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Published: June 26, 2017

The 411 on Hives

A rash showed up on your skin. Now what? Don’t panic. We will go over the possible cause of hives and help you figure out why in the world you have them!

What are Hives?
Hives, also known as urticaria, is an outbreak of swollen, pale red bumps or plaques (wheals) on the skin that appear suddenly -- either as a result of the body's reaction to certain allergens, or for unknown reasons.

Hives can itch, burn or sting. They can appear in different sizes and on different areas of your skin. They can even show up on including lips, tongue, or ears.

Many times the hives may occur with or without angioedema. Angioedema is when the swelling occurs beneath the skin instead of on the surface. Angioedema is typically characterized by deep tissue swelling, commonly around the eyes, ears and lips. Sometimes it can be found on the genitals, hands, and feet. Most episodes of swelling go away in less than 48-72 hours.

Angioedema of the throat, tongue, or lungs can block the airways, and can be life-threatening, but such life-threatening episodes are uncommon.

What Causes Hives and Angioedema?
Viral infections are the most common cause. However allergic reactions to medications, insect stings, sunlight exposure, or physical stimuli such as temperature and vibration can cause urticaria and angioedema. It's sometimes impossible to find out exactly why a person has urticaria and angioedema.

Think you Might have Urticaria or Angioedema?
Come in and see us. A thorough history and physical exam will be performed in an attempt to find the possible cause. Some specific tests for common causes of urticaria and angioedema may also be performed.

Skin tests may be performed to determine if  you are allergic to a specific allergen. Blood tests may also be done to determine if a systemic illness is present.

How is Urticaria/Angioedema Treated?
The best treatment for hives and angiodema is to identify and remove the trigger if one is identified, but this is often not possible. Antihistamines are usually prescribed by your doctor to provide relief from symptoms. Antihistamines work best if taken on a regular schedule to prevent hives from forming. If the urticaria and angioedema is persistent, we may opt to treat with a combination of medications. Though oral corticosteroids may be prescribed, we would try to find the safest and most effective treatment plan for each individual patient. An injectable drug, omalizumab (Xolair), is also approved to treat chronic hives in those at least 12 years of age.

All patients with urticaria and angioedema should see a healthcare professional with expertise on this condition.

Sources:
Vandana K. Patel, MD, FAAAAI
http://www.webmd.com/skin-problems-and-treatments/guide/hives-urticaria-angioedema#1

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