Urticaria, or hives, are itchy, raised, red skin rashes which occur in approximately 25% of the population at some point in their lives. These skin rashes are very itchy, raised and blotchy, and come and go over different areas of the body. Some hives can be as small as a pencil point, but size can vary widely, with some hives being larger than the palm of a hand!
There are many different causes of hives. Some of the more common causes of acute, or short-term (less than 6 weeks) hives are viruses and other illnesses, as well as allergic reactions to foods, environmental allergens such as grass or dust mites or drugs. Chronic hives (lasting over 6 weeks) are rarely due to allergies and often, causes for chronic hives are never found. Chronic hives can also be caused by different medical conditions including thyroiditis, viral hepatitis, and auto-immune diseases such as lupus. In rare cases, it can be a presentation of some cancers, in particular, lymphoma and leukemia. Recently, a specific hive-causing antibody was found in approximately 50% of patients with chronic hives.
There are many different options to treat both acute and chronic hives in adults and children. These include antihistamines, anti-reflux drugs, and in severe cases, immunomodulatory and chemotherapy drugs. Hives caused by allergies often respond to avoidance of the specific allergen or allergy treatment.
If you have any questions about hives, see your allergist--we can help!!
---by Dr. Katharine S. Nelson