Urticaria (Hives) Diagnosis And Treatment

September 26, 2020     

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Urticaria is an itchy rash characterized by a discharge that can appear anywhere on the body or from angioedema (swelling of the skin’s deeper layers). It is usually temporary and goes away within 24 to 48 hours. Hives have many possible causes, including allergies.

Whether you’ve recently been diagnosed with chronic idiopathic hives (CIU) or are worried you might have it, you are likely to be nervous, confused, and maybe a little afraid. It’s normal! Read this article to learn about the realities and challenges you will face with this condition and the best treatments, beneficial lifestyle changes, and all the essential information you need. Cosmosure Clinic is here to help you with the best treatments. 

What is urticaria?
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Urticaria, otherwise called hives, are red bumps or spots on the skin. They are swellings on the surface of the skin. They occur when your body is allergic to allergens, substances that are harmless to most people. However, it can also occur with autoimmune diseases or systemic diseases if the hives persist for a long time.

Sometimes hives form a more extensive area called plaque. Hives usually go away within 24 hours, although they can appear within a few days or more.

What are the types of hives (urticaria)?

There are several types of hives and angioedema, including:

  • Acute: Hives or swelling that lasts less than six weeks is considered acute, which suddenly comes on. Allergic reactions to certain foods or medications often cause acute itching and swelling.
  • Chronic: If hives persist for more than six weeks, the condition is chronic. For 95% of chronic diseases, no one knows what causes it, although it is believed to be an autoimmune disease.
  • Physical: Some people develop urticaria and swelling in certain situations. Some people react to vibration or pressure, or movement and sweating. Physical hives usually appear within an hour of exposure.

What causes hives?
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Allergens can cause this reaction. Allergens are substances that your body doesn’t like, and your immune system reacts by releasing a chemical called histamine. Histamine is a chemical produced by allergic cells (mast cells) and other immune cells (eosinophils, basophils, etc.) that are overloaded to eliminate allergens. However, your body may react to the histamine flow and have an allergic reaction that causes urticaria and inflammation. People get urticaria from all the below readings, including:

  • Airborne allergens such as tree and grass pollen, mould spores, and pet dander.
  • Bacterial infections such as strep throat and urinary tract infections.
  • Food allergies to milk, peanuts and nuts, eggs, fish, and shellfish.
  • Insect bites.
  • Drug allergy, including non-steroidal anti-inflammatory drugs (NSAIDs), codeine, and blood pressure medications, especially ACE inhibitors.
  • Rapid changes in body temperature due to heat, cold, or physical activity.
  • Viral infections such as the common cold or mononucleosis.
  • Allergy to other ingredients such as latex or detergents.
  • Hormonal problems such as body changes due to pregnancy, menopause, or thyroid disease.
  • Autoimmune disease.

Urticaria Symptoms:
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  • Skin Appearance: Spots appear in areas that are very itchy and sometimes red with a pale centre. In some cases, the raised regions enlarge and join together. Itching is usually the most troublesome symptom of itching and can be severe enough to affect work and sleep.
  • Severe pain, blistering, and bruising on the skin are not the hallmarks of hives. The presence of urticaria with fever and joint pain is also atypical. These symptoms indicate another condition called urticarial vasculitis that requires different treatment.
  • Angioedema: Nearly half of the people with hives will also develop a condition called angioedema. Angioedema is similar to hives but occurs in a deeper layer of skin. Angioedema can occur at the same time with hives. The symptoms of angioedema include:
    • Swelling of the face, eyelids, ears, mouth, arms, legs, and genitals
    • The swelling usually affects one side of the body or more than one side.
    • Feeling full or uncomfortable in the swollen area.
    • Slight redness of the skin, although the skin colour may be normal.

Hives can also appear as part of a more serious allergic reaction. You should see your doctor as soon as possible if you suddenly develop urticaria or angioedema and other symptoms such as:

  • Trouble breathing
  • Tightness in the throat
  • Nausea or vomiting
  • Cramping abdominal pain
  • Passing out

Urticaria Diagnosis:
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ost people with hives don’t need testing. Diagnosis is usually based on symptoms and a physical examination. However, testing may be recommended if hives are not approved within six weeks.

  • Tests: Skin tests for sensitivity to food and drugs may be recommended if there is concern about an allergy as its cause. This is usually done in people with acute urticaria. Allergies rarely cause chronic hives.
  • Blood tests are sometimes done if hives have lasted six weeks or more. Blood tests can determine if there are signs of an underlying condition, such as thyroid problems or autoimmune disease.
  • Skin biopsy: A skin biopsy (when a small sample is taken from the skin) can help identify urticaria unusual causes. A skin biopsy may be recommended for people with chronic hives and other symptoms such as persistent fever, painful hives, hives that last for days, or hives associated with bruising. A skin biopsy may also be recommended for people who have other symptoms or unusual blood tests.

Treatment of hives (urticaria):

There are several ways to treat urticaria.

  • Avoid known triggers: It is important to try to avoid known or suspected causes of urticaria. Although it is often possible to determine acute urticaria (which lasts hours, days, or sometimes weeks), the cause of chronic urticaria (which lasts more than six weeks and can last months or years) is often unknown. 
  • Please don’t go on diets unless the trigger has been confirmed. The eliminated diet must be monitored.
  • Salicylates found not only in aspirin but also in some fruits and supplements such as tartrazine and benzoate, are a relatively common cause. Aspirin can often worsen symptoms. If aspirin is causing your urticaria, it’s important to see a doctor before taking any medication, including non-steroidal anti-inflammatory drugs (NSAIDs).

What is the treatment for CIU?
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Your doctor will work with you to control your CIU through the use of medications and possibly some lifestyle changes. Some of the medications your doctor may prescribe include:

Antihistamines: Taking an over the counter antihistamine every day will help block the release of histamine, which in turn will relieve your symptoms. Some of the general pharmacies are Allegra (fexofenadine), Claritin (loratadine), and Zyrtec (cetirizine). They have very few side effects, but if you have a busy day ahead of you, make sure you get the sleepless version medications.

If OTC antihistamines alone don’t relieve your symptoms, your doctor may recommend that you try the following:

  • Histamine blockers: Also known as H-2 receptor antagonists, they can be taken orally or given an injection. They prevent histamine from binding to receptors in the body and inhibit or reduce symptoms. Examples are Pepcid (famotidine), Tagamet HB (cimetidine), and Zantac (ranitidine).
  • Anti-inflammatory drugs: Oral corticosteroids can reduce swelling, redness, and itching. You may be given a short 3 to the 5-day course for nest control. However, avoid long-term use. If you take them for a long time (usually months), they can cause serious side effects such as high blood pressure, fractures, weight gain, blurred vision, increased thirst, and fluid retention. The common corticosteroid is called prednisone. It slows down your immune system and how quickly your body reacts to injury and disease. In the case of the CIU, your system is inexplicably overloaded. So calming yourself down is usually the fastest way to check for hives.
  • Immunosuppressants: Use of these medications is recommended for people with severe CIU who cannot tolerate high doses of oral antihistamines and have not responded to conventional treatment. They block your immune response to reduce or stop symptoms. They are taken orally and must be used for up to 12 months. A possible side effect is an increased risk of infection.

Lifestyle and home remedies:
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Chronic hives can last for months and years and disturb sleep, work, and other activities. The following precautions can help prevent or reduce recurrent skin reactions in chronic hives:

  • Wear loose, light clothing.
  • Avoid scratching or using soaps that have harsh chemicals.
  • Soothe the affected area with a bath, fan, cool towel, anti-itch lotion, or cream.
  • Keep a book about when and where the nest appears, what you do, what you eat, etc. This can help you, and your doctor identifies the cause.
  • Avoid certain triggers.
  • Apply sunscreen before going outside.


Most cases of hives occur in children. As we get older, the majority develop from this disease. The lesions usually fade as the child grows older. Up to 25 per cent will not develop from disease, and the lesions will persist into adulthood.

If there is significant swelling, especially if your face, eyes, lips, or tongue are affected, or if there is wheezing associated with it, see a doctor immediately. For most people, hives are not severe. Children can overcome allergies caused by their hives.

Some people with chronic hives (lasting more than six weeks) will see the hives go away on their own, often within a year. However, for many people with chronic cases, hives come and go for months or years.

If the itching persists or becomes severe, it is important to see a Cosmosure Clinic doctor for the best treatment. Hives can be a sign of internal disease. Some people have severe swelling. If you have urticaria and have trouble breathing or swallowing, get emergency help right away. 

For more information about hives, contact Doctors at Cosmosure Clinic who can provide the best diagnosis and treatment based upon the conditions. Contact Cosmosure Clinic at and book your appointment now!