Hives are a bit of a mystery in terms of knowing exactly what causes them and how best to treat them. But they aren't a total mystery to anyone who has had them and dealt with the incessant irritating itching and the unsightly, even embarrassing red welts that can appear all over the body, to include your face.
Hives – formally known in medical terms as urticaria – is a skin reaction believed to be caused by an allergic reaction that produces itchy, red welts varying in size and shape. Per the American Academy of Dermatology, they can be as small as the tip of a pen or as large as a dinner plate, and some may even connect to form larger welts.
A case of hives resembles a case of poison ivy (this writer has experienced both), except in many cases hives typically disappear quicker than poison ivy goes away. Also, whereas hives can disappear from one place on the body and pop up somewhere else – without any help from our excessive scratching – poison ivy blisters don't resolve and then relocate, although our own scratching/touching can make it spread.
Per mayoclinic.org, the occurrence of hives can be triggered by certain foods, medications or other substances. Among the foods commonly linked to hives are nuts, chocolate, fish, tomatoes, eggs, fresh berries and milk, according to webmd.com. The formation of hives is presumed to be a response to histamine (a chemical released from specialized skin cells), a response in which blood plasma leaks out of small blood vessels.
The two types of hives most often seen are acute (lasting less than six weeks) and chronic (more than six weeks). Another condition similar to hives is angioedema, a more threatening allergic reaction that involves swelling in the skin's deeper layers, per drdeborahmd.com. What hives and angioedema do share is that they can be caused by using medications such as aspirin and other nonsteroidal anti-inflammatory agents (to include ibuprofen), as well as ACE inhibitors (for high blood pressure) and painkillers such as codeine, per webmd.com.
Other causes of hives include:
- Common allergens: Pollen, animal dander, latex and insect stings – all of which Mayo Clinic also singles out as sources of angioedema.
- Environmental factors: Not to give rise to hypochondria, but dozens of things could get listed here. For starters, let's go with heat, cold, sunlight, exercise, emotional stress and, yes, even water.
- Underlying medical causes: These can include blood transfusions, viruses such as Epstein-Barr, Hashimoto's disease (possibly caused by gluten or some other food sensitivity), hepatitis, some cancers, HIV and immune system disorders such as lupus.
Once somebody gets hives, it's wise to quickly see your physician or get to a clinic to get a proper diagnosis. Antihistamines are often included with any sort of treatment plan, although those can take days to work, and sufferers will typically beg some sort of relief remedies in the meantime. These can include:
- Cool water. Applied to the skin, water can help calm those nasty skin flare-ups.
- Topical ointment or cream. This can help in the healing process, but discuss with a health professional first because use over an extended period can cause long-term skin problems.
- Cold packs. An ice pack or a bag of ice – large sandwich baggies work well – wrapped in thin cloths can help soothe the affected areas. A frozen bag of peas might be the best choice of all.
- Therapeutic bathing. Soaking in a tub with oatmeal or apple cider vinegar added to the water, recommended at drdeborahmd.com, may work wonders for temporary relief. If using oatmeal, you will need something like a strainer to keep the oatmeal from going down the drain and possibly clogging things up.
- Wear loose-fitting, lightweight clothes. Think short-sleeve shirts/blouses and shorts, depending on the weather. Clothes rubbing across affected areas can be especially aggravating. Yes, it is tempting to cover up as much as possible to hide the ugly welts from public view (let alone your own), but better to deal with stares or looks of disgust than suffer constantly from blue jeans rubbing across affected areas such as inner thighs or elbows.
- Work and sleep in cooled rooms. Heat and hives are not a good mix.
To best treat hives, or even angioedema, you first need a physician's or dermatologist's diagnosis to confirm that it is indeed one or the other. There are no specific tests for hives, but you can undergo skin tests to determine the substance(s) to which you are allergic. That still might not determine what is triggering the hives (Shellfish? Whole milk? Tax season?), which can then turn into trial and error, and that can drag on for some time.
If antihistamines aren't effective in providing relief for cases of chronic hives, you may be prescribed corticosteroids, per webmd.com. A biologic drug known as omalizumab (Xolair) has been used for chronic hives sufferers ages 12 and older.