Urticaria

What it is

Urticaria, commonly known as hives, is a skin condition marked by the sudden appearance of raised, red, itchy welts or bumps on the skin. It can be acute, meaning short-term, or chronic, meaning long-term, and it varies in severity and duration.

In acute urticaria the hives typically last less than six weeks, and symptoms usually settle within a few hours to days once the trigger is removed. Chronic urticaria means hives that persist for six weeks or longer, with periods of remission and flare-up.

The welts are accompanied by itching, burning or stinging. In severe cases there may be swelling — angioedema — of the lips, eyes or face. Symptoms vary in intensity and can come and go unpredictably.

What causes it

Acute urticaria is often triggered by an allergic reaction to certain foods, to medicines such as antibiotics or anti-inflammatory painkillers, to insect bites or to an infection. Chronic urticaria may have several underlying causes, including autoimmune disorders, long-standing infections and hormonal imbalance, and in many people no cause is identified at all. Working it out may involve a detailed medical history, an examination, allergy testing and laboratory tests.

How we treat it

Antihistamines are commonly used to relieve the itching and reduce the severity of symptoms. In severe cases corticosteroids or other medicines may be prescribed. Cool compresses or cool baths soothe the itch and reduce inflammation, and moisturising lotions or creams keep the skin hydrated, since dryness makes itching worse.

What you can do

Identify and avoid the triggers that make your symptoms worse, whether foods, medicines or something in your surroundings. Stress and anxiety can make urticaria worse, so relaxation techniques such as deep breathing or yoga help.

Seek immediate medical attention if you notice severe swelling of the lips, tongue or throat, difficulty breathing or swallowing, dizziness, fainting or light-headedness, or if symptoms persist or get worse despite treatment.