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Student Health Services

Hives

What are Hives?

Hives are a common skin disorder characterized by raised, itchy and usually red spots ranging from tiny dots to patches several inches in diameter. These lesions are transient and usually resolve in a few hours, then possibly recur.

Acute urticaria is defined as eruptions lasting less than 6 weeks. Chronic hives are eruptions persisting over 6 weeks. Hives may be caused by a variety of agents such as drugs, laxatives, cold preparations and some vitamin supplements, nuts, eggs, chocolate, tomatoes, and strawberries. Hives may also be caused by local pressure (up to several hours later), cold, exercise, fever increase, environmental temperature, stress, and anything which may come in contact with your skin, such as lotions, detergents, soaps, and sun screens.

Angioedema is a severe form of hives involving swelling of the loose tissues around the eyes, lips, ears, tongue and larynx. This can cause difficulty in breathing.

The goal of treatment is to control the symptoms until the antigen (cause) is eliminated from the body. Therefore, the trigger factor needs to be identified and discontinued, if possible. However, this can be very difficult. A detailed diary may be helpful.

What do I do?

1. Treatment - The cornerstone of treatment is antihistamines, either by mouth or injection. Most of your symptoms result from the release of histamine by your body's immune system. The antihistamine blocks this chemical. Frequently your symptoms will completely fade after taking the antihistamine only to reappear when you're due for the next dose. Don't be alarmed - just take your antihistamine as directed. Epinephrine (adrenalin) and cortisone may also be used to treat hives, depending on the severity.

2. It is wise to omit common triggers (called antigens) such as aspirin, non-steroid anti-inflammatories (Advil, Nuprin, etc.), milk products, alcohol, excessive exertion, hot or cold and any previously suspected activity or substance.

3. Cool compresses and showers may help the itching. Avoid hot showers - it makes the itching worse.

4. Attention to diet (even a food diary) and attention to what occurs just before an episode can be helpful.

5. Most often if there is not a fairly quick resolution to the hive episodes, laboratory work and dermatologic referral may be necessary. Hives can be a symptom of other illnesses. These may need to be ruled out.