Urticaria (Hives)
Also known as: Hives, Nettle rash, Wheals, Welts
Urticaria or hives are itchy, raised bumps on skin caused by allergic or inflammatory reactions.
Signs & Symptoms
- Red, itchy bumps
- Raised welts
- Swelling of skin
- Burning or stinging sensation
- Transient lesions
Causes
- Allergic reactions
- Autoimmune response
- Non-allergic triggers
- Infection
- Medications
- Food allergies
Risk Factors
- Atopic history
- Autoimmune disease
- Chronic infections
- Aspirin or NSAID use
- Specific food allergies
When to See a Doctor
See a dermatologist if hives persist beyond 6 weeks, recur frequently, involve throat/lips swelling, or affect quality of life.
Treatment Options
Treatment options vary by individual. Consult a dermatologist for a personalised plan.
- Antihistamines (H1 and H2 blockers)
- Corticosteroids
- Immunosuppressive agents
- Epinephrine (anaphylaxis)
- Trigger avoidance
Understanding Urticaria
Urticaria (hives) are transient, pruritic skin reactions characterized by central wheals surrounded by erythema. Acute urticaria occurs in up to 20% of people; chronic urticaria affects 0.5-1%.
Pathophysiology
Mast Cell Degranulation: Histamine release from mast cells causes vasodilation and itching
Immune Response: IgE-mediated (allergic) or non-allergic mechanisms
Inflammatory Cascade: Additional mediators amplify reaction
Classification
Acute Urticaria: Lasts less than 6 weeks; often identifiable trigger
Chronic Urticaria: Lasts more than 6 weeks; triggers often unclear
Physical Urticaria: Triggered by physical stimuli (cold, heat, pressure, vibration, sunlight)
Angioedema: Deeper skin/mucosa involvement; requires urgent evaluation if involving airway
Common Triggers
Allergic:
- Foods (shellfish, nuts, eggs, dairy)
- Medications (penicillins, NSAIDs)
- Insect stings
- Environmental allergens
Non-Allergic:
- Infections (viral, bacterial, fungal)
- Autoimmune conditions
- Stress and emotions
- Temperature extremes
- Alcohol
- Additives and preservatives
Diagnostic Approach
- Clinical History: Trigger identification
- Physical Examination: Distribution and characteristics
- Allergy Testing: If indicated
- Systemic Evaluation: If chronic or severe
Severity Assessment
Mild: Few lesions, minimal impact on function
Moderate: Multiple lesions affecting daily activities
Severe: Extensive involvement, sleep disruption, facial involvement
Emergency Symptoms
Seek immediate attention if:
- Throat or tongue swelling
- Breathing difficulty
- Systemic symptoms (fever, hypotension)
- Angioedema involving airway
”When to See a Doctor”
Hives lasting beyond 6 weeks, recurring frequently, or significantly affecting quality of life warrant professional evaluation.
Management Principles
- Trigger identification and avoidance
- Symptom management with antihistamines
- Investigation of underlying causes
- Supportive care focusing on quality of life
Visit Dr. Dr. Sanjay Agrawal for evaluation and appropriate management of persistent or recurrent hives.
Have this condition?
Call the clinic or visit Dr. Sanjay Agrawal directly for a proper diagnosis and personalised treatment plan.