You are on page 1of 4


com/health/hives-and-angioedema/DS00313/DSECTION=2 Introduction
Hives — also known as urticaria — are raised, red, itchy welts (wheals) of various sizes that appear and disappear on your skin. Angioedema, a similar swelling, causes large welts deeper in your skin, especially near your eyes and lips. A more serious condition — hereditary angioedema (HAE) — is an uncommon, inherited disorder, which can cause sudden, severe and rapid swelling of your face, arms, legs, hands, feet, genitalia, digestive tract and airway. As many as one in five people experiences acute hives or angioedema at one time or another. HAE, on the other hand is rare. In most cases, hives and angioedema are harmless and don't leave any lasting marks, even without treatment. The most common treatment for hives and angioedema is antihistamine medications. Serious angioedema can be life-threatening if swelling causes your throat or tongue to block your airway and leads to loss of consciousness.

Signs and symptoms
Hives can be either acute or chronic. By definition, acute hives can last from less than a day to up to six weeks, whereas chronic hives last more than six weeks — sometimes occurring for months to years at a time. Angioedema and hives can occur at the same time. Hives are raised, red bumps of various sizes that appear and disappear on your skin. They're often itchy and may look similar to mosquito bites. Hives tend to occur in batches. Angioedema is similar to hives but occurs deeper in the skin. Signs and symptoms of angioedema include large welts or swelling of the skin that may occur in the following locations:

    

Especially near your eyes and lips On your hands On your feet On your genitalia Inside your throat

Signs and symptoms of hereditary angioedema include:

  

Sudden and severe swelling of your face, arms, legs, hands, feet, genitalia, digestive tract and airway Abdominal cramping as a result of digestive tract swelling Difficulty or obstructed breathing due to swelling of your airway

The lesions of hives and angioedema are caused by inflammation in the skin. In some cases, hives and angioedema are triggered when certain cells (mast cells) release histamine and other chemicals into your bloodstream and skin. Allergic reactions to medications or foods can cause acute hives or angioedema. Many allergens have been identified. Examples include:

Foods. Many foods can cause problems in sensitive people, but shellfish, fish, nuts, eggs and milk are frequent offenders.

The name of this condition literally means "write on the skin. such as lupus or cancer. others) and blood pressure medications. Your doctor will begin by asking you about your medical history. certain thyroid disorders. or if you feel your throat is swelling. he or she may ask for blood tests to check for levels and function of specific blood proteins. latex. Hereditary angioedema is an inherited form of angioedema and is related to low levels or abnormal functioning of certain blood proteins (C1 inhibitors). pressure on the skin. animal dander. including over-the-counter (OTC) drugs and herbal remedies. such as lupus. latex and insect stings. Additional triggers that may produce hives or angioedema include:  Physical factors. seek emergency care if you feel lightheaded. Other allergens." When pressure is applied to the skin or the skin is scratched. It's important to tell your doctor about all medications you take. This may include asking you to create a detailed diary of exposure to possible irritants. If your doctor suspects HAE. These inhibitors play a role in regulating how your immune system functions. Dermatographism.  Medications. See your doctor if your hives don't respond to treatment or if they continue to appear for more than a couple of days. or even a cold. and infections. animal dander. Your doctor may also want to conduct allergy tests. such as skin tests. raised lines appear on those areas due to histaminebased angioedema that leads to swelling beneath the skin. emotional stress and exercise. aspirin. Screening and diagnosis It's sometimes impossible to determine the cause of hives or angioedema. common culprits include antibiotics. lymphoma or thyroid disease Have a family history of hives. Risk factors You may be at greater risk of hives and angioedema if you:     Have had hives or angioedema before Have had other allergic reactions Have a disorder associated with hives and angioedema. immune system disorders. If your doctor suspects allergy to food. Complications . have difficulty breathing. Examples of these factors include heat. even if you don't take them every day. Environmental factors also can result in the release of histamine with subsequent hives or angioedema in some people. sunlight. pollen or medication. cold. such as hepatitis. angioedema or hereditary angioedema When to seek medical advice Mild hives and angioedema usually aren't life-threatening. Motrin. However. ibuprofen (Advil. water.  In addition to these triggers. Some examples of situations in which this might occur include blood transfusions. and often you can treat hives and angioedema at home. hives and angioedema sometimes may occur in response to your body's production of antibodies. Almost any medication may cause hives or angioedema. he or she may recommend allergy skin or blood tests. Other substances that can cause hives and angioedema include direct contact with pollen.

Be aware that some foods may contain ingredients that are listed by less common names on the label. Emergency situations For a severe attack of hives or angioedema. or situations. despite treatment. Your bronchial tubes narrow. Treatment If your symptoms are mild. your doctor may prescribe — and instruct you how to use — adrenaline to carry with you for use in emergency situations. redness and itching. In more serious cases — when swelling occurs inside your mouth or throat — complications can include difficulty breathing or loss of consciousness. such as danazol (Danocrine). Treatment for HAE Although useful in treating hives and angioedema.Hives and angioedema can cause itching and discomfort. If you have repeated attacks. others) Loratadine (Alavert. keep a food diary. others) Chlorpheniramine (Chlor-Trimeton. These include: Nonprescription medications     Diphenhydramine (Benadryl. doctors may prescribe an oral corticosteroid drug — such as prednisone — which can help lessen swelling. others) Clemastine (Tavist. it's difficult to breathe. Additionally. Claritin) Antihistamines such as diphenhydramine. you may need an emergency injection of adrenaline (epinephrine) and a trip to the emergency room. causing dizziness and perhaps loss of consciousness or even death. you may not need treatment. Anaphylactic shock occurs rapidly. Anaphylactic shock (anaphylaxis) is a serious allergic reaction involving your heart or lungs. that have triggered past allergic attacks. and your blood pressure drops. these medications are often ineffective in treating hereditary angioedema. that help regulate levels of blood proteins. Prevention To lower your likelihood of experiencing hives or angioedema. Loratadine usually doesn't cause drowsiness. and requires immediate medical care. . These may include certain foods or medications. Medications used specifically to treat HAE on a long-term basis include certain androgens. take the following precautions:   Avoid known triggers. which block the symptom-producing release of histamine. such as temperature extremes. clinical trials testing new medications to treat HAE are ongoing. Vistaril) Occasionally for severe hives or angioedema. Prescription medications     Desloratadine (Clarinex) Fexofenadine (Allegra) Cetirizine (Zyrtec) Hydroxyzine (Atarax. The standard treatment for hives and angioedema is antihistamines. Keep a diary. If you suspect foods of causing the problem. chlorpheniramine and clemastine may cause drowsiness.

Minimize vigorous activity. which can release more irritants into your skin. .Self-care If you're experiencing mild hives or angioedema. Wear loose. these tips may help relieve your symptoms:       Avoid irritating affected areas. light clothing. Use over-the-counter antihistamines to help relieve the itching. Apply cool compresses. Take cool showers.