two-pronged approach: treating the underlying condition and managing hive symptoms. This may require collaboration between different medical specialists, such as rheumatologists, endocrinologists, and dermatologists.

Strategies for Long-Term Hive Management

1. Immunosuppressants: Medications that modulate the immune system may be prescribed for autoimmune-related hives
2. Biologic Therapies: Newer treatments like omalizumab have shown promise for chronic hives
3. Lifestyle Modifications: Stress reduction techniques and dietary changes can help some patients
4. Regular Monitoring: Frequent check-ups to assess both the underlying condition and hive symptoms
5. Combination Therapies: Using multiple treatments simultaneously for better symptom control

Can chronic hives ever be completely cured? While complete cure is not always possible, many patients achieve long-term remission or significant symptom improvement with appropriate treatment and management of their underlying health conditions.

Prevention Strategies for Infection-Induced Hives

While it’s not always possible to prevent infections, there are steps individuals can take to reduce their risk of developing hives as a complication. These strategies are particularly important for those who have a history of hives or are prone to allergic reactions.

Tips for Reducing Hive Risk

• Maintain Good Hygiene: Regular handwashing and avoiding close contact with sick individuals can reduce infection risk
• Boost Immune Health: A balanced diet, regular exercise, and adequate sleep can support immune function
• Manage Stress: Chronic stress can weaken the immune system, making infections more likely
• Stay Hydrated: Proper hydration supports overall health and can help the body fight off infections
• Consider Vaccinations: Staying up-to-date on recommended vaccines can prevent many infectious diseases

Is it possible to completely prevent hives from infections? While these strategies can reduce risk, it’s not possible to completely eliminate the chance of developing hives from an infection. However, being proactive about health can significantly lower the likelihood of complications like hives when infections do occur.

When to Seek Medical Attention for Hives

While many cases of hives can be managed at home, there are situations where professional medical care is necessary. Understanding when to seek help can prevent complications and ensure proper treatment.

Signs That Warrant Medical Attention

1. Difficulty Breathing or Swallowing: This could indicate a severe allergic reaction requiring immediate care
2. Persistent or Worsening Symptoms: Hives lasting more than six weeks or not responding to over-the-counter treatments
3. Accompanying Fever or Joint Pain: These symptoms may suggest an underlying systemic condition
4. Severe Discomfort: If hives significantly impact daily life or sleep
5. Recurring Episodes: Frequent hive outbreaks without clear triggers

How quickly should one seek medical care for severe hive symptoms? For symptoms like difficulty breathing or widespread, rapidly progressing hives, immediate emergency care is crucial. For less severe but persistent symptoms, scheduling an appointment with a healthcare provider within a few days is advisable.

Understanding the connection between infections, chronic illnesses, and hives is crucial for effective management and treatment. While hives can be uncomfortable and sometimes alarming, they are often manageable with proper care and medical guidance. By recognizing triggers, implementing prevention strategies, and seeking appropriate treatment, individuals can minimize the impact of hives on their daily lives. Remember, persistent or severe symptoms always warrant professional medical evaluation to ensure optimal health and well-being.

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.