Urticaria is a condition in which raised rashes or welts form on your skin. In common terms, it is known as hives. These welts can form due to various reasons, such as an allergic reaction to a particular substance. In the majority of the cases, it is thought to occur as a result of an immune response. However, the exact cause of urticaria has remained unidentified for a long time. Urticaria can cause discomfort in regular routine activities. In severe cases, it may lead to a life-threatening condition called anaphylaxis, requiring immediate medical attention.
Urticaria can occur with or without an apparent cause. Long-term cases of urticaria in which the exact cause cannot be identified are categorized as idiopathic urticaria. In many cases, urticaria occurs as a response to a particular allergen. An allergic reaction can occur after consuming or touching something you are allergic to. It is also called contact urticaria. It can happen if you are allergic to latex, food substances, poisonous plants, certain medications, or chemicals in cosmetic and makeup products.
Urticaria can also occur due to various physical factors. These factors do not trigger an allergic reaction. Examples of physical triggers include harsh sunlight, extreme temperatures, wearing tight-fitted clothes, persistent scratching or rubbing of the skin, UV rays exposure from a tanning bed, etc. It can also occur if you have an adrenaline rush or your core body temperature is high after a workout or strenuous physical activity.
Many medical conditions also present with hives as a common symptom. These include viral, bacterial, or parasitic infections, insect bites, autoimmune diseases such as rheumatoid arthritis, lupus, etc. Urticaria can also result from psychological conditions such as stress or anxiety.
Based on its onset and duration, urticaria can be divided into acute and chronic types.
Acute urticaria can occur as a response to an allergen or a physical factor. It lasts less than six weeks and does not reappear in many of the cases.
Chronic urticaria can occur due to a known or unknown cause. It lasts more than six weeks and can persist from several months to years. It is further divided into many subtypes based on its occurrence and triggering factors.
Urticaria can occur in anyone, but people with a family history of this condition are more prone to develop it at some point in their life. Some forms of urticaria are hereditary and can be passed on from one generation to another. Females are more likely to be affected by this condition than males. The presence of preexisting allergies, such as nut allergy, latex allergy, etc., can increase the risk of urticaria if you come in contact with the allergen. Environmental factors such as living in regions with harsh sunlight, air pollution, or extreme temperatures can also increase the risk.
Approximately 12-24% of people get affected by urticaria on a global scale. It can occur at any age, but the majority of the cases that have been reported are from the age range of 20 to 40 years.
The appearance of hives can range from pinpoint bumps to welts that are spread over several inches of skin. They can be reddish, pink, or skin-colored. Itchiness or irritation on the affected area is a common symptom. If you are allergic to something, hives can occur within a few minutes to a few hours. These bumps or welts can appear on any part of the skin, including the face, neck, trunk, arms, and legs.
The diagnostic procedure for urticaria begins with obtaining a detailed history of your symptoms. Your doctor will ask questions about the onset and duration of hives, whether they occur due to an allergic response or are triggered by something. History can help identify the possible cause of urticaria. This is followed by a physical examination to notice the hive pattern, texture, and spread. Lab tests are required when an allergy or underlying medical condition is suspected. These may include allergy tests and blood work to diagnose signs of infection, antibodies, etc. CBC, ESR, and C-reactive protein tests are done in case of an infection.
Urticaria needs to be differentiated from other medical conditions, including hereditary or acquired deficiency of complement factor C1, cutaneous mastocytosis, connective tissue disorders, angioedema, contact dermatitis, and certain malignancies.
Treatment for urticaria depends on its type and severity. If you develop acute hives, your doctor will recommend home remedies to soothe the itch. Medications can be prescribed to reduce inflammation and halt allergic reactions. Chronic hives can also be managed using home remedies such as using a soothing lotion, using an ice pack, wearing light clothing, etc. Medications are also helpful in relieving symptoms, but avoidance of the trigger factor should be practiced. If you develop severe facial or neck swelling, immediate medical attention is required.
Antihistamines such as loratadine, cetirizine, diphenhydramine, etc., are first-line medications to treat hives. If there is inflammation or severe itching, topical corticosteroids may be recommended. Omalizumab is effective in cases of chronic spontaneous urticaria.
Majority of the cases of urticaria can be manages well over time by following treatment measures and taking necessary medications. Chronic urticaria may persist for years in some cases, especially in older adults.
The primary method to prevent urticaria is to avoid any known substance that you are allergic to. If you do not have any known allergies, keep a record of your symptoms the first time hives appear. Notice the possible triggering factors and try to avoid them in the future. Use cosmetics or products on your skin that do not cause any allergic reaction.
Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on June 02, 2023.
Hives (Urticaria) | Causes, Symptoms & Treatment (acaai.org)
global burden of chronic urticaria for the patient and society* | British Journal of Dermatology | Oxford Academic (oup.com)