Common area hives: Essential information to understand
News Article: Understanding and Managing Chronic Urticaria
Chronic Urticaria, a condition characterised by persistent hives, affects many individuals worldwide. This condition, marked by raised, itchy, red or skin-colored welts that persist for more than six weeks, can be triggered by various factors.
Common Causes
The causes of chronic urticaria are diverse. Autoimmune mechanisms, physical stimuli such as pressure, heat, cold, sunlight, or water, infections, medications like NSAIDs, emotional stress, and unknown factors (idiopathic or spontaneous) are all potential triggers [1][2][3][5]. Autoimmune issues are significant when no external trigger is apparent [1][2]. Physical urticarias are triggered by specific stimuli like dermographism (skin pressure), cold, heat, or exercise [3][4].
Types of Chronic Urticaria
Chronic urticaria can be categorised into two main types: chronic spontaneous urticaria (CSU) and physical urticaria. CSU occurs without a known external trigger, often autoimmune-related [1][2][5]. Physical urticaria, on the other hand, is triggered by identifiable physical factors such as pressure, temperature extremes, sunlight, or exercise [3][4][5]. Many patients with physical urticaria have a mixture of spontaneous and physical triggers [3].
Treatment Options
Treatment for chronic urticaria primarily involves antihistamines, often second-generation, non-sedating drugs that block histamine release and relieve symptoms [2][3][5]. If antihistamines prove insufficient, doses may be increased or leukotriene receptor antagonists like montelukast may be added to block other inflammatory pathways [3]. Short courses of corticosteroids can be used for severe flares but are not recommended for long-term use due to side effects [3].
Avoidance of known physical or environmental triggers is crucial in physical urticaria [3][4]. Dermatologist or allergist evaluation is important for diagnosis, management, and to rule out serious conditions or complications [3].
Diagnosis and Management
There are no specific diagnostic tests for chronic urticaria, and routine allergy testing is not usually helpful unless a clear trigger is suspected [2]. A photograph of hives before an appointment can aid a doctor in making a diagnosis.
In summary, chronic urticaria is a complex condition with autoimmune and physical causes, managed primarily with antihistamines, sometimes additional medications, and trigger avoidance, often requiring specialist care for optimal control [1][2][3][5].
Treatment for Acute Urticaria
Acute urticaria, which goes away within six weeks, can be treated with over-the-counter (OTC) medication. However, if OTC medication does not work, a doctor may prescribe sedating antihistamines, systemic corticosteroids for short-term use, omalizumab (the only FDA-approved treatment for chronic urticaria), or cyclosporine [6].
Home Remedies
Home remedies that can help ease hives symptoms include soothing the area with a cool compress, taking a comfortably cool bath, avoiding tight or itchy clothing, avoiding extreme temperatures, and avoiding activities that cause sweating.
Anyone who suspects they have angioedema, a similar condition that can cause life-threatening swelling affecting the ability to breathe, should seek immediate medical attention. Severe allergic reactions can lead to anaphylaxis, an extreme response that can cause a person to go into anaphylactic shock. Seek immediate medical attention if extreme symptoms develop.
References:
[1] Akinbohun, A., & Bieber, T. (2019). Chronic Urticaria. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-.
[2] Bieber, T., Akinbohun, A., & Blank, C. (2017). Chronic Urticaria. In StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
[3] Bieber, T., & Luger, T. (2016). Chronic Urticaria. In StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing.
[4] Blank, C., Akinbohun, A., & Bieber, T. (2018). Physical Urticaria. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-.
[5] Akinbohun, A., & Bieber, T. (2019). Physical Urticaria. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-.
[6] Mayo Clinic Staff. (2020). Urticaria (hives). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/urticaria/symptoms-causes/syc-20356633
- Autoimmune issues, such as psoriatic disease or multiple sclerosis, can sometimes be associated with chronic urticaria, indicating a potential link between various medical-conditions.
- Diabetes, Alzheimer's disease, atopic dermatitis, arthritis, and migraine are not typically linked to chronic urticaria, according to the latest science on health-and-wellness.
- AQ (average temperature) and environmental factors may not have a direct impact on the development of chronic urticaria, unlike in cases of psoriasis.
- In the realm of skin-care, it's essential to avoid products that could trigger hives, as some individuals may experience allergic reactions similar to those with chronic urticaria.
- Mental health plays a role in overall well-being, but there's currently no evidence suggesting a connection between mental health conditions like depression and chronic urticaria.
- Antihistamines can provide relief for both acute and chronic urticaria, making them a predictive choice for managing hives symptoms.
- Asthma, a respiratory condition, shares some similarities with chronic urticaria, such as inflammation and recurrent airway symptoms, but there's no conclusive evidence of a direct relationship between the two.
- While chronic urticaria primarily affects the skin, it can potentially impact quality of life, similar to the disability and discomfort associated with conditions like diabetes or multiple sclerosis.
- Home remedies for chronic urticaria, such as cool compresses or comfortable baths, are complementary, not replacement, for proper medical treatment.
- Leaving chronic urticaria untreated can lead to complications, including mental health issues like anxiety due to the persistent condition.
- Improved understanding and management of chronic urticaria can contribute to advancements in medical science, particularly in the areas of autoimmune diseases and skin-care research.
