Urticaria

GENERAL INFORMATION:

What is it?

• Urticaria (er-ti-KAR-ee-ah) is also called hives. Hives usually appear on the skin when it reacts to something, like a bug bite. Hives can show up as swollen welts (bumps) on any part of your body. You may have one or many hives. Hives can be a short-term or long-term problem. Hives can appear on your skin and stay for a few minutes. Instead, they may last for hours, days, or longer. They can come and go on different areas of your skin. Hives cannot be spread from person to person.
  
  
• Hives may be the first sign of anaphylaxis (an-ah-fi-LAK-sis). This is also called anaphylactic or allergic (al-ER-jik) shock. It can happen if your body is irritated after taking a medicine or eating a food. Some chemicals or other living things can cause anaphylaxis, like bugs, grasses, or weeds. Things you are allergic to are called allergens (AL-er-jens). When you come in contact with an allergen, your body tries to fight it. When your body over-reacts to an allergen, you can have an anaphylactic reaction. An anaphylactic reaction is an emergency.

What causes hives? Hives may be caused by an allergy or by some other problem. When a substance or object irritates your body, chemicals such as histamine are released into your blood. Histamine (HIS-tah-meen) and other chemicals cause fluid to leak out of your blood vessels and into your skin. This causes hives to form. Sometimes, the cause of hives is not known. Your hives may be triggered (may break out) by one or more of the following:

• Foods such as nuts, eggs, or shellfish.
  
  
• Food dyes, additives, or preservatives (added to keep foods fresh).
  
  
• Medicines, such as aspirin, ibuprofen (eye-bu-PRO-fen) or antibiotics (an-ti-bi-OT-iks).
  
  
• Infections. Some people have hives after getting infections such as a cold, mononucleosis (mon-oh-noo-klee-OH-sis) or hepatitis.
  
  
• Insect (bug) bites.
  
  
• Pets or plants.
  
  
• Cold, heat, or sunlight.
  
  
• Stress, such as being very upset.
  
  
• Exercise.
  
  
• You may be at a higher risk of having hives if you have family members who get them.

What are the signs and symptoms?

• Itching. This is often the first symptom of hives.
  
  
• Red or pink patches with pale, swollen centers. These itchy, swollen bumps are called wheals (HWEELS) or welts. Wheals may be large or small.
  
  
• Wheals can quickly change size, shape, and place. It is common for wheals to come and go on different areas of your body.
  
  
• Sometimes, people with urticaria also have swelling deeper in their body tissues. This is called "angioedema" (an-jee-oh-uh-DEE-mah). Angioedema often forms around the eyes, face, lips, feet, or hands.

How are hives diagnosed?

• Your caregiver will do a medical exam and ask questions about your hives. Tell the caregiver about the allergies you know you have, such as to medicines, foods, or insects. Your caregiver may tell you to stop taking certain medicines if he thinks they are causing your hives.
  
  
• Your caregiver may draw blood to run tests. Your caregiver may tell you see an allergist (AL-er-jist) or dermatologist (skin doctor). These caregivers can do skin testing if they think you may have allergies to foods, plants, or other substances. They may tell you to stop eating certain foods, then later start eating them again. This can help them learn if you are allergic to foods. They may do "challenge tests" to learn if problems, such as cold, heat, or exercise, cause your hives. Other tests can be done if you have a long-term hives problem. Many people never learn the cause of their hives.

How are hives treated? Hives often go away without treatment. If you have a bad reaction, you will need treatment. Treatments that may be used to treat your hives are as follows:

• Medicine. This is given to decrease itching, swelling, and redness of your skin. You may also be given medicine to prevent more wheals from forming.
  
  
• Lukewarm or cool water baths. These may help decrease your itching. You may also put a cool pack on 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 an oatmeal bath.
  
  
• Do not rub your hives. Rubbing your skin will warm it and release more histamine. This can cause more wheals.
  
  
• Avoid the cause of your hives. Stay away from what is causing your hives if you know what it is.
  
  
• Carry an emergency medicine kit. If you have bad allergic reactions, ask your caregiver if you should have special medicines. Having an emergency kit with you during a reaction may save your life. You may also want to wear a MedicAlert bracelet. This will let others know what allergies you have and how you should be treated. For more information, contact:
  • Medicalert Foundation
    2323 COLORADO AVENUE
    TURLOCK, CA 95382
    Phone: 1-209-6683333
    Phone: 1-888-633-4298
    

Call your caregiver if:

• You have a temperature over ____°F (____°C).
  
  
• You still have itching after taking medicine for 24 hours.
  
  
• You have pain or swelling in your joints.
  
  
• You still have hives after seven days of treatment.
  
  
• You have new symptoms.

Seek care immediately if: You think you are having the following early signs or symptoms of an anaphylactic reaction. Your airways could close, and you could die from an anaphylactic reaction. Call 911 or 0 (operator) immediately for help. Do not try to drive yourself. Early signs and symptoms are:

• Swollen lips or tongue.
  
  
• Trouble breathing or swallowing.
  
  
• Abdominal (belly) cramping or pain.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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