Chronic Hives (Urticaria)
Hives is a red, raised rash with itching and swelling. It can also have severe swelling under the skin around the eyes, lips, hands and feet. This swelling is called "angioedema". Hives and angioedema may happen alone or together.
Both may happen suddenly as a reaction to:
- a drug such as penicillin
- an infection such as hepatitis
- after a sting by an insect
- certain foods
Most patients who come to the allergist’s office have had hives almost daily for six weeks or more. Many times no cause can be found. This form of chronic hives usually is well controlled with antihistamines. Large studies on this have rarely found connections with serious diseases. For most patients, this problem will not last forever. They will usually improve within five years.
The doctor first does a history and physical, and orders lab tests. This is done to rule out any hidden illness. Treatment is usually begun with antihistamines. Cetirizine, hydroxyzine, and diphenhydramine are some good ones. If one does not seem to work, another may be used. In some cases foods are suspected. Your doctor may ask you to keep a food diary. This is to find the foods that may be causing the problem.
Sometimes hives will start after being in extreme cold or sunlight. It can happen during exercise. It may come from pressure on the skin (such as a tight belt or bra strap). These then are things to avoid.
In most cases, with the right medicine and avoidance measures, hives and angioedema can be controlled.
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