Hives (also called urticaria) is a very itchy skin rash. It appears as raised bumps or large patches of raised skin. They are typically red but can turn white if they are very swollen. The symptoms of this skin reaction are caused by a histamine response – an overreaction of the immune system that is often linked to skin or food allergies. Usually, the rash will resolve quickly with treatment. However, hives can keep coming back or last for many weeks. This condition is called chronic urticaria. It can be caused by environmental factors other than allergens including:

  • Exposure to heat or cold
  • Sun exposure
  • NSAID drugs (such as ibuprofen)
  • Many other medications including opoids and certain anti-biotics
  • Exercise
  • Pressure on the skin (such as from tight clothing)
  • Emotional stress

Underlying medical conditions such as hypothyroidism or viral infection of the upper respiratory tract are sometimes associated with chronic hives. However, the cause is usually not identifiable.

Potential Treatments

  • Hives are usually treated with over the counter or prescription antihistamines. Some of these drugs cause drowsiness as a side effect, so speak with your dermatologist about finding a non-drowsy formula for daytime use.
  • Steroids may be used for short term relief in some cases.
  • Acute urticaria associated with food or medication allergies is sometimes linked to a life threatening medical condition called anaphylaxis. This condition must be treated with a shot of epinephrine to immediately reduce swelling in the airway.
  • Chronic urticaria requires a full medical examination to uncover and treat any underlying potential underlying condition.

Identifying and avoiding substances or situations that trigger hives is part of the process of managing this skin condition.

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