Hives (urticaria or छ्पाकी) are smoothly raised, red, itchy bumps/welts on the skin often with a blanched center. They may sting or hurt sometimes. They can vary in size from as small as a ‘pencil tip’ to as large as a ‘dinner plate’. They may even connect/coalesce to form larger welts.
Hives are very common. They flare up suddenly. They can change size and shape rapidly and move around, disappearing in one place and reappearing in another one, often in a matter of hours. An outbreak that looks impressive, even alarming, first thing in the morning can be completely gone by noon, only to be back in full force later in the day.
An individual hive usually lasts no longer than 24 hours but new hives may appear as old ones fade, making an episode last for a few days or longer. If a bout of hives lasts for less than 6 weeks they are called acute hives and if they last for more than 6 weeks, they are called chronic hives.
Swelling deeper in the skin that may accompany hives is called angioedema. This swelling of the hands and feet or the face (lips or eyelids), can be as dramatic as it is brief. In rare cases, serious angioedema can cause your throat or tongue to swell and block your airway, making it hard to breathe or swallow. If this occurs, the person needs emergency care right away.
Why does one get it?
An allergic reaction can trigger hives. It causes your body to release chemicals like histamine from the mast cells present in the skin. Histamine causes fluid to leak from the local blood vessels, that can make your skin swell up.
Though anyone can get hives, people who have other allergies are more likely to get them. Since hives are a work of an over-driven immune mechanism, they are not contagious.
Things that commonly trigger an allergic reaction could be:
- Foods: fruits (especially citrus fruits), milk, eggs, peanuts, tree nuts, shellfish, wheat, soy or added colors/preservatives in foods.
- Insect bites and stings.
- Worm infestations like round worm, hook worm or tape worm in your gut.
- Animal fur or dander (protein in their saliva/urine).
- Touching something that you are allergic to, such as latex, certain chemicals etc.
- Medications: like morphine, codeine, anticonvulsants and nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, nemulid etc.
Less common causes of hives include:
- Infections including colds and infections caused by some bacteria or fungi.
- Certain illnesses including a type of vasculitis, lupus, and thyroid disorders.
- Adrenergic: Reaction to adrenaline/noradrenaline allergy shots (extremely rare)
- Stress: The reason why stress seems to precipitate an outbreak in many people is not completely understood but is likely related to the known effects of stress on the immune system.
Hives can happen within minutes of exposure to the trigger or you can have a delayed reaction of more than two hours.
A chronic urticaria as a result of direct physical stimulation by environmental forces like Heat (cholinergic) – while exercising or doing physical exertion, mostly in young people; Cold – caused by ice, cold air or water, worse with sudden change in temperature; Sunlight (solar urticaria) – more common in fair skinned; Water (aquagenic) and Delayed pressure on the skin – such as from sitting too long.
Dermographism or “skin writing”
Is another form of physical urticaria that exhibits an exaggerated form of what happens when your skin is scratched or rubbed. Raised, itchy red welts with adjacent flares appear wherever the skin is scratched or where belts and other articles of clothing like bra-straps or elastic bands on undergarments rub against the skin, causing mast cells to leak histamine.
How is hives diagnosed?
Very few skin diseases occur and then resolve so rapidly, therefore, even if you have no evidence of hives to show when you get to your doctor for examination, the diagnosis can be established based upon the accurate recounting of your symptoms and signs. Because hives fluctuate so much and so fast, it is helpful to bring along a photograph of what the outbreak looked like at its most severe point.
Finding the cause of hives can be another challenge (This is especially true for hives that have been around for more than 6 weeks). If you aren’t certain what is causing you hives talking to your physician can help you identify potential allergic triggers. He or she will review your health history, ask questions, and do a physical examination. Your doctor can also order the following blood or skin tests for allergies if necessary.
- Allergy tests (on the skin or blood tests).
- Blood work (to rule out an illness or infection).
- A skin biopsy (in a few cases).
Hives: Personal care tips
Since hives are so common and acute urticaria, by definition, resolves spontaneously, doctors do not generally expend much time or expense to evaluate the cause of hives of less than eight weeks’ duration. The goal of treating most cases of ordinary acute urticaria is to relieve symptoms while the condition goes away by itself.
- In milder cases, applying cool compresses or taking a cool shower may help soothe the itch of a hives rash.
- Keep your finger nails short to avoid scratching.
- Use gentle fragrance-free soaps and avoid bubble baths or scented lotions.
- Moisturize liberally in dry or cold weather.
- Maintain a comfortable environment. In summers air conditioning is preferred and in winters its helpful to have a humidifier.
- Dress up in comfortable loose clothes that are 100% cotton to help reduce sweat.
- Switch to a simple, bland diet and avoid tea, coffee or alcohol.
- Regular application of coconut oil multiple times in a day helps in relieving itching on the affected parts. It has been known to have some medicinal effects too which help in reducing local inflammatory response.
What is the treatment for hives?
Your dermatologist may prescribe antihistamines in mild to moderate case to relieve symptoms like itching, redness or swelling. These can be taken up to three times a day, but because these medications can cause drowsiness, they are often taken at bedtime. When prescribed for chronic hives, you take this medicine once every day to prevent hives from forming. Those who take them should be especially careful and be sure they are fully alert before driving or participating in other activities requiring mental concentration.
Antibiotics like Dapsone can also help relieve redness and swelling.
Topical anti-histamine or menthol ointments provide a soothing effect.
In stubborn cases your doctor may resort to corticosteroids like prednisone. These are prescribed for short periods due to side effects with long-term usage.
Omalizumab is an injectable medicine can help patients with chronic idiopathic urticaria (CIU), a type of hives that can last for months or even years.
For some cases of hives or angioedema (where the swelling occurs deeper in the skin), you may need an injection of epinephrine (shot of adrenaline). If you have hives and trouble breathing or swallowing, get emergency care right away.
Talk to your doctor about a prescription medicine called an “auto-injector.” This medicine stops the allergic reaction when you inject it into your thigh. Follow your doctor’s advice on how to use this medicine.
All these medicines help oppose the effects of the histamine leaked by mast cells but have possible side effects.
Homoeopathy for Hives
Though Homoeopathy has a number of specifics for urticaria like Apis mellifica, Astacus fluviatilis, Dulcamara, Ledum Pal, Natrum mur, Urtica urens, Antipyrin, Rhus Tox, Sepia, Sulphur and many more, the most accurate remedy is selected after a thorough case analysis including the medical history, your physical and mental constitution, and your individual predispositions or susceptibilities. These medicines help wipe-off your tendency for a hyperactive immune response to the substances in the environment, that pose as allergens/triggers for you.
In my practice of two and a half decades I’ve had the success of treating innumerable cases of hives of various causation and severity. Patients who had been on long term anti-allergics or steroids could do away with them after a relatively short term course of Homoeopathic treatment for a few months. Homoeopathy offers a permanent cure for hives in the most gentle and safe way without any side effects. The patients so far have never come back with a recurrence.
Note :: Homoeopathic medicines are not habit forming and once cured, you can stop taking them altogether upon your physician’s advice.