Urticaria, commonly known as hives, is a skin condition characterised by itchy, raised welts that can vary in size and shape. These hives often appear suddenly and may fade within hours, but in some cases, they can persist for weeks or even longer. Urticaria can be triggered by allergic reactions, stress, infections, or environmental factors, making it a challenging condition to manage.
While mild cases of urticaria often resolve on their own, chronic or severe hives may require medical treatment to control symptoms and prevent discomfort. The treatment approach depends on whether the condition is acute (lasting less than six weeks) or chronic (persistent or recurring for more than six weeks).
At City Dermatology Clinic, Dr Andreea Anton offers expert advice and tailored treatment plans to help manage urticaria effectively, providing relief from itching and irritation while addressing underlying causes.
Understanding the Causes of Urticaria
Urticaria can develop when the body releases histamine and other chemicals into the skin, causing inflammation and fluid leakage from blood vessels. This reaction leads to the formation of hives, which may appear as red, raised welts on the skin. There are two main types of urticaria: acute and chronic, each with different triggers and risk factors.
Common Triggers of Acute Urticaria
Acute urticaria typically lasts less than six weeks and is often triggered by:
- Allergic Reactions: Common allergens include foods (nuts, shellfish, eggs), insect stings, latex, and medications (antibiotics, NSAIDs).
- Infections: Viral infections, such as the cold or flu, can trigger hives, particularly in children.
- Environmental Factors: Exposure to pollen, pet dander, or mould can lead to hives in those with allergies.
- Physical Triggers: Heat, cold, sunlight, or pressure on the skin can cause physical urticaria, where hives appear in response to external stimuli.
- Stress and Emotional Factors: High stress levels or emotional responses may contribute to hives, particularly in those with sensitive skin.
Causes of Chronic Urticaria
Chronic urticaria is defined as hives that persist for more than six weeks or recur frequently. It is often more difficult to identify triggers and may be associated with:
- Autoimmune Reactions: The immune system mistakenly attacks healthy cells, leading to hives without an external trigger.
- Underlying Health Conditions: Conditions such as thyroid disease, lupus, or other autoimmune disorders can trigger chronic hives.
- Long-Term Infections: Bacterial, viral, or parasitic infections may contribute to persistent urticaria.
- Medications: Some medications, including aspirin, ACE inhibitors, and antibiotics, can cause ongoing hives as a side effect.
Effective Treatment Options for Urticaria
Treating urticaria involves managing symptoms, reducing itching, and preventing new hives from forming. Treatment options vary depending on whether urticaria is acute or chronic, with approaches ranging from over-the-counter medications to specialist therapies.
| Treatment Method | How It Works | Expected Results | Best For |
|---|---|---|---|
| Antihistamines | Block histamine release, which reduces itching, redness, and swelling. | Effective relief of mild to moderate hives, can be used daily for chronic urticaria. | Acute and chronic urticaria, particularly when triggered by allergies. |
| Oral Corticosteroids | Reduces inflammation quickly, often used in short courses for severe cases. | Provides rapid symptom relief, but not recommended for long-term use. | Severe acute urticaria with significant swelling or angioedema. |
| Leukotriene Receptor Antagonists | Help reduce inflammation and control hives, often used with antihistamines. | Additional relief for chronic urticaria, particularly if antihistamines alone are not effective. | Chronic urticaria, especially with asthma or allergies. |
| Biologic Treatments (e.g., Omalizumab) | Target specific immune responses involved in chronic urticaria, reducing flare-ups. | Effective for chronic spontaneous urticaria, particularly in resistant cases. | Patients with chronic urticaria not responding to traditional treatments. |
| Topical Soothing Creams | Hydrates and soothes the skin, providing a cooling effect to reduce itching and irritation. | Ideal for relieving itching and supporting skin health, particularly with mild hives. | Mild cases of urticaria, used as supportive care. |
| Avoiding Triggers | Identifying and avoiding known triggers such as certain foods, medications, or environmental factors. | Reduces the frequency and severity of flare-ups, helps maintain symptom control. | All types of urticaria, particularly if triggers are identifiable. |
Lifestyle and Home Care Tips
- Wear Loose, Comfortable Clothing: Tight clothing or rough fabrics can irritate the skin and worsen symptoms.
- Use Cool Compresses: Applying a cool cloth to the affected area can help reduce itching and swelling.
- Avoid Hot Showers: Hot water can aggravate hives, so opt for lukewarm baths instead.
- Maintain a Symptom Diary: Tracking when hives appear can help identify patterns and triggers, aiding in long-term management.
Achieving Long-Term Relief from Urticaria
Managing urticaria effectively involves a combination of medical treatments, lifestyle adjustments, and preventive strategies. Consistent care can help reduce flare-ups, maintain healthy skin, and improve quality of life.
Managing Flare-Ups and Preventing Hives
- Avoid Known Triggers: Identify allergens, medications, or environmental factors that cause hives and take steps to avoid them.
- Wear Loose Clothing: Choose soft, breathable fabrics, like cotton, to avoid skin irritation.
- Use Gentle Skincare Products: Avoid perfumed lotions or harsh soaps, which can irritate sensitive skin.
- Stay Cool: High temperatures and sweating can trigger hives, so use cool compresses and maintain a comfortable indoor climate.
- Manage Stress: Stress is a known trigger for chronic urticaria, so relaxation techniques like meditation, yoga, or deep breathing can help reduce symptoms.
Long-Term Treatment Strategies
- Follow Medical Advice: Take medications as prescribed and attend regular check-ups to monitor progress.
- Keep a Symptom Diary: Note when hives occur, what triggers them, and how long they last. This information can be valuable for treatment adjustments.
- Use Antihistamines Safely: If using antihistamines daily, consult with a dermatologist to avoid overuse or side effects.
- Maintain a Healthy Lifestyle: Eating a balanced diet, staying hydrated, and maintaining good sleep hygiene can help support the immune system and prevent hives.
When to See a Dermatologist
- If Hives Persist: Chronic urticaria lasting more than six weeks may require specialist treatment.
- Severe Reactions: If hives are accompanied by swelling of the lips, tongue, or difficulty breathing, seek immediate medical attention.
- New or Worsening Symptoms: If current treatments are not effective, or if symptoms change, a professional evaluation can help adjust treatment plans.
Dr Andreea Anton at City Dermatology Clinic offers advanced treatment options and personalised care, helping patients achieve long-term relief from urticaria symptoms. Combining professional treatments with everyday management strategies can provide significant improvement, ensuring comfortable, healthier skin.
