Most of us have heard of hives. Many people develop hives at some point in their lives. The scientific name for hives is urticaria. A hive is a raised, extremely itchy "wheal" or bump on the skin with surrounding skin redness. Hives often last for less than a day and usually clear up within a few hours. They may be small bumps or large and irregularly shaped areas. Hives typically do not leave a mark or scar and are not painful. Hives can occur in any location, but if they occur in some areas, such as the eyelid or ear, they can appear to be very swollen. They can also be associated with other areas of swelling, also called angioedema.
Hives (urticaria) can be acute or chronic. Acute urticaria is when someone has hives for less than six weeks. If someone has hives for a longer period of time, he or she is diagnosed with chronic urticaria.
Itching may be severe enough to interfere with daily activities. A hive is a small to large, raised, itchy bump (wheal) that usually clears up within a few hours. Hives may be small bumps or large, irregularly shaped areas. Hives are typically asymmetrical, meaning that one half of the body does not mirror the other half of the body. Hives can occur on any part of the body. If hives occur in some areas, such as the eyelid or ear, they can appear to be very swollen. A deeper swelling of the skin may also occur with hives. This deeper swelling is called angioedema.
Eliminating or avoiding an identified source or cause if a trigger is identified is the best way to treat hives.
If hives occur, and particularly in the case of Recurrent Spontaneous Urticaria, medications can be used to treat hives.
First line treatment: Non-sedating oral antihistamines are prescribed, as often as four times a day.
If the hives continue, sedating antihistamines may be prescribed. In addition other types of medications may be prescribed (H2 antagonists, tricyclic antidepressants or leukotriene modifiers).
For acute severe flares of hives, a course of oral steroids may be prescribed. Oral steroids should be used cautiously and tapered off as quickly as possible because of the potential for serious side effects.
For chronic, severe urticaria, omalizumab has been shown be be effective. This is a medication given as a shot every 4 weeks. Oral immunosuppressive agents can also be tried if the urticaria are is not responding to omalizumab.
Avoidance of Things that Make Hives Worse
People known to get hives should try to avoid things that make them worse, such as infections, NSAIDs, alcohol, stress, heat or exertion.