Allergy & Immunology

Urticaria & Angioedema

Urticaria, known as hives, is a common allergic reaction. Hives are the raised, itchy reddish areas on the skin. Hives may begin at any age and can appear without warning. Acute urticaria happens after a specific exposure to an allergen or after a viral infection whereas chronic urticaria lasts for an extended period of time. An allergist will help determine if you have acute or chronic urticaria.

Angioedema is swelling underneath the surface of the skin. It usually occurs in the face, throat, hands, and feet. It is possible to develop swelling in the abdomen and other areas of the body. Throat swelling maybe life-threatening reaction and requires immediate medical attention. Angioedema isn’t just a reaction for allergies; it is also found with various disorders and conditions. It is also a reaction that can occur with or without hives.

Types of Urticaria and Angioedema

Acute urticaria is often related to a viral infection, food, insect bites, or a latex or drug allergy/reaction. Nuts, fish, fresh berries, and tomatoes are the most common foods to trigger hives. Fresh foods are more likely to cause an outbreak of hives than cooked foods. Aspirin, ibuprofen, Advil, Motrin, high blood pressure medications, and painkillers like codeine can also cause hives. 

Chronic Urticaria

The causes of chronic urticaria are more difficult to identify. The causes of more than 80 percent of chronic urticaria cases are unknown. An autoimmune disorder may be associated with chronic urticaria. The onset of chronic urticaria peaks between 20 to 40 years of age, and onsets affect women more than men. Chronic urticaria can occur for many years but will disappear at times. Some patients may develop hives from physical causes such as exercise, cold or hot temperature or pressure.

Treatment and Management

There isn’t a cure for hives, but medications can help alleviate them. The best treatment for the initial onset of hives are antihistamines. Non-sedating antihistamines will help control the itching with fewer side effects. It may also help to apply a cool compress or wet cloths to the affected areas. You should also sleep in a cool room during an outbreak of hives. Wearing loose-fitting clothing will help you remain comfortable during the outbreak.

In chronic urticarial, about 50 percent of people will respond to antihistamine as treatment. For the others who don’t respond to antihistamine, Xolair is an option. Xolair is an injectable medication given once a month to people with chronic urticaria.