What are the main differences between hives and angioedema. How long can hives typically last. What are the most common triggers for urticaria. When should you seek immediate medical attention for hives or angioedema.

The Basics of Hives and Angioedema: What You Need to Know

Hives, also known as urticaria, are a common skin condition characterized by swollen, pale red bumps or patches that appear suddenly on the skin. These welts can vary in size, from as small as a pencil eraser to as large as a dinner plate. On darker skin tones, hives may appear skin-colored, making them more difficult to detect.

Angioedema, on the other hand, involves swelling beneath the skin’s surface. This condition often affects areas such as the eyes, lips, genitals, hands, and feet. While both conditions can be uncomfortable and sometimes alarming, understanding their characteristics and causes can help manage symptoms effectively.

Key Characteristics of Hives:

• Sudden appearance of raised, itchy bumps or welts
• Can burn or sting in addition to itching
• May appear anywhere on the body, including face, lips, tongue, and ears
• Can change size rapidly and move around the body
• Often disappear within hours but can persist for weeks or even years

Distinguishing Features of Angioedema:

• Deep swelling under the skin
• Commonly affects eyes, lips, genitals, hands, and feet
• Generally lasts longer than hives, but usually subsides within 24 hours
• In rare cases, can affect the throat, tongue, or lungs, potentially obstructing airways

Unraveling the Causes: What Triggers Hives and Angioedema?

The underlying cause of hives and angioedema is the release of histamine in the body. This chemical can cause blood plasma to leak out of small blood vessels in the skin, resulting in the characteristic swelling and redness. But what prompts this histamine release?

Common Triggers for Hives and Angioedema:

1. Allergic reactions
2. Certain foods and food additives
3. Insect stings
4. Exposure to sunlight
5. Medications
6. Viral, bacterial, or fungal infections
7. Physical stimuli (in cases of physical urticaria)

It’s worth noting that in some cases, doctors may not be able to identify the exact cause of hives or angioedema. This uncertainty can make treatment more challenging but not impossible.

Acute vs. Chronic: Understanding the Duration of Hives and Angioedema

Hives and angioedema can be classified based on their duration, which can help in determining the appropriate treatment approach and potential causes.

Acute Urticaria and/or Angioedema:

When hives or swelling last less than 6 weeks, they are considered acute. The most common triggers for acute cases include:

• Foods (especially nuts, chocolate, fish, tomatoes, eggs, fresh berries, soy, wheat, and milk)
• Medicines (such as aspirin, NSAIDs, high blood pressure medications, and certain painkillers)
• Latex
• Infections
• Insect bites

Chronic Urticaria and/or Angioedema:

When hives or swelling persist for more than 6 weeks, they are classified as chronic. Identifying the cause of chronic cases can be more challenging. Potential triggers include:

• Immune system disorders
• Chronic infections
• Hormonal imbalances
• Tumors (in rare cases)

Physical Urticaria: When Your Skin Reacts to External Stimuli

Physical urticaria is a unique form of hives triggered by direct physical stimulation of the skin. Unlike other types of hives, these usually appear right where the skin was affected and rarely spread to other areas.

Common Triggers for Physical Urticaria:

• Cold
• Heat
• Sunlight
• Vibration
• Pressure
• Sweating
• Exercise

Most cases of physical urticaria develop within an hour of exposure to the triggering stimulus. A specific type of physical urticaria, known as dermatographism, occurs when hives form after firmly stroking or scratching the skin.

Diagnosing Hives and Angioedema: What to Expect

If you’re experiencing symptoms of hives or angioedema, it’s important to consult a healthcare professional for an accurate diagnosis. The diagnostic process typically involves several steps:

Medical History and Physical Examination:

Your doctor will ask detailed questions about your symptoms, potential triggers, and medical history. They will also perform a thorough physical examination to assess the characteristics of your skin reaction.

Allergy Testing:

To identify potential allergens, your doctor may recommend skin tests or blood tests. These can help pinpoint specific substances that may be triggering your symptoms.

Additional Tests:

In some cases, particularly for chronic hives or angioedema, your doctor may order additional blood tests to check for underlying conditions or infections that could be contributing to your symptoms.

Treatment Approaches: Managing Hives and Angioedema Effectively

The primary goal in treating hives and angioedema is to identify and remove the trigger. However, when this isn’t possible or when symptoms persist, various treatment options are available:

Antihistamines:

These medications are often the first line of defense against hives and angioedema. They work by blocking the effects of histamine in the body, helping to reduce itching and swelling. Your doctor may prescribe antihistamines to ease your symptoms or as a preventive measure.

Combination Therapy:

For chronic hives, a combination of medications may be necessary. This could include antihistamines along with other drugs such as:

• Steroids: These can help reduce inflammation and suppress the immune system’s response.
• Biologic drugs: These target specific components of the immune system involved in chronic hives.

Emergency Treatment:

In severe cases of hives or angioedema, especially if there’s a risk of airway obstruction, emergency treatment may be necessary. This could involve:

• Epinephrine injection: To quickly reduce swelling and other severe allergic symptoms.
• Steroid medications: To reduce inflammation and prevent symptom recurrence.

Self-Care Strategies: Easing Discomfort at Home

While waiting for hives or angioedema to subside, several self-care measures can help alleviate discomfort:

1. Use lukewarm water instead of hot water when bathing or showering.
2. Choose gentle, mild soaps to avoid skin irritation.
3. Apply cool compresses or wet cloths to affected areas for relief.
4. Keep your environment cool, both for working and sleeping.
5. Wear loose-fitting, lightweight clothes to minimize skin irritation.
6. Use over-the-counter anti-itch medications like antihistamines or calamine lotion.
7. Apply a fragrance-free moisturizer regularly to prevent skin dryness.

When to Seek Immediate Medical Attention

While most cases of hives and angioedema are not life-threatening, certain symptoms warrant immediate medical attention. If you experience any of the following in conjunction with hives or angioedema, seek emergency care:

• Dizziness
• Wheezing
• Difficulty breathing
• Tightness in the chest
• Swelling of the tongue, lips, or face

These symptoms could indicate a severe allergic reaction or angioedema affecting the airways, which can be potentially life-threatening if not treated promptly.

Living with Chronic Hives: Coping Strategies and Long-Term Management

For individuals dealing with chronic hives or recurrent episodes of angioedema, developing effective coping strategies is crucial for maintaining quality of life. Here are some approaches that can help:

Identify and Avoid Triggers:

While it’s not always possible to pinpoint the exact cause of chronic hives, keeping a detailed diary of your symptoms, activities, and potential triggers can help you identify patterns. Once you’ve identified potential triggers, avoiding them can significantly reduce flare-ups.

Stress Management:

Stress is known to exacerbate many skin conditions, including hives. Incorporating stress-reduction techniques into your daily routine can be beneficial. Consider practices such as:

• Meditation
• Deep breathing exercises
• Yoga
• Regular physical exercise
• Adequate sleep

Dietary Considerations:

While food allergies are more commonly associated with acute hives, some individuals with chronic hives may benefit from dietary modifications. Consider these steps:

1. Keep a food diary to track potential correlations between certain foods and hive outbreaks.
2. Consider an elimination diet under the guidance of a healthcare professional to identify potential food triggers.
3. Avoid foods high in histamine or histamine-releasing compounds if you notice they worsen your symptoms.

Skin Care Routine:

Maintaining healthy skin can help minimize irritation and reduce the frequency of hive outbreaks. Implement a gentle skincare routine that includes:

• Using mild, fragrance-free cleansers
• Applying a hypoallergenic moisturizer regularly
• Avoiding hot showers or baths
• Protecting your skin from extreme temperatures and direct sunlight

Support Groups and Mental Health:

Living with a chronic condition can be emotionally challenging. Joining support groups for individuals with chronic hives or seeking professional mental health support can provide valuable coping strategies and emotional relief.

Advancements in Hives and Angioedema Research: What’s on the Horizon?

The field of dermatology and immunology continues to advance, bringing new hope for individuals suffering from chronic hives and angioedema. Here are some areas of ongoing research and potential future treatments:

Biologic Therapies:

Researchers are exploring new biologic drugs that target specific components of the immune system involved in chronic hives. These therapies aim to provide more targeted and effective treatment options with fewer side effects.

Personalized Medicine:

Advancements in genetic research and biomarker identification may lead to more personalized treatment approaches. This could help doctors predict which treatments will be most effective for individual patients based on their unique genetic and immunological profiles.

Novel Antihistamines:

Scientists are working on developing new antihistamines that may be more effective and have fewer side effects than current options. These could provide better symptom relief for individuals with chronic hives.

Immunomodulatory Treatments:

Research is ongoing into new immunomodulatory treatments that could help regulate the immune system’s response in chronic hives and angioedema, potentially offering long-term relief.

Microbiome Research:

Emerging evidence suggests that the gut microbiome may play a role in chronic urticaria. Future treatments may involve modulating the gut microbiome to alleviate symptoms.

As research progresses, individuals living with chronic hives and angioedema can look forward to potentially more effective and tailored treatment options in the future. Staying informed about these developments and maintaining open communication with healthcare providers can help ensure access to the most current and appropriate treatments as they become available.

Hives, Urticaria, and Angioedema: Symptoms, Causes, and Treatment

Written by WebMD Editorial Contributors

• Causes
• Types
• Diagnosis
• Treatment
• 7 Simple Tips
• When Should I Call the Doctor?
• More

Hives are swollen, pale red bumps, patches, or welts on the skin that appear suddenly. On darker skin tones, they can appear skin-colored and can be more difficult to see. They can happen because of allergies or other reasons. Your doctor may call them urticaria.

Hives usually itch, but they may also burn or sting. They can show up anywhere on your body, including the face, lips, tongue, throat, and ears. Hives can change size rapidly and move around, disappearing in one place and reappearing in other places, often in a matter of hours. Hives can often appear and then clear up within a few hours. Some people have one flare-up and never get hives again. It’s also possible to have many flare-ups.

They range in size from a pencil eraser to a dinner plate and may join together to form larger areas known as plaques. They can last for hours, weeks, or even years.

Angioedema is different. The swelling happens under the skin, not on the surface. It’s marked by deep swelling around the eyes and lips and sometimes of the genitals, hands, and feet. It generally lasts longer than hives, but the swelling usually goes away in less than 24 hours. It’s rare, but angioedema of the throat, tongue, or lungs can block your airways, making it hard to breathe.

Allergic reactions, chemicals in foods, insect stings, sunlight, and medicines can make your body release a chemical called histamine. Histamine sometimes makes blood plasma leak out of small blood vessels in the skin, causing hives or angioedema.

Sometimes, doctors don’t know exactly why hives have formed.

Urticaria, also known as hives, is a skin rash of raised, itchy bumps. The welts may also burn or sting. They often last hours or days, can move around, and don’t leave lasting skin changes. Viral, bacterial, or fungal infections may trigger hives, and they frequently happen again.

Acute urticaria and/or angioedema: With these conditions, hives or swelling lasts less than 6 weeks. The most common causes are foods, medicines, latex, and infections. Insect bites or a disease may also be responsible.

The most common foods that cause hives are nuts, chocolate, fish, tomatoes, eggs, fresh berries, soy, wheat, and milk. Fresh foods cause hives more often than cooked foods. Certain food additives and preservatives may also be to blame.

Drugs that can cause hives and angioedema include aspirin and other NSAIDs (such as ibuprofen), high blood pressure medications (such as ACE inhibitors), and painkillers such as codeine.

Chronic urticaria and/or angioedema: Hives or swelling that lasts more than 6 weeks. The cause is usually harder to find than in acute cases. The causes can be similar to those of acute urticaria but can also include your immune system, chronic infections, hormonal disorders, and tumors.

Physical urticaria: Hives caused by direct physical stimulation of the skin – for example, cold, heat, sunlight, vibration, pressure, sweating, and exercise. They usually happen right where the skin was affected and rarely appear anywhere else. Most appear within 1 hour after exposure.

Dermatographism: Hives that form after firmly stroking or scratching the skin. You may also have other forms of hives.

Hereditary angioedema: Painful swelling under the skin. It runs in families.

Your doctor will ask you many questions to try to find the cause of hives or angioedema. You’ll also get a checkup.

Your doctor may give you skin tests to find out if you’re allergic to something. You may get blood tests, too.

The best treatment is to identify and remove the trigger. But that’s not always easy.

Your doctor may prescribe antihistamines to ease your symptoms or help prevent them.

If you have chronic hives, you may need antihistamines or a combination of medications, such as steroids or a biologic drug.

For severe hives or angioedema, you may need a shot of epinephrine or a steroid medication.

While you wait for the hives and swelling to disappear:

1. Avoid hot water. Use lukewarm water instead.
2. Use gentle, mild soap.
3. Apply cool compresses or wet cloths to the affected areas.
4. Try to work and sleep in a cool room.
5. Wear loose-fitting lightweight clothes.
6. Use anti-itch medication that you can get without a prescription, such as an antihistamine or calamine lotion.
7. Apply a fragrance-free moisturizer several times a day to keep your skin from getting dry.

If you have hives or angioedema and any of the following symptoms, call your doctor right away:

• Dizziness
• Wheezing
• Trouble breathing
• Tightness in the chest
• Swelling of the tongue, lips, or face

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Hives, Urticaria, and Angioedema: Symptoms, Causes, and Treatment

Written by WebMD Editorial Contributors

• Causes
• Types
• Diagnosis
• Treatment
• 7 Simple Tips
• When Should I Call the Doctor?
• More

Hives are swollen, pale red bumps, patches, or welts on the skin that appear suddenly. On darker skin tones, they can appear skin-colored and can be more difficult to see. They can happen because of allergies or other reasons. Your doctor may call them urticaria.

Hives usually itch, but they may also burn or sting. They can show up anywhere on your body, including the face, lips, tongue, throat, and ears. Hives can change size rapidly and move around, disappearing in one place and reappearing in other places, often in a matter of hours. Hives can often appear and then clear up within a few hours. Some people have one flare-up and never get hives again. It’s also possible to have many flare-ups.

They range in size from a pencil eraser to a dinner plate and may join together to form larger areas known as plaques. They can last for hours, weeks, or even years.

Angioedema is different. The swelling happens under the skin, not on the surface. It’s marked by deep swelling around the eyes and lips and sometimes of the genitals, hands, and feet. It generally lasts longer than hives, but the swelling usually goes away in less than 24 hours. It’s rare, but angioedema of the throat, tongue, or lungs can block your airways, making it hard to breathe.

Allergic reactions, chemicals in foods, insect stings, sunlight, and medicines can make your body release a chemical called histamine. Histamine sometimes makes blood plasma leak out of small blood vessels in the skin, causing hives or angioedema.

Sometimes, doctors don’t know exactly why hives have formed.

Urticaria, also known as hives, is a skin rash of raised, itchy bumps. The welts may also burn or sting. They often last hours or days, can move around, and don’t leave lasting skin changes. Viral, bacterial, or fungal infections may trigger hives, and they frequently happen again.

Acute urticaria and/or angioedema: With these conditions, hives or swelling lasts less than 6 weeks. The most common causes are foods, medicines, latex, and infections. Insect bites or a disease may also be responsible.

The most common foods that cause hives are nuts, chocolate, fish, tomatoes, eggs, fresh berries, soy, wheat, and milk. Fresh foods cause hives more often than cooked foods. Certain food additives and preservatives may also be to blame.

Drugs that can cause hives and angioedema include aspirin and other NSAIDs (such as ibuprofen), high blood pressure medications (such as ACE inhibitors), and painkillers such as codeine.

Chronic urticaria and/or angioedema: Hives or swelling that lasts more than 6 weeks. The cause is usually harder to find than in acute cases. The causes can be similar to those of acute urticaria but can also include your immune system, chronic infections, hormonal disorders, and tumors.

Physical urticaria: Hives caused by direct physical stimulation of the skin – for example, cold, heat, sunlight, vibration, pressure, sweating, and exercise. They usually happen right where the skin was affected and rarely appear anywhere else. Most appear within 1 hour after exposure.

Dermatographism: Hives that form after firmly stroking or scratching the skin. You may also have other forms of hives.

Hereditary angioedema: Painful swelling under the skin. It runs in families.

Your doctor will ask you many questions to try to find the cause of hives or angioedema. You’ll also get a checkup.

Your doctor may give you skin tests to find out if you’re allergic to something. You may get blood tests, too.

The best treatment is to identify and remove the trigger. But that’s not always easy.

Your doctor may prescribe antihistamines to ease your symptoms or help prevent them.

If you have chronic hives, you may need antihistamines or a combination of medications, such as steroids or a biologic drug.

For severe hives or angioedema, you may need a shot of epinephrine or a steroid medication.

While you wait for the hives and swelling to disappear:

1. Avoid hot water. Use lukewarm water instead.
2. Use gentle, mild soap.
3. Apply cool compresses or wet cloths to the affected areas.
4. Try to work and sleep in a cool room.
5. Wear loose-fitting lightweight clothes.
6. Use anti-itch medication that you can get without a prescription, such as an antihistamine or calamine lotion.
7. Apply a fragrance-free moisturizer several times a day to keep your skin from getting dry.

If you have hives or angioedema and any of the following symptoms, call your doctor right away:

• Dizziness
• Wheezing
• Trouble breathing
• Tightness in the chest
• Swelling of the tongue, lips, or face

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