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Learn how to prepare for Severe Allergy Attacks.

Urticaria

What is urticaria?

Urticaria is also called hives. Hives can change size and shape, and appear anywhere on your skin. They can be mild or severe and last from a few minutes to a few days. Hives may be a sign of a severe allergic reaction called anaphylaxis that needs immediate treatment. Urticaria that lasts longer than 6 weeks may be a chronic condition that needs long-term treatment.


What causes urticaria?

Hives are caused by an immune system reaction. The following are common triggers:

  • Food allergies, such as to nuts, eggs, or shellfish

  • Food dyes, additives, or preservatives

  • Medicine allergies, such as to ibuprofen or antibiotics

  • Infections, such as a cold or mono

  • Bug bites

  • Pets, plants, or latex

  • Stress

How is urticaria diagnosed?

  • A skin test is used to see how your skin reacts to possible triggers. Your healthcare provider will put a small amount of the trigger onto your skin. He will cover the area with a patch that stays on for 2 days. Then he will check your skin for a reaction.

  • A challenge test is used to give you increasing doses of what may be causing your hives. Your healthcare provider will watch for a reaction.

How is urticaria treated?

Hives often go away without treatment. Chronic urticaria may need to be treated with other medicines if the following medicines used for mild symptoms do not work:

  • Antihistamines decrease mild symptoms such as itching or a rash.

  • Steroids decrease redness, pain, and swelling.

  • Epinephrine is medicine used to treat severe allergic reactions such as anaphylaxis.

What steps do I need to take for signs or symptoms of anaphylaxis?

  • Immediately give 1 shot of epinephrine only into the outer thigh muscle.

  • Leave the shot in place as directed. Your healthcare provider may recommend you leave it in place for up to 10 seconds before you remove it. This helps make sure all of the epinephrine is delivered.

  • Call 911 and go to the emergency department, even if the shot improved symptoms. Do not drive yourself. Bring the used epinephrine shot with you.

What safety precautions do I need to take if I had an allergic reaction?

  • Keep 2 shots of epinephrine with you at all times. You may need a second shot, because epinephrine only works for about 20 minutes and symptoms may return. Your healthcare provider can show you and family members how to give the shot. Check the expiration date every month and replace it before it expires.

  • Create an action plan. Your healthcare provider can help you create a written plan that explains the allergy and an emergency plan to treat a reaction. The plan explains when to give a second epinephrine shot if symptoms return or do not improve after the first. Give copies of the action plan and emergency instructions to family members, work and school staff, and daycare providers. Show them how to give a shot of epinephrine.

  • Carry medical alert identification. Wear medical alert jewelry or carry a card that explains the allergy. Ask your healthcare provider where to get these items.

  • Keep a record of triggers and symptoms. Record everything you eat, drink, or apply to your skin for 3 weeks. Include stressful events and what you were doing right before your hives started. Bring the record with you to follow-up visits with your healthcare provider.

What can I do to manage urticaria?

  • Cool your skin. This may help decrease itching. Apply a cool pack to your hives. Dip a hand towel in cool water, wring it out, and place it on your hives. You may also soak your skin in a cool oatmeal bath.

  • Do not rub your hives. This can irritate your skin and cause more hives.

  • Wear loose clothing. Tight clothes may irritate your skin and cause more hives.

  • Manage stress. Stress may trigger hives, or make them worse. Learn new ways to relax, such as deep breathing.

Call 911 for signs or symptoms of anaphylaxis,

such as trouble breathing, swelling in your mouth or throat, hives, or wheezing. You may also have itching, a rash, or feel like you are going to faint.

When should I seek immediate care?

  • Your heart is beating faster than it normally does.

  • You have cramping or severe pain in your abdomen.

When should I contact my healthcare provider?

  • You have a fever.

  • Your skin still itches 24 hours after you take your medicine.

  • You still have hives after 7 days.

  • Your joints are painful and swollen.

  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2015 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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