Hives or Wheals (Urticaria)

Hives, also called wheals and urticaria, are swollen red patches on the skin. They are caused by a histamine reaction, and are usually accompanied by itching, and sometimes by a burning sensation, flushing and wheezing.

Symptoms of Hives

The symptoms of hives are:

  • Multiple patches in circular, semicircular or ring shape
  • Raised, swollen bumps
  • Pink, red, or white in color with the central area paler than the outer portions
  • About 1 inch to more than several inches in diameter
  • Severe itching
  • Burning or stinging sensation (occassionally)
  • Flushing or wheezing (occassionally)

These patches can occur at any part of the body, and usually disappear after 1 hour. New spots may come and go for hours or even weeks. In rare cases of chronic hives, these patches are present daily for many years.

The wheezing associated with hives is caused by swelling of the airways, similar to the swelling of the skin. If this swelling blocks the airways completely, hives can be life-threatening and therefore require immediate medical attention.

Causes of Hives

Hives are caused when histamines are released by the body. This release of histamine is triggered by:

  • Medications
  • Food, such as chocolate, nuts, shellfish, cheese, berries, and tomatoes
  • Insect bites and contact with caterpillar spines

Hive-producing caterpirllar
Skin contact with the hair-like spines of Megalopyge opercularis or
hive-producing caterpillar can induce hive breakout.

  • Infections
  • Stress
  • Exercise
  • Exposure to sunlight
  • Exposure to cold

Treatment of Hives

Hives treatments include:

  • Prescription and over-the-counter non-drowsy antihistamines for the daytime, such as cetrizine and loratadine.

  • Over-the-counter, sedating antihistamines before bedtime, such as diphenhydramine and chlorpheniramine

  • Cool compresses to the affected areas

  • Epinephrine or adrenaline injection, intravenous antihistamine, and corticosteroid medicines for hives patients with difficulty in breathing.

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