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

Understanding Hives: Symptoms and Causes

Hives, medically known as urticaria, are raised, itchy welts that appear on the skin. These bumps can be red or white and may vary in size, sometimes merging to form larger patches. While often associated with allergic reactions, hives can also be triggered by various infections and illnesses.

What exactly causes hives to appear? When the body’s immune system detects a potential threat, it releases histamine and other chemicals into the bloodstream. This reaction causes small blood vessels to leak, leading to swelling in the skin – the characteristic appearance of hives.

Key Characteristics of Hives

• Raised, itchy welts on the skin
• Red or white in color
• Can appear anywhere on the body
• May change shape, size, or location over time
• Can be acute (lasting up to 6 weeks) or chronic (persisting beyond 6 weeks)

Are all hives the same? While hives may look similar, their underlying causes can vary significantly. Acute hives often result from specific triggers like infections or allergic reactions, while chronic hives may be linked to ongoing health conditions or have no identifiable cause.

Viral Infections: A Common Culprit for Hives

Viral infections are among the most frequent causes of acute hives, especially in children. In fact, studies suggest that up to 80% of acute hive cases in children can be attributed to viral infections. But why do viruses trigger hives in some individuals?

When a virus invades the body, the immune system launches a counterattack. In some people, this immune response can lead to the release of histamine in the skin, resulting in 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 Viral Infections Associated with Hives

1. Common Cold: This ubiquitous viral infection, while primarily affecting the respiratory system, can also trigger hives in some individuals.
2. COVID-19: The novel coronavirus has been associated with various skin manifestations, including hives that can persist for 2-12 days.
3. Mononucleosis: Although less common, this viral infection, often referred to as “mono,” can occasionally cause hives, particularly in teenagers and young adults.

Do hives always indicate a serious viral infection? Not necessarily. While hives can be a symptom of various viral infections, their presence alone doesn’t indicate the severity of the underlying condition. However, if hives are accompanied by other concerning symptoms like difficulty breathing or swallowing, immediate medical attention is crucial.

Bacterial Infections and Their Link to Hives

While viral infections are more commonly associated with hives, certain bacterial infections can also trigger these itchy welts. The mechanism is similar to that of viral infections – the immune response to the bacteria can lead to histamine release in the skin.

One notable bacterial infection that can cause hives is a urinary tract infection (UTI). UTIs, typically caused by bacteria like E. coli, are known for symptoms such as burning during urination and frequent urges to urinate. However, in some cases, they can also trigger a hive outbreak.

How long do hives from bacterial infections typically last? The duration can vary, but hives often resolve once the underlying infection is treated. In the case of UTIs, appropriate antibiotic treatment can help clear both the infection and the associated hives.

Chronic Illnesses and Persistent Hives

While acute hives often have identifiable triggers, chronic hives – those lasting more than six weeks – can be more challenging to pin down. In some cases, underlying chronic illnesses, particularly autoimmune diseases, may be responsible for persistent or recurrent hives.

Autoimmune diseases occur when the body’s immune system mistakenly attacks its own tissues. This misdirected immune response can sometimes manifest as skin symptoms, including hives. But which chronic conditions are most commonly associated with hives?

Autoimmune Diseases Linked to Hives

• Celiac Disease: This autoimmune reaction to gluten can cause a specific type of hives called dermatitis herpetiformis in up to 25% of patients.
• Lupus: Approximately 10% of individuals with lupus may experience hives as part of their symptom profile.
• Rheumatoid Arthritis: This inflammatory joint condition can sometimes trigger hives, either due to the disease itself or as a side effect of treatments.
• Thyroid Disorders: Both hypothyroidism and hyperthyroidism have been associated with chronic hives in some patients.

Can treating the underlying autoimmune condition resolve chronic hives? In many cases, yes. Managing the autoimmune disease can often lead to improvement or resolution of associated skin symptoms, including hives. However, it’s important to note that hives may sometimes persist even with proper disease management, necessitating additional targeted treatments.

Metabolic Disorders and Hive Outbreaks

Beyond autoimmune conditions, certain metabolic disorders have also been linked to the development of hives. These conditions, which affect the body’s ability to process and utilize nutrients, can sometimes trigger unexpected immune responses that manifest as skin symptoms.

Diabetes, both Type 1 and Type 2, has been associated with hive outbreaks in some individuals. In Type 1 diabetes, an autoimmune disorder, the connection to hives is more straightforward – it’s linked to the overactive immune response characteristic of the disease. But why do some people with Type 2 diabetes experience hives?

In Type 2 diabetes, hives may not be directly caused by the condition itself, but rather by the treatments used to manage it. Some individuals may develop hives as a reaction to insulin injections or other diabetes medications. This highlights the importance of monitoring for unexpected side effects when starting new treatments.

Other Metabolic Conditions Associated with Hives

• Thyroid Disorders: Both hypothyroidism and hyperthyroidism can affect metabolism and potentially trigger hives.
• Metabolic Syndrome: This cluster of conditions that increase the risk of heart disease, stroke, and diabetes has been linked to chronic hives in some studies.

How can one determine if hives are related to a metabolic disorder? A thorough medical evaluation is key. Your healthcare provider may recommend blood tests to check thyroid function, blood sugar levels, and other metabolic markers to identify any underlying conditions contributing to persistent hives.

Rare Conditions and Unusual Hive Presentations

While common infections and chronic illnesses account for many cases of hives, there are also rare conditions and unusual presentations that healthcare providers should be aware of. These atypical cases can sometimes provide valuable insights into the complex relationship between the immune system and skin health.

One such condition is vitiligo, an autoimmune disorder that causes loss of skin pigmentation. While vitiligo is primarily known for its characteristic white patches, some individuals with this condition may also experience hives. This association underscores the intricate connection between immune function and skin manifestations.

Unusual Hive Presentations

• Cold Urticaria: Hives triggered by exposure to cold temperatures
• Aquagenic Urticaria: Extremely rare condition where hives develop after contact with water
• Cholinergic Urticaria: Hives induced by elevated body temperature, often during exercise
• Delayed Pressure Urticaria: Hives that appear hours after sustained pressure on the skin

How are these rare forms of hives diagnosed? Diagnosis often involves specialized testing, such as ice cube tests for cold urticaria or exercise challenges for cholinergic urticaria. A detailed patient history and careful observation of trigger patterns are also crucial in identifying these unusual presentations.

Diagnostic Approaches for Hives of Unknown Origin

When the cause of hives isn’t immediately apparent, healthcare providers may need to employ a range of diagnostic strategies to uncover the underlying trigger. This process often involves a combination of patient history, physical examination, and targeted testing.

One important diagnostic tool is the allergy skin test, which can help identify specific allergens that may be causing the hives. However, in cases where infections or chronic illnesses are suspected, additional tests may be necessary.

Common Diagnostic Approaches for Hives

1. Detailed Medical History: Understanding the timing, duration, and potential triggers of hive outbreaks
2. Physical Examination: Assessing the characteristics of the hives and looking for signs of underlying conditions
3. Blood Tests: Checking for markers of infection, autoimmune diseases, or metabolic disorders
4. Skin Biopsy: In rare cases, a small sample of skin may be examined to rule out other conditions
5. Provocation Tests: Exposing the skin to potential triggers under controlled conditions

What if no clear cause is found despite extensive testing? In some cases, hives may be classified as idiopathic, meaning no specific cause can be identified. However, this diagnosis is only made after thorough investigation to rule out other potential triggers.

Treatment Strategies for Hives Caused by Infections and Illnesses

The treatment approach for hives often depends on the underlying cause. When hives are triggered by infections or chronic illnesses, addressing the root cause is typically the first step in management. However, symptomatic relief is also an important aspect of treatment.

For hives caused by acute infections, such as viral colds or bacterial UTIs, treating the infection itself often leads to resolution of the hives. Antihistamines are commonly used to provide relief from itching and reduce the appearance of hives while the body fights off the infection.

Treatment Options for Hives

• Antihistamines: First-line treatment for symptom relief
• Corticosteroids: Used for severe cases or when antihistamines are insufficient
• Immune Modulators: May be prescribed for chronic hives associated with autoimmune conditions
• Targeted Therapies: Newer medications like omalizumab for chronic spontaneous urticaria

How long does it typically take for hives to respond to treatment? The response time can vary depending on the underlying cause and the chosen treatment. Acute hives often improve within days to weeks with appropriate management, while chronic hives may require longer-term treatment strategies.

In cases where hives are linked to chronic illnesses, such as autoimmune diseases or metabolic disorders, managing the underlying condition is crucial. This may involve medications to modulate the immune system, dietary changes, or other targeted therapies depending on the specific diagnosis.

It’s important to note that treatment plans should be tailored to the individual patient, taking into account the severity of symptoms, any underlying health conditions, and potential medication interactions. Regular follow-up with a healthcare provider is essential to monitor progress and adjust treatment as needed.

In conclusion, while hives are often associated with allergic reactions, they can also be triggered by a wide range of infections and illnesses. Understanding these diverse causes is crucial for accurate diagnosis and effective management. Whether dealing with acute hives from a viral infection or chronic hives linked to an autoimmune condition, a comprehensive approach that addresses both the underlying cause and symptomatic relief can help patients find comfort and improved quality of life.

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.