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Acne Help (Home) > Rare Skin Disorders > Hives Hives: Causes, Symptoms and TreatmentHives are red, itchy, raised sections of skin. Hives may appear in varying shapes and sizes like rings or large patches. Wheals (welts), red lesions with a red "flare" at the borders, are one manifestation of hives. Hives range in size from a few millimeters to several inches in diameter. In the language of medical dictionary, hives is called urticaria. Hives can occur anywhere on the body, such as the trunk, arms, and legs. One remarkable property of hives is their tendency to change size rapidly and to move around, disappearing in one area and reappearing in other places, often in a matter of hours. An outburst that appears striking, even alarming, first thing in the morning can be completely gone by noon, only to be back in full force later in the day. Very few, if any other skin diseases occur and after resolve so rapidly. Therefore, even if you have no evidence of hives to point out the doctor when you get to the office for examination, he or she can often establish the investigation based upon the history of your symptoms. Sometimes it is helpful to bring along a photograph of what your rash looked like at its worst. Swelling deeper in the skin that may accompany hives is called angioedema. This may be seen on the hands and feet as well as on mucous membranes (with swelling of the lips or eyes.) Causes of HivesHives are produced by histamine and other compounds released from cells called mast cells, which are a normal part of skin. Histamine causes gas to leak from the local blood vessels leads to swell in the skin. Hives are very common. Although they can be disturbing, they in most instances resolve on their own over a period of weeks, and are rarely medically acute. Some hives are caused by allergies to such things as foods and medications, but the substantial majority of cases are not allergic, and no specific cause for them is ever found. Although this is frustrating to patients, such common maneuvers as changing diet, soap, detergent, and makeup are in most instances not helpful in preventing hives and for the most part are not fundamental. In rare cases (some hereditary, others caused by bee stings or drug allergy), urticaria and angioedema are accompanied by shock and perplexity breathing. This is called anaphylaxis. Ordinary hives may be widespread and disturbing to look at, but the tremendous majority of cases does not lead to being-threatening unanticipated problems. Symptoms of HivesWheals or welts come and go on the skin or mucous membranes. These may itch intensely, tickle only a little, or not itch at all. Each commonly has a whitish, raised patch of skin surrounded by a reddish halo. The welts may be tiny or colossal, and may be all over the body or restricted to one area. Hives TreatmentThe definite purpose of treating most cases of normal urticaria is to relieve symptoms while the condition going away by itself. The most frequently used oral treatments are antihistamines, which aid opposes the effects of the histamine leaked by mast cells. The main side-effect of antihistamines is weakness. Many antihistamines are available without prescription, such as diphenhydramine (Benadryl), taken in doses of 25 milligrams and chlorpheniramine (Chlor-Trimeton), taken in a dose of 4 milligrams. These can be taken up to three times a day, but because these medications can cause drowsiness they are often taken at bedtime. Those who take them should be particularly prudent and be confident they are fully vigilant before driving or participating in other activities requiring mental concentration. Loratadine (Claritin, 10 milligrams) is another provision that is also available over-the-table and is less likely to cause drowsiness. Antihistamines that need a perpetual prescription include hydroxyzine and cyproheptadine. Sometimes physicians combine these with other types of antihistamines, such as ranitidine and cimetidine. This antihistamine list is not exhaustive. Physicians individualize treatment plans to suit specific patients, and significantly modify them depending on the institutional response. Oral steroids (prednisone, Medrol) can help severe cases of hives in the short-term, but their usefulness is constrained by the circumstance that many cases of hives last too long for steroid used to be continued safely. Topical therapies for hives include creams and lotions which ease numb nerve endings and reduce itching. Some components which can accomplish these are camphor, menthol, diphenhydramine (Benadryl), and pramoxine. Many of these topical preparations require no prescription. Cortisone-containing creams (steroids), even strong ones needing a prescription, are not very helpful in controlling the desire of hives.
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