Hives: causes and treatment

Hives form – usually without any apparent reason – red wheals that cause severe itching. The triggers for the skin disease can be varied and are difficult to determine. We have put together everything you need to know about hives here.

What is hives?

In principle, hives, also known as urticaria, are not an allergic reaction, but a hypersensitive reaction of the skin to certain stimuli. The name hives comes from the fact that a skin rash appears that resembles that after contact with stinging nettles. Hives are not contagious.

According to studies, around 20 percent of the population in Germany are affected by hives at least once in their lives, including three to six percent of children under the age of 16. In almost 80 percent of cases, the exact trigger of the complex skin disease cannot be determined.

The symptoms that occur with hives, which usually appear a few minutes after the triggering stimulus, often subside on their own after about 24 hours, but they can also persist for several days or weeks. If hives do not last longer than six weeks in total, it is called an acute phenomenon. Anything beyond that is called chronic.

How is hives manifested?

Although there are many potential causes and triggers for hives, all forms have very similar symptoms:

  • Wheals: The trigger stimulus is followed by the formation of mostly red wheals. They vary greatly in shape and size; for example, they can be as small as a pinhead or as big as the palm of a hand. Depending on the severity of the hives, they appear in individual areas or all over the body. The wheals can also change their position and thus migrate, so to speak, over the body.
  • Itching: Typically, the wheals cause severe, excruciating itching. Sometimes burning also occurs.
  • Angioedema: In half of all cases of hives, the body reacts by forming cushion-like swellings in the subcutaneous tissue.
  • Swollen mucous membranes: Certain areas of the mucous membranes can also swell. If this happens in the throat, for example, it can cause difficulty swallowing or nausea. Shortness of breath, up to and including unconsciousness, can also be the result.

What Causes Hives?

Hives are an immune response of the body. In response to a specific stimulus, the mast cells of the immune system are stimulated to release messenger substances, primarily histamine. The blood vessels dilate, the skin swells, and the typical skin inflammation develops.

This process of the immune system actually serves to ward off “invaders” such as bacteria. In hives, the mast cells react incorrectly to stimuli that often do not give rise to an immune response. These triggers can be very diverse:

  • infections
  • Medications such as acetylsalicylic acid, diclofenac and ibuprofen
  • Physical stimuli such as heat, cold or pressure
  • light
  • friction
  • stress
  • Physical exertion

Hives can also show up as a symptom of other allergies, such as a food intolerance. For example, hot spices can increase hives. In addition, it sometimes occurs spontaneously, so that no trigger can be determined.

How is hives diagnosed?

Since hives can have so many completely different triggers, it is very difficult to find the responsible stimulus. However, since the most effective treatment for hives is to avoid the trigger altogether, it is very important to diagnose as accurately as possible.

In order to narrow down potential triggers, the doctor treating you will first conduct an anamnesis interview. He tries to find out whether other allergies exist, whether medication is taken regularly or other environmental stimuli could be responsible for the hives. It can be very helpful if the patient keeps an allergy diary in which they enter when, how severely and how long the hives appeared. Photos of the wheals can also be an advantage, since they may have already healed by the time a doctor’s appointment is made.

One or more of the following test procedures will then be used to accurately diagnose the hives trigger:

  • Prick test: In this standard test, possible allergens are applied to the skin in liquid form. The epidermis is then slightly scratched so that the allergens can penetrate the skin. After about 30 minutes, the doctor checks whether an allergic reaction with wheals or reddening of the skin has taken place.
  • Patch test: In this test, the suspected substances are simply applied to the skin with a patch. After about 24 hours, this is removed and the skin reactions checked. This check is repeated after 48 and 72 hours.
  • Intradermal test: In this test, a single allergen is injected under the skin. An allergy can be determined much more precisely with an intradermal test, but severe allergic reactions, up to and including anaphylactic shock, can also occur.
  • Provocation test: If none of the other diagnostic methods can be used to find a trigger for hives, a provocation test can be carried out. This means that the patient is brought into direct contact with the potential trigger or that he is exposed to special stimuli such as heat or cold. However, since strong reactions can also occur in this way, such a test should only be carried out under medical supervision.
  • Blood, urine or stool sample: To confirm the diagnosis and to determine whether increased histamine is being released, blood, urine or stool samples can also be taken.

How is hives treated?

In many cases, the symptoms of hives will go away on their own after a few days without leaving any marks or scars. However, to alleviate the symptoms or to prevent hives altogether, there are various treatment methods.

The most effective way to prevent hives from occurring is to avoid the trigger, if known. In addition, antihistamines are usually used, which block the effect of the histamine released by the mast cells. Especially people who suffer from a chronic form of hives take these drugs over several months so that a level in the blood is built up. Research shows that when hives are effectively treated, symptoms do not return even after the drug is stopped.

Hives in pregnancy
If hives occur during pregnancy, it is better for the affected person to refrain from taking medication. However, hives often improve during pregnancy.

The doctor usually prescribes anti-inflammatory agents and glucocorticoids to combat the wheals and rash, which reduce the release of histamine and stabilize the mast cells. Ointments and creams also allow the skin reactions to subside and relieve the itching. Cold towels or cooling pads can also help against this. Note: This variant should only be used if it is absolutely certain that the hives are not cold-induced. Heat, on the other hand, can intensify the itching because it stimulates blood circulation even further.

Depending on how strong the reactions are when hives occur, it makes sense to put together an emergency kit with effective medication. A kind of allergy ID card, on which it is noted what the reaction is, can also be an advantage.

Similar Posts

Leave a Reply

Your email address will not be published. Required fields are marked *