Author: V. Dimov, M.D., Allergist/Immunologist, Cleveland Clinic
Reviewer: S. Randhawa, M.D., Allergist/Immunologist and Assistant Professor at NSU
Hives (also called urticaria) are red, itchy, raised areas of the skin that can range in size and appear anywhere on your body. They often move from place to place.
Urticaria affects up to 20 percent of people at some point in their lives. More than two-thirds of cases of urticaria are self-limited (acute).
Most common hives are acute, where food or drug allergies are triggers. These hives usually go away within a few days. Hives that are due to foods, for example, do not last two weeks. They usually last a matter of hours.
Food or drug reactions are a common cause of acute hives and/or angioedema. Viral or bacterial infection can also trigger hives in both adults and children. Many patients have idiopathic urticaria which means that no cause can be found.
If the cause of your hives can be identified, you should avoid that trigger. With acute hives, some drugs or foods may take days to leave the body, so your allergist may prescribe antihistamines to relieve your symptoms until that happens.
In cases of chronic urticaria (hives), people may suffer for months to years.
Chronic spontaneous urticaria (CSU) is defined as the presence of urticaria with daily or almost daily symptoms for 6 weeks or more. CSU affects 0.1%-0.8% of people.
Fifty percent of patients with chronic urticaria do not have hives after one year. However, 40 percent of patients with chronic urticaria may have autoimmune urticaria and in this case the hives typically last longer than one year. A board-certified allergist can help determine if you have chronic urticaria and if it is autoimmune or not.
Physical urticaria are hives resulting from a non-allergic source: rubbing of the skin, cold, heat, physical exertion or exercise, pressure and direct exposure to sunlight. Some patients have idiopathic urticaria which means that no cause can be found.
While hives are unpleasant and troublesome, there are steps you can take to treat them.
An allergist/immunologist, often referred to as an allergist, is the most qualified physician to treat allergic diseases. An allergist can determine which condition you have and develop a treatment plan to help you feel better.
Angioedema is a swelling of the deeper layers of the skin that sometimes occurs with hives. Angioedema is usually not red or itchy. It may be painful. The areas often involved are the eyelids, lips, tongue, hands and feet.
Angioedema (AE) can be allergic or non-allergic. There are 5 types of non-allergic angioedema (AE):
- acquired AE
- hereditary AE (HAE), genetic, affects several family members
- ACE-inhibitor induced AE, due to a blood pressure medication
- idiopathic AE, it can occur with chronic urticaria, cause is unknown
- pseudoallergic AE, e.g. reaction to pain medications such as NSAIDs
Allergic Skin Conditions. AAAAI.
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