Hives/Urticaria is characterised by very itchy weals (hives), with or without surrounding erythematous flares. The name urticaria is derived from the common European stinging nettle Urtica dioica. Urticaria can be acute or chronic, spontaneous or inducible.
Hives is not contagious. However, if it stems from an underlying infection, that infection could be contagious. Examples of these infections include the flu, the common cold, glandular fever, also known as mono, and hepatitis B.
Urticaria is classified according to its duration.
• Acute urticaria (< 6 weeks duration, and often gone within hours to days)
• Chronic urticaria (> 6 weeks duration, with daily or episodic weals)
Chronic urticaria may be spontaneous or inducible. Both types may co-exist.
Signs and symptoms of chronic hives include:
• Batches of red or skin-colored welts (wheals), which can appear anywhere on the body
• Welts that vary in size, change shape, and appear and fade repeatedly as the reaction runs its course
• Itching, which may be severe
• Painful swelling (angioedema) of the lips, eyelids and inside the throat
• A tendency for signs and symptoms to flare with triggers such as heat, exercise and stress
• A tendency for signs and symptoms to persist for more than six weeks and to recur frequently and unpredictably, sometimes for months or years
Short-term (acute) hives appear suddenly and clear up within a few weeks.
Allergens can causes these reactions. An allergen is a substance your body doesn’t like, and your body’s immune system reacts by releasing chemicals called histamines. Histamines are a chemical made by allergy cells (mast cell) and other immune cells (eosinophils, basophils, etc) that goes into overdrive to get rid of the allergen. But your body may respond to the flood of histamines by having an allergic reaction that causes hives and swelling.
People get hives from all kinds of things, including:
• Airborne allergens like tree and grass pollen, mold spores and pet dander.
• Bacterial infections, such as strep throat and urinary tract infections.
• Food allergies to milk, peanuts and tree nuts, eggs, fish and shellfish.
• Insect stings.
• Medication allergies, including non-steroidal anti-inflammatory drugs (NSAIDs), codeine and blood pressure medicine, especially ACE inhibitors.
• Quick changes in body temperature due to heat, cold or physical activity.
• Viral infections, such as the common cold or mononucleosis.
• Allergies to other materials, like latex or detergents.
• Hormonal issues, like changes in your body because of pregnancy, menopause or thyroid disease.
• Autoimmune conditions.
Hives vs. other rashes
Hives are a kind of rash. If someone has hives, the rash typically has these features –
• It is raised and itchy.
• There may be swelling under the affected skin.
• There may be papules or plaques.
• The affected areas of skin can expand and join together.
• The rash may be pink, red, or skin-colored.
• The center turns pale in the middle if someone presses on it.
• Each bump may last less than 24 hours, but other bumps may replace it.
• The bumps can seem to appear and disappear and change shape or location suddenly.
Complications of hives may include:
• Anaphylaxis (a life-threatening, whole-body allergic reaction that causes breathing difficulty)
• Swelling in the throat can lead to life-threatening airway blockage
Your doctor will do a physical exam and ask you a number of questions to try to understand what might be causing your signs and symptoms. He or she may also ask you to keep a diary to keep track of:
• Your activities
• Any medications, herbal remedies or supplements you take
• What you eat and drink
• Where hives appear and how long it takes a welt to fade
• Whether your hives come with painful swelling
If your physical exam and medical history suggest your hives are caused by an underlying problem, your doctor may have you undergo testing, such as blood tests or skin tests.
Most of the time, hives and swelling go away without treatment. Your healthcare provider might recommend medications and at-home care to help you feel better and lower your chances of having hives again. Treatments include:
• Allergy medications
Medicines called antihistamines block histamine’s effects on your body. Antihistamines relieve itching from hives and prevent allergic reactions. Some antihistamines react fast, like diphenhydramine (Benadryl®). Depending how severe the hives are, your healthcare provider may recommend daily over-the-counter (OTC) or prescription allergy medications, like
▪︎cetirizine (Zyrtec®) or levocetirizine (Xyzal®).
• Allergy shots
For hard-to-treat chronic hives, your healthcare provider may recommend a monthly injection of a drug called omalizumab (Xolair®). This medication blocks the body’s allergy antibody, immunoglobin E (IgE), from causing allergy reactions. People with severe allergies can make too much IgE, leading to problems like hives and asthma.
• At-home treatments
To relieve hives, you can take a cool bath or shower, wear loose-fitting clothing and apply cold compresses. An OTC hydrocortisone cream, such as Cortizone®, can relieve itching and swelling.
Severe allergic reactions and swelling can lead to a life-threatening condition called anaphylaxis. Symptoms include hives, swelling, shortness of breath, wheezing, vomiting and low blood pressure. People experiencing anaphylaxis need an immediate epinephrine injection (EpiPen®) to open a swollen airway.
• Oral steroids: Corticosteroids, such as prednisone, can relieve hive symptoms that don’t respond to antihistamines.
Ayurvedic Perspective –
In Ayurveda, all skin diseases are considered under “Kushta Roga” and Urticaria is identified as Sheetapitta. An aggravation of Kapha (water) and Vata (air) doshas occurs when people come in contact with cold air, according to Ayurveda. The aggravation of pitta dosha (fire) which spread into the Rakta Dhatu (blood tissues) is also caused by it. An excess of pitta impairs the Rakta Dhatu. Sheeta Pitta is then caused when the aggravated doshas relocate to the skin. The treatments include identifying the cause and focusing on the same.
* One can take bath with neem infused warm water for relief
*Apply coconut oil or mustard oil or Neel oil all over your body
*If the urticaria is chronic and does not seem to pacify with ayurvedic medicines, then resorting to panch-karma is the best option.
▪︎Effective Ayurvedic Therapies
Ayurveda massage therapy to loosen trapped endogenous toxins, warm up muscles, and improve circulation. Abhyanga oils may be edible grade plain or made from a recipe for deeper healing.
Abhyanga with Kshara, Lavana Taila is beneficial to treat Urticaria
• Lepa (anointment)
Herbal paste made from specific ingredients to treat skin-related conditions. Famous for Urticaria are Durva and Nishi.
Sprinkling, showering or stream pouring of warm Kwatha (decoction) prepared with herbs that pacify Vata or Vata-Kapha morbidity over the body. Parisheka with hot water is done for soothing skin irritation.
It is one of the five steps of Panchakarma which is used in treating Kapha related disorders and is also known as medical vomiting or medical emesis. The vitiated Dosha are eliminated through the upper gastrointestinal tract through the emesis.
Another step of the Panchakarma process, Virechana is a controlled process that assembles all the ama or toxins of the body in the small intestine and eliminates them. It helps the body to be free from the aggravated Pitta dosha and its toxic disease-causing symptoms and is only performed after the tolerance of an individual is accurately determined beforehand.
• Panchvalkala lepam
Allergy tests can help your healthcare provider figure out which substances bring on hives and swelling. Once you know your triggers, you can avoid them.
You may want to:
• Cut certain foods or liquids out of your diet.
• Reduce exposure to airborne allergens.
• Switch to detergents and soaps without scents or dyes.
• Avoid extreme changes in temperature.
• Relax and take a break when you’re stressed or overworked.
• Wear loose-fitting, lightweight clothing.
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