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  Hives

Hives are a skin condition characterized by red, itchy, raised swellings on the skin that appear in different shapes and sizes. Hives can be a few millimeters in size to several inches. Hives can appear in rings, small patches and large patches. Hives can appear anywhere on the body. Welts are the red flare caused by itching hives. The medical term for hives is urticaria.

Hives Skin diseases
Hives


Hives have a tendency to appear suddenly, change size quickly and move around on the surface of the skin – that is disappearing from one area and reappearing on another area. A dramatic outbreak that appears at lunchtime can be cleared up by dinner and re-appear at bed time.

Hives fall into two classes ordinary urticaria and physical urticaria. Ordinary urticarias (hives) appear without warning and for no specific reason. Welts will develop and the hives will be itchy. Ordinary hives appear, go away in minutes to hours and flare up again somewhere else on the body. These episodes or flare ups can occur over weeks. The duration of most hives episodes is no more than six weeks.

Causes
Hives are a body’s reaction to histamine and other compounds that released by mast cells of the skin. Histamine causes fluid to leech from the local blood vessels which causes the skin to swell.

The release of histamine is caused by allergies, but a large majority of hives cases are not caused by allergies. In those cases, the cause of hives may not ever be determined. Changing soap, diet, perfume and make up will usually not help prevent recurring hives.

Severe hives are called angioedema and are accompanied by shock and difficulty breathing. This is usually caused by a bee sting, food allergy or drug allergy. This reaction is called anaphylaxis and requires immediate emergency, medical attention.

Ordinary hives may present in large patches on the body, be irritating and look nasty, but most cases of hives are not life-threatening.

Almost all hives fall into two categories: ordinary urticaria (ordinary hives) and physical urticaria (physical hives).

Ordinary hives flare up suddenly and usually for no specific reason. Welts appear, often in several places. They flare, itch, swell, and go away in a matter of minutes to hours, only to appear elsewhere. This sequence may go on from days to weeks

Physical hives are produced by a direct contact with a substance that stimulates or irritates the skin. The most common form of physical hives are known as demographia, when translated means skin writing. When dermographia occurs red itchy welts appear where ever the skin is scratched and where ever contact has been made with the irritant.

Cholinergic hives are also physically induced hives. These hives manifest as hundreds of small red dots surround by a red ring. The individual dots are only 2-3 mm in diameter. These hives occur right after physical exertion, a hot shower or bath or on a hot day. In babies, these hives are referred to as heat rash.

Most hive episodes last less than six weeks. Although that cutoff point is arbitrary, hives that last more than six weeks are often called “chronic.” Chronic hives may be caused by nerves or stress, and usually no systemic or environmental cause can be determined.

Treatment
The goal for hive treatment is to relieve the itchy, swelling symptoms. Inmost cases the condition goes away without intervention. Until the condition ameliorates, over the counter anti- histamines can be used to relieve the symptoms of hives. The primary side effect of anti-histamines is drowsiness.

Benadryl and Chlor-Trimeton are over the counter drugs that are most commonly used. They can be taken up to three times per day, but due to the drowsy side effect, they are usually taken before bed time. Patients who are susceptible to drowsiness caused by anti-histamines should use caution. Lortadine is an over the counter drug that is less likely to cause drowsiness.

Antihistamines that require a prescription are hydroxyzine, ranitidine, cimetidine and cyproheptadine. Doctors determine which drugs to used based on clinical responses for give hives presentations.

Oral steroids are prescribed for a sever case of hives. Oral steroids can not be used for long periods of time and are therefore not recommended for chronic cases of hives.

Other common treatments for hives includes anti-itch creams and lotions. These creams and lotions numb nerve ending to reduce the itching. Cortisone creams help control the swelling of hives, but do not control the itching.

To determine exactly what causes your hives and what kind of hives you are experiencing, you should consult your physician. Remember most hives are neither serious or allergic unless they are accompanied by difficult breathing. Hives are annoying, not pretty – but hardly ever chronic.

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